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Photographic 

Sciences 

Corporation 


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23  WECT  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


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CIHM/ICMH 
Microfiche 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


v  - 


Technical  and  Bihiiographic  Notes/Notes  techniques  et  bibliographiques 


The  Institute  has  attempted  to  obtain  the  best 
original  copy  available  for  filming.  Features  of  this 
copy  which  may  be  bibliographically  unique, 
which  may  alter  any  of  the  images  In  the 
reproduction,  or  which  may  significantly  change 
the  usual  method  of  filming,  are  checked  below. 


L'Institut  a  microfilm6  le  meilleur  exemplaire 
qu'il  lui  a  6t6  possible  de  se  procurer.  Les  details 
de  cet  exemplaire  qui  sont  peut&tre  uniques  du 
point  de  vue  bibliographique,  qui  peuvent  modifier 
une  image  reproduite,  ou  qui  peuvent  exiger  une 
modification  dans  la  m6thode  normale  de  filmage 
«snni  >ndiqu^s  ci-dessous. 


D 
D 
D 

D 
D 


D 


Coloured  covers/ 
Couverture  de  couleur 

Covers  damaged/ 
Couverture  endommag6e 

Covers  restored  and/or  laminated/ 
Couverture  restaur6e  et/ou  pellicul6e 

Cover  title  missing/      f 

Le  titre  de  couverture  manque 

Coloured  maps/ 

Cartes  gSographiques  en  couleur 

Coloured  ink  (i.e.  other  than  blue  or  black)/ 
Encre  de  couleur  (i.e.  autre  que  bleue  ou  noire) 

Coloured  plates  and/or  illustrations/ 
Planches  et/ou  illustrations  en  couleur 

Bound  with  other  naterial/ 
Reli6  avec  d'autres  documents 


m 

D 
D 
D 
□ 


Coloured  pages/ 
Pages  de  couleur 

Pages  damaged/ 
Pages  endommag6es 

Pages  restored  and/or  laminated/ 
Pages  restaur§es  et/ou  pelliculees 

Pages  discoloured,  stained  or  foxed/ 
Pages  d^color^es,  tachet^es  ou  piqu6es 

Pages  detached/ 
Pages  d^tach^es 

Showthrough/ 
Transparence 

Quality  of  print  varies/ 
Qualit^  in^gale  de  I'impression 

Includes  supplementary  material/ 
Comprend  du  materiel  supplementaire 


D 


Tight  binding  may  cause  shadows  or  distortion 
along  interior  margin/ 

La  reliure  serr6e  peut  causer  de  I'ombre  ou  de  la 
distortion  le  long  de  la  marge  int6rleure 

Blank  leaves  added  during  restoration  may 
appear  within  the  text.  Whenever  possible,  these 
have  been  omitted  from  filming/ 
II  se  peut  que  certainas  pages  blanches  ajout^es 
lors  d'une  restauration  appar^issent  dans  le  texte, 
mais.  loraque  cela  6tait  possible,  ces  pages  n'ont 
pas  6t6  film6es. 


Only  edition  available/ 
Seule  Edition  disponible 

Pages  wholly  or  partially  obscured  by  errata 
slips,  tissues,  etc.,  have  been  refilmed  to 
ensure  the  best  possible  image/ 
Les  pages  totalement  ou  partiellement 
obscurcies  par  un  feuillet  d'errata,  une  pelure, 
etc.,  ont  6t6  film6es  d  nouveau  de  fapon  d 
obtenir  la  meilleure  image  possible. 


D 


Additional  comments:/ 
Commentaires  suppl6mentaires: 


This  Item  is  filmed  at  the  reduction  ratio  checked  below/ 

Ce  document  est  film6  au  taux  de  r6duction  indiquS  ci-dessous. 

10X  14X  18X  22X 


26X 


SOX 


1 1 1 1 1 nT^ 


12X 


16X 


20X 


24X 


28X 


32X 


ails 
du 

)difier 
une 
nage 


The  copy  filmed  here  has  been  reproduced  thanks 
to  the  generosity  of: 

Library  of  Congress 
Photoduplication  Service 

The  images  appearing  here  are  tho  best  quality 
possible  considering  the  condition  and  legibility 
of  the  original  copy  and  in  keeping  with  the 
filming  contract  specifications. 


L'exemplaire  film6  fut  reproduit  grdce  d  la 
gi§n6rosit6  de: 

Library  of  Congress 
Photoduplication  Service 

Les  images  suivantes  ont  6t6  reproduites  avec  le 
plus  grand  soin,  compte  tenu  de  la  condition  et 
de  la  nettetd  de  l'exemplaire  filmd,  et  en 
conformity  avec  les  conditions  du  contrat  de 
filmage. 


Original  copies  in  printed  paper  covers  are  filmed 
beginning  with  the  front  cover  and  ending  on 
the  last  page  with  a  printed  or  illustrated  impres- 
sion, or  the  back  cover  when  appropriate.  All 
ether  original  copies  are  filmed  beginning  on  the 
first  page  with  a  printed  or  illustrated  impres- 
sion, and  ending  on  the  last  page  with  a  printed 
or  illustrated  impression. 


The  last  recorded  frame  on  each  microfiche 
shall  contain  the  symbol  ^^>  (meaning  "CON- 
TINUED "),  or  the  symbol  V  (meaning  "END"), 
whichever  applies. 


Les  exemplaires  originaux  dont  la  couverture  en 
papier  est  imprim^e  sont  filmds  en  commenpant 
par  le  premier  plat  et  en  terminant  soit  par  la 
dernidre  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration,  soit  par  le  second 
plat,  selon  le  cas.  Tous  les  autres  exemplaires 
originaux  sont  film6s  en  commen9ant  par  la 
premidre  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration  et  en  terminant  par 
la  dernidre  page  qui  comporte  une  telle 
empreinte. 

Un  des  symbolas  suivants  apparaitra  sur  la 
dernidre  image  de  cheque  microfiche,  selon  le 
cas:  le  symbole  — ►  signifie  "A  SUIVRE  ",  le 
symbole  V  signifie  "FIN". 


Maps,  plates,  charts,  etc.,  may  be  filmed  at 
different  reduction  ratios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  left  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  following  diagrams  illustrate  the 
method: 


Les  cartes,  planches,  tableaux,  etc.,  peuvent  §tre 
film^s  d  des  taux  de  reduction  diffdrents. 
Lorsque  le  document  est  trop  grand  pour  dtre 
reproduit  en  un  seul  cliche,  il  est  film6  d  partir 
de  Tangle  sup^rieur  gauche,  de  gauche  d  droite, 
et  de  haut  en  bas,  en  prenant  le  nombre 
d'images  ndcessaire.  Lev  diagrammes  suivants 
illustrent  la  m^thode. 


irrata 
to 


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32X 


1 

2 

3 

1 

2 

3 

4 

5 

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V 


WARREN'S 

HOUSEHOLD  PHYSICIAN, 

ENLARGED  AND  REVISED, 


TOR  TIB  08IB  OF 


PHYSICIANS,  FAMILIES,  MARINERS,  AND  MINERS. 

BHIKQ  A 

BRIEF  DESCRIPTION,  IN  PLAIN  LANGUAGE, 


or  ALL  TKB 


DISEASES  OF  MEN,  WOMEN  AND  CHILDREN, 


■WITH  THE 


LATEST  AMD  MOST  APPROVED  METHODS  OF  TREATMENT. 
IRA  WAEREN,  A.  M.,  M.  D., 

Fellow  qf  the  SlatvichuKfU  itedical  Societji,  etc. 
AND 

A.  E.  SMALL,  A.  M.,  M.  D., 


/i 


Prtndent  of  the  Ilahnemam  Jledieal  College,  Chicago,  JU. 


6^ 


r,^  ALLOPATHIC  DEPARTMENT 

/    ^       '  P.;SV18ED  BY 

WILLIAM     THORNDIKE,     M.D., 

Fellow  <tf  MoMoehuietU  JUetlical  Society,  and  Member  <tf  llotton  Society  for  the  Improvement  of  IMieine,  etc. 

HOMCEOPATHIC  DEPARTMENT 

BETI8ED  BT  !     ■' 

HEBER     SMITH,     M.    D., 

Frofeasor  of  Materia  Medica,  Boston  Univerritu  School  of  Medicine,  and  lau 
I'reeidenI  q/  Mauachvuctte  Homoeopathic  Medical  Society. 


ILLUSTRATED 


BV  THIRTY-SIX  FIGURES  ON  EIGHT  SPLENDID  COLORED  LITHOGRAPH  PLATES, 
AND  THREE  HUNDRED  AND  THIRTY-SIX  ENGRAVINGS. 


TUB  BIQDT  OP  TBAKSLATION  IB  RBBEBTBD 


BOSTON. 
1885. 


■  'T  itrtiiaiiifiror  lii.  li  vm  li  II  Ciii  ■^iia.^^^ii-^-t^:^^.^ 


MMMMaMliti 


/ 


\ 


%'^ 


Bntered  Jicoordlng  to  Aetcf  Oongreet,  in  the  je«r  188t,  1w 

IBA    WABItBN, 

Jn  tke  Clerk'.  Office  of  the  District  Court  of  the  District  of  Massachusetlfc 

Entered  according  to  Act  of  Congress,  Jn  the  year  1883,  by 

lll.V    WAUREN, 

II  the  Clerk's  Office  of  the  District  Court  of  the  Dtotriot  of  Mtw-aohuseWB. 

Entered  according  to  Act  of  Congress,  in  the  year  1870,  by 

CHARLES  ROBINSON,  Jr., 
In  thi  Office  of  the  Librarian  of  Congress,  at  Washington. 

Entered  according  to  Act  ot  Congress,  In  the  year  1886.  by 

CHARLES  ROBINSON,  Jr., 
In  the  Office  of  the  Librarian  of  Congress,  at  Washington. 


\ 


L^ 


\\ 


tJWA 


PREFACE. 


This  book  is  written  for  tlie  people.  It  is  based  on  tlie  assumption  tliat  every 
man  —  the  meclianic,  tl\o  I'arraer,  and  the  day  laborer,  as  well  as  the  professional 
man  —  has  a  right  to  all  the  knowledge  ho  is  cajjable  of  acquiring,  on  all  8ul> 
jeets, — medicine  net  excepted.  The  book  aims,  therefore,  to  popularize,  and 
adapt  to  the  many  what  has  been  claimed  as  belonging  only  to  the  few. 

I  do  not  hesitate  to  avow  that  my  sympathies,  as  a  man,  are  with  the  great 
masses,  who  may  be  called  the  bone  and  muscle  of  the  race.  They  are,  in  tlie 
main,  more  shrewd,  more  endowed  wlih  common  sense,  more  simple  and  true 
in  their  natural  instincts,  and  consequently  less  pirverted,  than  tliose  who  claim 
more  refinement  and  a  liigher  place  in  the  social  scale. 

"All  men,"  says  Hippocrates,  one  of  the  great  fathers  of  medicine,  "ought 
to  be  acquainted  with  the  medical  art.  I  believe  that  knowledge  of  medicine  is 
the  sister  and  companion  of  wisdom."  Such  knowledge  would  shield  the  many 
from  the  impositions  of  quackery.  No  one,  I  venture  to  say,  who  reads  this  book 
thoroughly,  wi!'  bo  often  imposed  upon  thereafter  by  quack  nostrums,  or  quack 
doctors.  Every  man's  physical  organization  is  his  own ;  and  he  is  charged  with 
the  responsibility  oi'  taking  cai-e  of  it.  To  do  this  properly,  he  needs  knowledge 
of  it;  and  to  withhold  this  from  him,  is  another  form  of  the  old  oppression, 
which  decreed  knowledge  and  power  to  the  few,  and  ignorance  and  obedience  to 
the  many. 

In  accordance  with  the  design  of  the  work,  it  has  been  written  in  plain,  simple 
English,  and  brought  within  the  comprehension  of  all  who  have  medium  powers 
of  mind.  It  has  not  been  thought  needful  to  reduce  its  language  to  ihe  simper- 
ing style  of  baby-talt. ;  that  is  done  only  by  those  who  don't  linow  much  about 
the  people. 

In  preparing  this  book,  a  ^eat  number  of  authors  have  Leon  carefully  consult- 
ed, to  whom  I  acknowledge  large  Indebtedness ;  yet  the  work  is  not  a  mere  compi- 
lation. With  the  exception  of  a  few  minor  parts,  as  those  on  Hydropathy,  the 
Management  of  the  Slck-Room,  the  Symptoms  of  Diseases,  and,  as  in  all  medical 
works,  a  portion  of  the  recipes,  it  huS  all  taken  sliape,  coloring,  character,  and 
language,  in  my  own  mind.  In  dealing  with  each  disease,  I  have  aimed  to 
sketch  a  brief  pen-and-ink  portrait,  so  like  it  that  every  reader  shall  know  the 


— u 


W-!' 


IV 


PREFACE. 


original  whonovor  ho  sees  it;  and  then  to  give,  in  tho  fewest  words,  tI>o  best 
treatment. 

No  work  of  t'.io  sort  has  over  explained  tho  reasons,  or  given  the  wliys  and 
wherefores  of  medicine  to  anytiiing  liiio  the  extent  of  this;  nor  has  any  one 
been  so  extensively  illustrated.  Tho  engravings  amount  to  two  hundred  and 
tliirty-six  in  number,  and  have  been,  with  few  exceptions,  done  expressly  for 
this  work.  Of  tho  colored  lithographs,  there  are  Thirty-six  Fiijures  on  eigiit 
splendid  plates.  They  are  inserted  at  great  expense,  and  add  much  to  tho  value 
of  tlie  book. 

-  I.  W 


seco:n"d  preface. 


The  Household  Physician  was  written  in  the  belief  that  the  people  were  ready 
and  waiting  for  a  popular  medical  work  based  on  liberal  principles ;  and  that  one 
hundred  thousand  copies  have  already  found  a  welcome  home,  in  as  many  Amer» 
loan  families,  is  a  sufficient  evidence  that  the  b:''ief  was  well-founded.  I  say 
welcome  home ;  and  with  very  little  stretch  of  modesty  I  might  emphasize  the 
word,  for  the  popularity  of  the  book  has  far  outrun  the  author's  hopes  —  many 
persons  assuring  the  atJthor  and  the  publishers  that  fifty  or  one  hundred  dollars 
would  be  no  temptation  for  them  to  part  with  the  copy  they  have  if  they  could 
not  obtain  another.  Such  an  extensive  sale  of  so  large  a  book,  with  the  demand 
constantly  increasing,  has  been  quite  unexpected. 

For  these  evidences  of  public  favor  the  author  is  not  ungrateful  or  unmindful 
of  corresponding  duties  on  his  part.  A  chapter  is  now  added,  therefore,  on 
••  Old  Age  and  its  Diseases,"  —  a  subject  never  before  introduced  into  any  popular 
treatise  on  medicine,  and  very  rarely,  indeed,  into  any  medical  book.  I  have  taken 
great  pains  in  preparing  it,  and  sincerely  hope  that  many  Fathers  and  Mothers 
will,  iu  future  years,  be  kindly  remembered  in  consequence  of  the  suggestions  it 
contains.  I  also  have  the  pleasure  to  present,  from  the  pen  of  Dr.  Dio  Lewis,  a 
very  valuable  conti'ibution  upon  his  new  popular  Gymnastics,  illustrated  with 
many  cuts. 

With  these  and  some  smaller  additions,  —  improvements  I  think  I  may  call 
them,  —I ,  abmit  the  work  again  to  the  popular  judgment 

I.  W. 


less 


GMEEAL   INTEODUCTORY   EEMAEKS. 


y  Progress  of  Medicine. 

Medicine  may  be  divided  into  a  science  and  an  art.  -  It  is  a  science 
as  it  presents  facts  and  evolves  principles;  an  art  as  it  consists  of 
rules  for  practice.  For  its  present  attainments,  it  is  indebted  partly 
to  researches  scientifically  conducted,  and  partly  to  empirical  and 
hap-hazard  discovery. 

As  a  science,  medicine  is  chiefly  indebted,  and  must  ever  be,  to  the 
members  of  what  is  culled  the  "  regular  profession."  This  body  of 
men,  while  it  contains  numerous  persons  whose  talents  and  attain- 
ments do  not  raise  thca  above  the  merest  quacks,  does  yet  embrace 
larfro  numbers  of  men  who  are  alike  ornaments  of  the  race,  and  lights 
of  their  profession.  It  is  to  the  writings  of  this  class  that  every  stu- 
dent must  go  who  would  qualify  himself  for  the  proper  discharge  of 
the  duties  of  a  physician  ;  and  he  wlio  attempts  the  practice  of  medi- 
cine without  a  knowledge  of  standard  medical  writings  is  either  a 
fool  or  a  knave  —  either  without  the  brains  to  understand  science,  or 
destitute  of  the  honesty  to  deal  fairly  with  men. 

While  this  is  said,  however,  it  must  be  granted  that  a  respectable 
portion  of  the  facts  which  make  up  the  science  of  medicine  have  been 
contributed  by  the  industry  of  men  who  have  not  had  what  is  called 
a  regular  standing  in  the  profession.  I  am  sorry  to  be  obliged  to  add 
that  the  great  body  of  this  class  have  been  quacks  and  charlatans, 
while  only  a  few  of  them  have  had  talents  and  acquirements. 

Nevertheless,  they  have  been  too  indiscriminately  condemned. 
Their  labors  have  been  useful  in  various  ways,  and  have  contributed 
to  the  advancement  of  medical  knowledge.  A  regard  for  truth,  not 
less  thin  justice  to  these  persons,  requires  this  statement. 

One-Idea  Men,  —  The  "irregulars,"  as  they  have  been  called,  have 
generally  had  their  hobbies,  which  they  have  ridden  with  singular 
diligence,  and  often  in  little  better  than  John  Gilpin  i)llght.  Yet  they 
have  drawn  attention  to  great  truths,  which  the  regular  profession 
either  did  not  see,  or  would  not  commend ;  and  they  have  done  this 
by  dwelling  incessantly  upon  some  single  idea. 

The  one-idea  men,  of  every  class,  have  been  ridiculed  in  all  ages  ; 
and  indeed  have  always  exhibited  some  singular  obliquities.  Yet 
when  they  have  been  men  of  learning  and  talents,  they  have  accom- 
plished great  things,  either  for  good  or  evil. 


Martin  Luther  was  Btrictly  a  one-idea  man.  Tlio  wIk^Io  force  of 
his  oxtraoriliiuuy  cliaracter  was  given  to  tlio  propagation  of  the  single 
doctrine  of  justification  by  faith  ;  and  by  the  incessant  efforts  he  made 
for  this  purpose,  he  sank  the  doctrine  deeper  into  the  heart  of  Europe 
than  a  hundred  equally  powerful  men  could  have  done  by  giving  it 
only  an  ordinary  share  of  attention. 

William  Ellory  Channing  was  a  ono-ideaist.  3fan,  the  noblest 
work  of  creation,  to  be  developed,  educated,  adorned,  loved,  made 
like  unto  God,  wad  the  thought  of  his  life,  —  a  tho.ight  which  ho  em- 
bellished and  moulded  into  all  the  forms  of  beauty  which  our  flexible 
language  is  capable  of  producing.  Under  the  mild  promptings  of 
his  genius,  and  the  workings  of  this  thought,  philanthropy,  quick- 
ened into  a  new  life,  spread  out  her  arms,  and  embraced  the  world. 

Sir  Isaac  Newton,  was  a  one-ideaist.  So  entirely  did  he  devote  his 
great  powers  to  astronomy  and  the  higher  mathematics,  that  he  be- 
came unfitted  for  the  duties  of  social  and  domestic  life  —  so  unfitted, 
that  when  induced  by  his  friends  to  give  a  little  attention  to  courtship, 
he  fell  into  one  of  his  abstractions,  and  detected  himself  in  using  his 
lady-love's  fore-finger  to  poke  down  the  ashes  in  his  pipe  !  But,  Sir 
Isaac  advanced  mathematical  science  to  a  point  far  beyond  its  previ- 
ous attainments,  iuid  laid  it  under  such  obligations  as  no  general 
scholar  could  have  done. 

It  is  in  this  way,  though  in  a  vastly  less  degree,  and  without  the 
scientific  method,  that  one-ideaists  in  medicine  benefit  the  world. 
They  seize  upon  some  single  remedy,  — generally  one  which  has  been 
overlooked,  —  and  using  it  themselves  to  the  exclusion  of  all  others, 
they  press  it  upon  the  world  as  the  panacea  for  all  its  ills.  With 
them  disease  is  a  unit,  and  they  have  found  its  one  all-important 
remedy.  Thus  convinced,  they  press  it  upon  others  with  the  enthu- 
siasm of  fanatics.  Testing  it  in  all  cases,  they  develop  all  its  virtues. 
Those  who  have  the  good  sense  to  turn  their  attention  to  it  have 
ouly  to  use  it  in  those  cases  for  which  its  adaptation  is  proved. 

It  is  in  this  way  that  these  men  become,  incidentally,  medical  dis- 
coverers ;  and  not  being  burdened  with  modesty,  they  never  with- 
hold their  importunities  till  the  world  acknowledges  whatever  value 
there  is  in  their  discovery.  And  although  they  may  do  some  mis- 
chief with  the  single-edged  tool  which  they  handle  so  industriously,  I 
doubt  if  they  do  much  more  than  many  better  workmen  who  use  too 
many.  At  all  events,  wise  and  generous  men  thank  them  for  their 
gift  to  the  profession,  small,  though  it  may  be,  and  use  it  in  the  light 
of  a  clearer  knowledge. 

Ilj'dropntliy.  —  As  an  illubtration  of  what  I  have  just  been  saying, 
I  may  refer  to  hydropathy,  or  the  plan  of  treating  all  diseases  by  water. 

The  singularly  careful  avoidance,  by  the  whole  med"cal  faculty,  for 
many  ages,  of  the  article  of  pure  water  as  a  medicinal,  or,  rather, 
health-imparting  agent,  was  anything  but  creditable  to  the  profession. 

It  is  now  admitted  by  all  sensible  men  that  water,  cold  and  warm, 
used  at  proper  times  and  to  a  reasonable  extent,  has  great  power  over 


GENERAL    INTBODUCTOHV    UEMAhKB. 


several  diseasos,  niitl  i.s  n  powerful  promoter  of  health.  No  physicians, 
except  those  who  are  too  iiulolont  to  know  what  is  jjoiiifj;  on  in  the 
world,  or  too  fast  locked  in  old  projiulicca  to  touch  new  things,  now 
omit  its  use  in  mani/  cases.  IIow  Avarni  and  sincere  my  own  approval 
of  water  as  a  leniedy  is,  almost  every  page  of  this  volume  will  attest. 
Indeed,  it  may  honestly  bo  allowed  that  the  hydropathists  have 
fairly  drov:ne(l  the  almost  criminal  professionsil  prejudice  against 
water.  Tl.oy  are  in  all  the  more  need  of  this  concession,  since  in 
their  absurd  zeal  to  cure  all  diseases  by  water,  and  make  aquatic  ani- 
mals of  men,  they  have  also  drowned  their  own  common  sense. 

Homoeopathy.  —  This  mode  of  practice  is  of  comparatively  recent 
origin ;  but  it  I'as  already  sunk  itself  dee|)  into  the  popular  heart, 
and  has  drawn  t )  its  support  many  of  the  wealthy,  the  cultivated, 
and  the  intelligent,  in  our  most  refined  commimities.  I  do  not  pro- 
fess to  comprehend  and  appreciate  its  principles,  nor  would  it  be 
honest  in  mc  to  pretend  to  see  how  its  infinitesimal  doses  can  produce 
the  results  which  it  often  shows,  and  which  it  is  fair  to  confess  look 
like  singular  success  ;  and  saying  this,  I  can  neither  adopt  nor  ap- 
prove the  violent  denunciations  and  censures  which  so  many  are 
induced  (by  fashion,  I  fei  .)  to  employ  towards  this  generally  well-cul- 
tivated  class  of  practitioners.  I  hold  them  as  useful  members  of  the 
profession,  and  mean  ever  to  cultivate  towards  them  fraternal  feelings. 
They  give  great  attention  to  exercise,  diet,  the  use  of  water,  etc.,  — 
things  which  contribute  very  powerfully  to  preserve  health,  and  to 
restore  it  when  lost.  In  this  thing,  the  old  school  practitioners  ought 
to  learn  a  most  important  lesson  from  them.  In  truth,  they  are 
learning  it,  but  very  slowly  and  reluctantly ,  I  am  sorry  to  say. 

The  central  idea  of  the  homoBopathist,  that  "like  cures  like,"  the 
"great  law  of  cure,"  as  he  styles  it,  I  do  not  feel  called  upon  to  dis- 
cuss—  theories  being  of  much  less  consequence  than  rules  of  prac- 
tice. The  old-school  men  have  certainly  much  to  learn  from  him 
respecting  the  augmented  power  of  medicine  from  the  greatest  possi' 
ble  division  by  trituration.  We  have  learned  from  him,  too, — . 
though  many  are  too  ungenerous  to  confess  the  source  of  the  infor- 
mation,—  tliat  wo  may  gain  our  purposes  with  much  less  medicinq 
than  wo  were  once  in  the  habit  of  giving. 

Eclectics.  —  There  is  a  large  and  gi'owing  class  of  physicians,  called, 
at  first,  after  the  founder  of  the  school,  Thomsonians.  Subsequently, 
they  were  generally  known  as  Botanic  Physicians.  Now  they  pass 
under  the  title  of  Eclectics. 

These  men,  directing  their  attention,  at  first,  chiefly  to  cayenno 
and  lobelia,  have  gradually  extended  their  zealous  researches  over 
the  vegetable  kingdom,  and  have  gathered  much  information  worthy 
to  be  preserved.  These  researches  have  revealed  a  sadly  neglected 
duty  on  the  part  of  old-school  practitioners,  and,  in  1852,  drew  from 
the  "  Committee  on  Indigenous  Medical  Botany,"  appointed  by  the 
"American  Medical  Association,"  the  confession  that  our  practi- 
tioners generally  have  been  extremely  ignorant  of  the  medicinal 
plants  even  in  their  own  neighborhoods ;  and  to  this  fact  the  com- 


t  '•' 


GENERAL    INTnOOUOTOHY    RRMARKS. 


Qiittoo  nttributod  it,  lluit  tho  Ecloctio  physiciuiis  huil  in  so  inimy  in- 
stttiices  Hupplaiitcd  the    "  roguliirs  "  in  tho  confidonco  of  tho  people. 

The  cduciition  and  talonta  of  this  chiss  of  prautitioiiers  have  grad- 
ually risen,  year  by  year,  until  they  have  several  medical  schools, 
where  students  are  well  instructed  in  tho  principles  of  medicine,  by 
men  of  real  ability.  This  is  particularly  true  of  the  school  at  Cin- 
cinnati. They  have  also  a  literature  of  no  mean  Bignificance,  espe- 
cially in  the  department  of  materia  medica.  The  list  of  remedies 
they  have  given  to  the  world,  drawn  from  our  home  plants,  are  a 
boon  of  no  small  value.  I  regard  them  as  equal  in  value  to  all  we 
were  previously  in  possession  of  from  the  vegetable  kingdom.  The 
podopiiyllin  and  leptaudrin,  as  substitutes,  in  most  cases,  for  mercu- 
rials, can  hardly  bo  too  highly  prized. 

And  yet,  it  is  mortifying  that  tho  remedies  which  these  men  have 
given  us  are,  by  hundreds  of  our  old-school  practitioners,  not  even 
known  by  name,  and  whore  known,  generally  not  honored  with  a 
trial.  King's  "  American  Eclectic  Dispensatory,"  a  book  of  1,300 
pages,  in  which  they  are  well  described,  is  almost  unknown  among  us. 
Aside  I'rom  tho  copy  in  my  own  library,  I  do  not  know  that  one  is 
owned  by  any  member  of  the  Massachusetts  Medical  Society,  in 
Boston.  I  consider  thi^s  a  disgrace,  for,  however  learned  a  man  may 
be,  he  is  not  fully  equipped  as  a  practitioner  until  ho  is  acquainted 
with  this  class  of  medicines. 

Physiologists.  —  Beside  these  various  direct  practitioners  of  medi- 
cine, there  is  the  large  and  quite  intelligent  class  of  pliysiologists, 
Including  the  phrenologists,  who  nearly  discard  medicine,  and,  ap- 
pealing to  the  laws  of  life  established  by  the  Creator,  urge  temper- 
ance in  eating  and  drinking;  exercise  in  the  omou  air ;  securing  of 
pure  air  by  ventilating  dwellings,  school-housed,  and  churches  ;  bath- 
ing in  cold  and  warm  water;  eheerfulness  of  mind  ;  and  the  cultiva- 
tion of  tho  Christian  virtues,  as  the  only  rational  modes  of  securing 
health  and  life. 

I  confess  myself  inclined  to  forgive  this  class  their  error  in  ban- 
ishing medicine,  in  view  of  their  zeal  and  success  in  disseminating 
hygienic  information  of  the  utmost  value  and  importance  to  mankind. 
Put  man  into  harmony  with  nature,  and  establish  over  him  the  em- 
pire of  reason,  and  their  theory  would  bo  excellent ;  but  as  things 
are,  medicines,  like  pri3!)ns,  and  alms-houses,  and  large  cities,  are 
"  neces.sary  evils." 

Other  Practitioners.  —  Finally,  wo  have  Mesmerists,  Pathetists, 
Electro-biologists,  Spiritualists,  Nutritivists,  and  what  not,  all  pre- 
tending to  cure  disease  by  processes  peculiar  to  themselves.  They 
are  all  experimenters  in  different  departments  of  nature,  —  now 
spreading  over  our  eyes  a  large  plaster  of  humbuggery,  and  now 
drawing  a  small  curtain  and  giving  us  a  peep  into  tho  large  and  well- 
furnished  rooms  which  nature  has  fitted  up  for  our  reception,  by  and 
by,  v/hen  we  are  better  instructed. 

All  Useful  in  a  Degree.  —  On  tho  whole,  I  am  disposed  to  regard 
all  the  operators  iu  the  diflferent  departments  of  medicine  as' useful 


ORNERAL    ISTRODUCTOnr    REMARKS. 


9 


in  their  degree ;  excepting  iihvays  thuso  mcrconnry  qimcka,  who  lio 
about  tlu'ir  roniediea  to  nmko  money.  Each  of  all  these  (I  mean  all 
sincere  and  true  men  who  l)ellovowhat  they  toach)  is  aiding  in  some 
measure  the  general  advancement.  And  though  the  truths,  as  they 
gather  and  present  them,  are  hut  fragmentary,  they  are  useful  in  the 
hands  of  tlioso  trun  Eclccticn,  who  have  the  wisdom  and  indepondonco 
to  select  the  hest    hii\ga  out  of  all  systems. 

General  Couelusion.  —  This  brings  mo  to  remark  that  there  is  l)ut 
one  truly  liberal  and  philosophical  school  of  medicine.  It  is  the 
Eclectic,  —  c'()inp»)Hcd  of  those  who  have  liberality  enough  to  nject 
every  exduane  si/stein,  and  to  select  out  of  all  systems  those  thi  igs 
which  are  ai)proved  by  experience  and  reason. 

I  have  already  spoken  of  a  school  of  practitioners  called  Eclectic. 
To  a  certain  extent  they  are  entitled  to  the  name,  but  I  think  not 
entirely.  They  have  formed  a  separate  and  exclusive  school.  They 
have  turned  some  articles  out  of  the  materia  medica  possibli/  for  no 
better  reason  than  because  their  party  is  committed  to  their  rejec- 
tion ;  whereas  they  should  have  no  party,  but  allow  each  man  to  act 
as  if  he  were  a  citizen  of  the  world  only,  and  not  a  member  of  any 
restricted  association.  But  I  will  not  quarrel  with  them  on  this 
point.     I  think  they  are  becoming  eclectic. 

Progress  of  Medicine.  —  There  have  been  long  periods  when  tho 
science  and  the  art  of  medicine  made  scarcely  any  progress.  They 
are  now  advancing,  —  in  some  departments  quite  fast. 

Tho  Chemistry 'of  Man,  commonly  called  Animal  Chemistry,  is 
opening  new  sources  of  light.  Few  of  the  profession  have  yet 
studied  this  essential  branch  of  medical  science  ;  but  the  delinquents 
are  sleeping  in  the  rear,  and  will  soon  awako  to  tind  themselves 
among  the  ghosts  of  a  dead  generation. 

The  writer  was  in  the  habit  of  asserting,  many  years  ago,  that 
most  of  the  true  progress  in  medicine  must  come  through  Animal 
Chemistry ;  and  the  developments  of  the  last  few  years  have  made 
good  the  assertion.  Liebig,  a  diligent  student  in  chemistry,  has  done 
much  to  open  the  way  for  inquirers  in  this  department.  Simon  has, 
perhaps,  done  more.  Mialhe  is  a  yet  later  explorer,  and  has  made 
valuable  discoveries. 

Tho  result  is,  that  students  have  now  before  their  minds,  and  are 
endeavoring  to  solve  and  act  upon  as  fast  as  possible,  inquiries  and 
propositions  like  these  :  — 

What  is  the  chemical  composition  of  the  solids  and  fluids  of  the 
healthy  human  body  ? 

What  is  the  nature  of  the  changes  which  occur  in  the  comp*^  ''^ion 
of  tho  solids  and  fluids  during  disease  ? 

What  alterations  in  the  chemical  composition  of  the  solius  and 
fluids  take  place  during  tho  operation  of  medicines? 

Before  it  can  exert  any  remote  action  on  the  animal  economy,  a 
remedy  must  be  absorbed. 

Before  it  can  be  absorbed,  it  must  be  soluble  in  the  fluids  of  the 
living  body. 


I 


w 


;jim' 


M 


10 


•GENERAL    IN'TRODUCTOUT    REMARKS. 


I- 


t 

it: 
J- 


■1     - 


Medicines  are  subject  to  chemical  changes  during  their  jjussago 
through  the  system. 

These  changes  are  regulated  by  ordinary  chemical  laws,  and  may 
therefore,  to  some  extent,  bo  foretold  and  made  available  in  the  cure 
ol"  disease. 

Tiicso  chemical  laws  are  disturbed  and  varied,  to  some  extent,  by 
the  law  of  vitality, — just  as  the  needle  is  made  to  vary  by  disturb- 
ing forces. 

What  are  those  disturbances,  and  to  what  extent,  and  under  what 
circumstances,  do  tliey  occur? 

With  these  and  similar  inquiries  and  propositions  before  his  mind, 
diligently  studied,  a  man  will  in  time  learn  to  prescribe  with  some 
intelligent  aim.  Ho  will  not  know  everything,  to  be  sure,  but  what 
ho  does  know,  he  will  have  a  reason  for  knowing.  If  he  give  a  medi- 
cine, he  will  have  iu  \  lew  the  chemical  changes  of  the  solids  and  fluids 
of  the  body,  known  to  bo  produced  by  the  disease  he  is  combating. 
He  will  also  keep  in  mind  the  solution  of  the  medicine  iu  the  fluids 
of  the  body,  and  the  chemical  reaction  between  its  components  and 
the  acids,  alkalies,  etc.,  found  in  the  alimentary  tube  and  elsewhere. 

As  the  science  of  medicine  advances,  and  beooraes  liberal  and 
eclectic  in  its  character,  gatliering  from  all  systems  tlio  best  attested 
tacts,  and  using  them  to  the  exclusion  of  all  mere  theories,  these  facta 
must  not  themselves  degenerate  into  mere  petted  theories,  but  must 
be  held  in  subordinntion  to  future  experience.  Medical  practitioners, 
who  would  meet  the  wants  of  the  age,  must  be  r.ien  of  progress. 
The  light  of  to-morrow,  with  them,  must  modify  and  improve  the 
light  of  to-day.  They  must  knock,  every  hour,  for  admission  into 
some  new  apartment  of  nature. 

Need  of  Liberality. —  That  medical  progress  may  be  real,  physi- 
cians must  be  free  from  bigotry.  They  must  have  no  narrow  preju- 
dices against  any  man,  or  class  of  men  ;  but  be  ready  to  examine 
candidly  any  new  thought  or  new  remedy  brought  to  their  notice, 
from  whatever  source  it  may  come. 

They  shoulrl  not  hedge  themselves  about  with  such  restrictive  by- 
laws and  societary  rules  as  are  calculated  to  fetter  their  thoughts,  and 
turn  their  investigations,  by  a  sort  of  moral  necessity,  into  the  nar- 
row channels  of  party  conservatism;  remembering  that  ho  who  is 
once  enclosed  by  such  restrictions  must  hew  a  path  for  his  feet 
through  bigotry,  and  even  malevolence  itself,  before  ho  can  escape 
them,  or  be  a  free  man  in  any  noble  sense. 

The  members  of  medical  societies  do  themselves  no  credit,  in  the 
nineteenth  century,  by  putting  on  airs,  and  telling  others  to  stand  at 
a  distance.  This  would  do  better,  had  medicine  become  an  exact 
science  ;  but  while  the  primary  e  (Tects  of  even  opium  are  not  settled  — 
some  physicians  considering  it  as  primarily  stinmlunt,  others  as  seda- 
tive, others  as  stimulant  to  the  nerves  and  sedative  to  the  muscles, 
other"?  as  neither,  and  still  others  as  alterative,  —  such  exclusiveness 
S"ems  neither  wise  nor  modest.  When  the  professors  of  the  healing 
art  can  hoard  medical  kno wedge  as  misers  hoard  gold,  and  can  sub- 


they  b( 
chiefly 
in  whic 
iiji^jrovc 
Thesi 
unless 
propcrl 
tropolis 
tbo  bro 
h"ght  oi 
readily 
freely  tc 


■<M 


GENERAL    INTRODUCTORT    REMARKS. 


11 


8S 


b- 


mit  its  purity  to  equally  certain  tests,  it  will  appear  in  better  taste 
for  them  to  grow  exclusive.  Until  then,  the  most  becoming  badge 
they  can  wear  is  the  Christian  direction  :  "  Let  each  esteem  others 
better  than  himself." 

Medical  societies,  with  liberal  by-laws,  a;e  fitted  to  do  good ;  but 
it  would  be  hard  to  show  that  those  with  stringently-restrictive  rules 
can  operate  otherwise  than  as  checks  upon  progress.  In  truth,  they 
are  apt  to  become  mere  catacoraba  in  which  to  embalm  dead  ideas. 
They  arc  very  liable  to  bo  made  the  instruments  for  accomplishing 
tlic  ambitious  purposes  of  a  few  leading  men.  They  tend  to  sii.ppress 
all  sympathy  with  everything  outside  their  organization  ;  aad  they 
beget  a  feeling  like  that  which  would  forbid  the  fixed  stars  to  drop 
their  light  uito  our  atmosphere  without  first  coming  down  and  joining 
the  solar  system. 

Conservative  Leaders.  —  There  are  no  influences  which  hold  so 
steady  a  check  upon  medical  progress  as  the  conservative  leaders  in 
many  of  our  medical  associations.  Not  that  tliey  are  opposed  to  im- 
provement in  the  medical  art,  or  would  object  to  any  amount  of  dis- 
covery, if  it  could  come  to  the  profession  through  channels  which  they 
have  the  honor  of  opening.  But  against  all  light  from  outside,  or  from 
obscure  sources,  they  will  draw  down  the  curtains,  and  close  the 
doors  ;  and,  if  it  chance  by  any  means,  in  spite  of  them,  to  get  within 
the  sacred  enclosure,  they  will  call  it  darkness,  and,  as  priests  of  the 
temple,  will  attempt  to  atone  for  the  indignity  offered  to  the  god  of 
medicine,  and  fill  the  whole  sky  with  murky  clouds  from  their  altars. 

These  men  have  strong  faith  in  caste,  and  in  the  right  of  the  few 
to  govern  the  many.  In  the  'ow  places  of  society,  they  look  for 
nothing  but  ignorance  and  poverty.  Notwithstjinding  that  the  light 
of  every  natural  day  breaks  in  the  horizon,  and  ascends,  they  so  far 
despise  analogies  as  to  insist  that  all  medical  light  breaks  at  what 
they  call  the  zenith  of  the  profession,  and  comes  down.  With  them 
the  temples  of  Esculapius  are  all  rebuilt,  and  they  are  the  priests ; 
and  to  offer  in  sacrifice  the  smallest  medicinal  plant  is  a  sacrilege, 
uiiless  it  bo  entrusted  to  their  hands. 

Such  persons  measure  and  weigh  a  man  by  the  amount  of  money 
ho  has.  Property  is  their  god,  which  gives  laws  to  everything. 
V^lth  them,  knowledge,  like  property,  goes  to  posterity  by  will, — 
they  being  the  principal  testators.  Like  their  money,  too,  it  goes 
chiefly  to  their  sons,  and  to  certain  favored  institutions,  by  whom,  and 
ill  which,  it  is  to  be  hoarded,  and  whence  it  is  to  go  out  only  in  certain 
aiJ|)roved  channels,  weighed  and  stamped,  like  coin  from  the  mint. 

These  are  the  men  who  regard  knowledge  as  a  contraband  article, 
unless  regularly  entered  at  the  custom-house,  with  bills  of  lading 
properly  certified  by  the  conservative  magnates  at  some  other  me- 
tropolis. With  them,  knowledge  is  not  like  the  west  wind,  fanning 
tbo  brow  of  the  peasant  as  gently  as  that  of  the  king,  —  not  like  the 
light  of  heaven,  entering  the  small,  clean  window  of  the  hut,  as 
readily  as  the  larger  one  of  the  palace  ;  not  a  boon  which  comes  alike 
freely  to  all,  and  which  is  to  be  everywhere  amplified,  changed  as 


t. 

^  :■■ 

t  ■ 

:  y 
Tb  V 


¥ 


I': 


12 


GENERAL    INTRODUCTORY    REMARKS. 


circumstances  and  conditions  require,  and  especially  adapted  to  th© 
present  hour.  It  is  ratlier,  as  they  too  often  view  it,  lilce  litho- 
graphed letters  of  advice,  printed  upon  stamp  paper,  and  carefully 
sealed  up  and  addressed  to  posterity.  And  then,  if  they  can  bo 
made  the  mail-carriers,  and  be  permitted  to  pass,  unchallen<i;ed,  with 
the  precious  bag,  from  post  to  post,  and  pass  it  over,  carefully  sealed, 
to  the  next  generation,  they  will  think  it  has  done  its  work,  and  that 
they  have  fulfilled  their  mission. 

I  would  not  be  unjust  or  severe,  but  I  cannot  but  remark  further, 
that  these  men  present  but  one  view  of  humanity.  They  are  monot- 
onous objects  of  inspection.  Look  ut  them  a  thousand  times,  and 
you  see  only  the  same  unaltered  phase  of  life.  To  the  mariner  on 
life's  ocean,  they  are  not  safe  lights.  If  ho  approach  them  on  the 
dark  side,  they  remain  black  as  night  to  him,  until  he  comes  round  to 
their  shining  front.  They  are  not  revolving  lights.  They  have 
light ;  it  may  be  bright  and  genial ;  but  it  gleams  out  upon  the  waters 
only  in  one  direction.  It  does  not  sweep  round,  and  throw  its  rays 
upon  every  mariner's  path. 

Such  men  are  useful,  but  only  to  a  certaia  class.  They  have  in 
them  no  true  omnilogy  —  they  arc  not  all-teaching.  Their  lives  are 
instructive  to  their  friends,  their  clique,  their  party,  their  school ; 
but  a  stumbling-block,  a  hindrance,  an  oppression,  an  offence  to  every- 
body else.  They  are  like  porcupines,  with  fronts  smooth  and  easy 
of  access ;  but  their  backs  bristle  with  quills  to  stick  into  those  on 
the  wrong  side.  They  are  not  whole  men.  Humanity  has  infused 
into  them  only  one  or  two  of  its  elements.  They  have  length,  but  no 
breadth.  They  are  citizens  of  Boston,  New  York,  Philadelphia,  or 
Cincinnati,  but  not  of  the  world.  Within  certain  circles,  they  are 
genial  friends,  but  cynics  and  haters  outside  of  them.  From  their  high 
places,  they  come  down  to  their  humble  followers  with  tokens  of  friend- 
ly recognition  ;  upon  others  they  frown  and  lower  like  armed  castles. 

The  True  Physician.  —  How  different  the  character  of  the  true  man 
and  physician  I  He  is  gonial  in  his  disposition.  Ho  h  is  no  dislikes 
and  antipathies,  and  hates  no  men  except  tyrants.  He  accepts  knowl- 
edge, though  it  come  from  the  humblest  source  ;  believing  there  is  no 
experience  butAvill  repay  a  study  of  it,  and  no  husbandman's  plough- 
share but  turns  up  a  soil  worth  analyzing.  He  belongs  exclusively 
to  no  party,  and  can  be  approached  easily  by  respectable  men  of 
every  stamp.  Whether  belonging  to  the  same  society  with  him,  or 
not,  you  may  take  hold  of  his  nature  and  draw  it  out,  without  hav- 
ing it  slip  from  your  fingers,  and  spring  back  from  your  ^  resence  into 
a  thousand  kinks,  like  an  overtwisted  thread.  He  is  a  whole  man. 
God  made  him  for  the  world,  and  not  for  a  party.  By  some  strong 
influence  you  may  possibly,  for  a  time,  draw  him  from  the  world  into 
some  narrower  sphere,  but  not  only  will  his  reluctant  nature,  like  a 
retiring  tide,  run  back  continually  to  embrace  the  continent,  but  will 
soon  break  from  its  confinement,  and  like  a  full  sea,  come  back,  boil- 
ing and  running  over. 

What  is  now  Wantedt  —  The  foregoing  remarks  indicate  one  great. 


leading  want,  in  order  that  ^iiedical  knowledge 


It  is 


f^^  may  increase. 

liherdlity,  in  the  true  and  full  Bcnse.  Wo  want  true  men  in  high 
places,  who  will  not  only  let  their  own  light  shine  everywhere,  but  will 
ceai>e  to  hinder  other  men's  light  from  shining. 

Beyond  this,  and  of  nearly  equal  importance  with  it,  we  ivant  medi- 
cal knowledge  diffused  among  the  people.  We  want  —  what  the 
world  has  never  seen  —  a  popular  medical  literature.  Wo  want  the 
temples  of  Esculapius  pulled  down,  and  the  priests  turned  into  the 
streets  to  become  teachers  of  the  multitude,  rather  than  .  'sliippers 
in  the  inner  sanctuary. 

I  know  this  want  will  be  stoutly  denied,  but  not,  I  think,  on  well- 
considered  grounds.  We  do  not  think  it  necessary  to  confine  a  knowl- 
edge of  the  soul  to  the  ministers  of  religion.  There  is  no  branch  of 
theology  which  we  do  not  deora  it  proppr  for  laymen  to  study  ;  we 
even  jjopularize  it  for  our  children.  In  the  obscurest  towns  of  New 
England,  laymen  who  follow  the  plough  or  push  the  plane,  become, 
in  many  eases,  eminent  theologians.  Why  should  they  not  study 
the  lower  science  which  relates  to  the  body  ?  They  have  not  been 
able  to  heretofore,  because  its  mysteries  have  been  purposely  hidden 
under  technicalities.     These  coverings  should  be  torn  off. 

It  is  said  that  those  who  begin  to  read  upon  medicine  are  very  apt 
to  imagine  themselves  afflicted  with  the  various  symptoms  they  find 
dcscril)cd.  To  some  small  extent  this  is  true  ;  but  it  is  also  true  that 
the  light  they  obtain  relieves  them  from  many  apprehensions  which 
their  i)reviou8  ignorance  allowed  to  prey  upon  them ;  as  boys  lose 
their  fears  when  the  light  of  the  morning  changes  to  some  familiar 
object  the  ghost  of  the  preceding  night. 

Physicians  oppose  tiie  popularizing  of  this  kind  of  knowledge  too 
often,  I  fear,  upon  the  sordid  ground  of  self-interest.  They  think 
their  own  services  will  be  less  sought. 

We  do  not  dispense  with  the  services  of  ministers  because  the 
people  study  theology,  neither  shall  we  cease  to  employ  teachers  and 
practitioners  of  medicine  when  each  man  and  woman  is  wise  enough 
to  study  the  healing  art.  The  principal  change  we  shall  witness  will 
be  much  .arger  attainments  in  knowledge  among  practitioners,  — just 
as  the  .ministers  of  religion  now  know,  and  are  obliged  to  know,  ten 
times  as  much  as  in  those  darker  periods  when  the  people  received 
all  spiritual  knowledge  from  their  mouths.  The  teachers  of  any  art 
or  science  are  obliged  to  keep  in  advance  of  their  pupils.  Let  medi- 
cine become  a  popular  study,  and  we  shall  have  very  few  ignorant 
physicians,  and  quackery  will  become  one  of  the  impossibilities. 
Homoeopathists,  Eclectics,  Hydropathists,  and  Physiologists,  believe 
in  scattering  medical  books,  stripped  of  their  technicalities,  among 
the  multitude,  and  their  people  purchase  very  few  secret,  advertised 
medicines ;  —  these  being  chiefly  bought  and  consumed  by  the  fol- 
lowers of  those  who  believe  this  kind  of  reading  fosters  quackery  1 


M 


A.  2!>^  ATOMY 


r'L. 
1^' 


Anatomy  describes  the  structure  and  organization  of  living  beings. 

Special  Anatomy  treats  of  the  weight,  size,  shape,  color,  etc. ,  of 
each  organ  separately. 

General  Anatomy  investigates  the  tissues  or  structure  ;  from  which 
organs  are  formed. 

Surgical  Anatomy  or  Kegional  Anatomy  considers  the  relations  of 
organs  to  one  another. 

Physiological  Anatomy  treats  of  the  uses  or  functions  of  organs  in 
health. 

Pathological  Anatomy  describes  the  alterations  made  upon  diflferent 
organs  by  disease. 

We  shall  here  introduce  a  very  brief  compendium  only  )f  Special 
Anatomy. 

It  is  of  great  consequence  that  every  person  should  h.  >  some 
knowledge  of  anatomy  and  physiology.  Self-knowledge  ou^^lit  to 
extend  to  the  body  as  well  as  the  mind.  To  know  one's  self,  physi- 
cally, is  to  gain  anew  insight  into  that  wonderfully  skilful  adjustment 
of  means  to  ends  which  is  never  absent  from  the  works  of  God. 
Without  this  knowledge,  one  cannot  know  how  to  take  care  of  the 
health ;  and  without  health,  life  loses  most  of  its  value. 


'  Structure    cf  the   Body.        / 

The  human  body  is  composed  of  solids  and  fluids. 

The  fluids  are  most  abundant  in  children  and  youth.  It  is  this 
which  gives  softness  and  pliancy  to  their  flesh.  In  old  age  the  fluids 
are  less  abundant,  and  the  flesh  is  more  hard  and  wrinkled. 

The  fluids  contain  the  whole  body,  as  it  were,  in  a  state  of  solution ; 
or  rather,  they  hold  the  materials  out  of  which  it  is  manufactured. 

Chemical    Properties    of  the    Body. 

The  four  elements,  oxygen,  hydrogen,  carbon,  and  nitrogen,  make 
up  nearly  the  whole  bulk  of  the  fluids  and  soft  solids  of  the  human 
body.  A  number  of  other  elements,  chiefly  in  a  state  of  combina- 
tion, and  in  much  smaller  quantities,  enter  into  several  of  the  tissues. 

Binary  Compounds.  —  Thus,  we  have  carbonic  acid  iu  blood,  urine 


ANATOMT. 


15 


and  sweat ;  and  wo  have  water  universally  diffused  through  tiio  sys- 
tem,—  cacli  of  tlieso  substances  being  a  binari/  compound,  that  is, 
composed  of  two  elements. 

Compounds  of  more  thim  two  Elements  arc  widely  distributed 
over  the  body ;  as, 

Carbonate  of  /Soda  in  serum,  saliva,  bile,  mucus,  sweat,  and  tears. 

Carbonate  of  Lime  in  cartilage,  bone,  and  teeth. 

Phosphate  of  Lime  in  bones,  teeth,  and  cartilage. 

Phosphate  of  Iron  in  blood,  gastric  Juice,  and  urine. 

Chloride  of  /Sodium  in  blood,  brain,  muscle,  bone,  cartilage  and 
pigment. 

Chloride  of  Potassium  in  blood,  gastric  juice,  milk,  and  saliva. 

Chloride  of  Calcium  in  gastric  juice. 

/Sulphate  of  Potassa  in  urine,  gastric  juice,  and  cartilage. 

Sulphate  of  Soda  in  sweat,  bile,  and  cartilage. 

Sulphate  of  Lime  in  bile,  hair,  and  scarf-skin. 

Oxide  of  Iron  in  blood,  black  pigment,  and  hair. 

Org^auized  Compounds.  —  Beside  the  above  inorganic  elements  and 
compounds,  several  organized  substances,  ov proximate  elements,  as 
they  arc  called,  exist  largely  in  the  body.  The  chief  of  these  are 
albumcu,  fibrine,  gelatine,  mucus,  fat,  caseine,  and  osmazome.  Otiiers 
need  not  be  named. 

Albumen  is  found  in  great  abundance  in  the  human  body.  It  is 
the  raw  material  out  of  which  the  flesh  and  other  tissues  are  made. 
The  white  of  an  eg^,  which  is  nearly  pure  albumen,  is  a  good  speci- 
men of  it. 

Fibrine,  when  removed  from  the  human  body,  changes  from  a  solu- 
ble to  an  insoluble  state.  In  other  words,  it  coagulates  in  a  kind  of 
net-work.  Nearly  the  same  thing  takes  place  constantly  in  the  living 
body,  when  the  liquid  fibrine  leaves  its  soluble  state,  and  is  deposited 
as  solid  flesh.  Fibrine  bears  the  same  relation  to  albumen  that  wool- 
leu  yarn  does  to  wool ;  it  is  spun  from  it  in  the  busy  wheel  of  or- 
ganic life.  And  the  flesh  or  muscle  is  related  to  fibrine  as  the  cloth 
is  to  yarn  ;  it  is  woven  from  it  in  the  vital  loom.  Fibrine  has  been 
called  liquid  flesh. 

Gelatine  exists  largely  in  the  ligaments,  cartilages,  bones,  skin,  and 
cellular  tif-sue.  When  dissolved,  five  parts  in  one  hundred  of  hot 
water,  it  forms  a  thick  jelly.  Isinglass  is  a  form  of  gelatine  obtained 
from  the  air-bladder  of  the  sturgeon  and  the  cod-fish.  Glue  is  still 
another  form  of  gelatine.  It  is  extracted  from  the  bones,  and  parings 
of  hides,  and  the  hoofs  and  ears  of  cattle,  by  boiling  in  water.  Black 
silk,  varnished  over  with  a  solution  of  gelatine,  forms  court-plaster. 

Mucus  is  a  sticky  fluid  secreted  l)y  the  gland-cells.  It  is  spread 
over  the  surface  of  the  mucous  membranes,  and  serves  to  moisten  and 
defend  them  from  injury. 

Fat  consists  of  cells  held  together  by  cellular  .  )Ue  and  vessels, 
and  contains  glycerine,  stearic  acid,  margaric  acid,  and  claic  acid.     It 


Mib. 


.'* ' 


16 


ANATOMT. 


hi 


has  no  nitrogen.  If  tlic  stearic  acid  be  in  excess,  the  fat  is  hard  ;  if 
tho  chiic  acid  preponderate,  it  is  soft.  The  stearine  extracted  from 
fat  id  used  for  nialiing  very  hard  candles. 

Caseine  is  abundant  in  milk  and  constitutes  its  curd.  It  is  held  in 
sohUion  in  milk  by  a  little  soda.  When  dried,  it  is  cheese.  It  is 
found  in  blood,  saliva,  bile,  and  tho  lens  of  the  e3'e.  It  forms  tlio 
thief  nourishment  of  those  young  animals  which  live  on  milk.  It  is 
found  in  peas,  beans,  and  lentils.  Vegetable  and  animal  caseine  are 
precisely  alike  in  all  their  properties.  Fibrine  and  albumen  contain 
almost  exactly  the  same  amount  of  oxygen,  hydrogen,  carbon,  nitro- 
<:en,  aud  sulphur,  which  is  found  in  caseine.  This  latter,  when 
taken  into  the  stomach,  therefore,  goes,  without  much  change,  to  the 
formation  of  the  albumen  and  fibrine  of  the  body. 

Physical    Properties    of  the    Body. 

The  Tissnes.  —  The  solid  organized  substances  of  which  the  human 
body  is  composed,  are  called  tissues.  There  are  various  kinds  of 
tissues. 

The  Cellular  Tissue,  commonly  called  areolar,  is  made  up  of  small 
filn-es  and  bands  woven  together  into  «  sort  of  net-work,  with  numer- 
ous little  spaces  opening  into  each  other.  These  spaces  are  tilled  with 
a  watery  fluid ;  and  when  this  is  grei.tly  increased  by  disease,  so  as 
to  cause  the  parts  to  swell,  and  the  skin  to  shine,  the  person  has  ana- 
sarca, or  cell  dropsy.  The  uses  of  this  tissue  are  to  give  i)arts  and 
organs  a  kind  of  elastic  cushion  to  rest  upon,  so  that  they  may  not  be 
bruised  and  injured  by  the  shocks  of  life ;  to  make  a  kind  of  safe 
highway  for  delicate  vessels  to  pass  from  one  part  of  the  body  to 
another ;  and  to  furnish  a  beautifully  arranged  lodgment  for  the  wa- 
tery fluid  which  gives  (?uch  roundaess,  smoothness,  and  grace  to  the 
human  form.  The  opening  of  the  cells  into  each  other  explains  the 
reason  why  feeble  persons  have  swelled  feet  and  ankles  in  the  even- 
ing, and  not  in  the  morning,  —  the  fluid  settling  down  from  cell  to  cell, 
into  tho  lowest  parts,  while  they  are  up  during  the  day,  and  running 
back  to  its  proper  place  while  they  are  lying  down  during  the  night. 

The  Mucous  Tissue,  or  mwcotw  »iem6mne,  lines  all  the  cavities  which 
i-omniunicato  with  the  air,  as  the  mouth,  stomach,  bowels,  lungs,  etc. 
It  is  supplied  with  numerous  small  glands  which  secrete  a  sticky  kind 
of  fl;iiii  called  mucus,  to  protect  the  surface  from  any  injury  which 
might  bo  inflicted  by  air,  or  by  irritating  substances  suspended  in  it. 

Tlie  Serous  Tissue,  or  membrane,  lines  all  the  cavities  which  do  not 
communicate  with  the  air,  that  is,  all  those  which  are  shut,  and  have 
no  outward  opening.  The  skull,  the  chest,  and  the  belly  are  lined  by 
this  kind  of  membrane.  The  membrane  itself  forms  the  closed  sack, 
—  one  layer  of  it  being  attached  to  the  cavity  it  lines,  while  tho  other 
is  folded  back  upon  and  around  tiie  contents  of  the  cavity,  which  are 
left  outside  of  the  sack.  A  watery  fluid  oozes  from  the  inner  surface 
of  the  sack,  to  make  its  sides  glide  easily  upon  each  other.     When 


together, 
and  bund 


rsy- 


ANATOMY 


17 


fiome  disease  causes  this  water  to  be  poured  out  too  freely,  so  as  to 
fill  or  partly  fill  the  cavity,  we  have  dropsy  of  the  bruia,  or  chest,  or 
belly,  as  the  case  mwy  be. 

The  Dermoid  Tissue  covers  the  whole  outside  of  the  body.  "We 
call  it  the  skin,  or  cntL.  It  is  similar  iu  structure  to  the  mucous  mem- 
branes, which  are  a  mere  continuation  uf  it.  It  is  harder  than  the 
mucous  membrane,  because  more  oxposed  to  inji./y.  In  health,  it 
never  ceases  to  secrete  and  throw  off  a  fluid  vhich  wo  cull  insensible 
perspiration  while  it  is  in  the  form  of  an  iuvisii  'i,  vmdot,  and  perspira- 
tion, or  sweat,  when  it  is  so  increased  as  to  be  sewi.  So  great  is  the 
sympathy  botween  this  dermoid  covering  of  the  body  and  the  mucous 
membranes,  that  when  it  is  chilled  so  as  to  otop  the  invisible  perspira- 
tion, the  internal  membrane  becomes  aflected,  and  we  have  a  sore 
throat,  or  diarrhoea,  or  running  at  the  nose  ;  that  is  tc  say,  whoa  the 
skin  cannot  sweat,  the  mucous  membrane  begins  to  sweat. 

The  Fibrous  Tissue  consists  of  closely  united  fil)res,  and  for  what- 
ever purpose  used,  forms  a  lino,  dense,  and  enduring  body.  In  some 
cases  it  takes  the  form  of  a  membrane,  as  the  dura  maier,  which  lines 
the  interi  jr  of  the  skull  ai.d  spinal  column.  The  ligaments  which  hold 
he  bones  together,  and  the  tendons  or  cords,  which  fasten  the  muscles 
';0  the  bones,  are  fibrous  bodies.  It  is  this  firm  substance  of  whick 
rheumatism  frequently  takes  hold,  and  this  is  the  reason  why  it  linger!^ 
so  much  about  the  joints.  It  sometimes  takes  hold  of  the  ligament 
which  fastens  the  deltoid  muscle  to  the  bone  of  the  upper  arm,  about 
two-thirds  of  the  way  from  the  elbow  to  the  shoulder.  This  muscle 
lifts  up  the  arm.  In  this  form  of  rheumatism,  therefore,  the  arm  hangs 
helpless  at  the  side. 

The  Cartilaginous  Tissue  covers  the  ends  of  the  bones  where  they 
come  together  to  make  a  joint.  It  is  well  fitted  to  make  the  joint 
work  easy,  being  smooth,  hard,  and  elastic.  »     - 

The  Osseous  or  Bony  Tissue  varies  in  its  composition,  density,  and 
strength,  according  to  the  age  of  the  person,  and  the  uses  of  the  bone. 

The  Muscular  Tissue,  or  muscle,  being  made  for  a  great  deal  of 
Fig.  1.  pulling  and  lifting,  is  formed  some- 

thing like  a  rope,  except  that  there 
is  no  twisting.  Many  small  fibres  or 
filaments  unite  to  form  fasciculi.  A 
fasciculus  is  a  bundle  of  fibres  sur- 
rounded by  a  delicate  layer  of  cell 
tissue  called  sarcolemma,  — just  as  a 
cord  is  a  number  of  smaller  threads 
of  cotton  or  hemp  bound  together.  A 
number  of  these  fasciculi  united  to- 
gether, make  a  muscle,  — just  as  sev- 
eral chords,  called  strands,  twisted 

together,  make  a  rope.    Figure  1  gives  us  a  good  view  of  the  fibres 

and  bundles,  highly  magnified.  - 


I 


18 


▲NATOMT. 


The  Adipose  Tissue  is  the  material  which  the  human  body  works 
up  into  pot8  and  cells  containing  fat.  It  is  found  chiefly  under  the 
skin  and  muscles  of  the  belly,  and  around  the  heart  and  kidneys. 
By  the  increase  of  this  tissue,  persons  may  become  enormously  en- 
larged without  having  their  muscles  at  all  increased  in  size.  Such  a 
condition  is  to  be  deplored,  —  the  body  having  become  merely  the 
store-house  or  depot  of  myriads  of  pots  of  fat. 

The  Nervous  Tissue  is  composed  of  two  distinct  kinds  of  matter, 
—  the  one  gray  ^d  pulpy,  called  cineritious,  the  other  white  and 
fibrous,  called  medullary.  The  external  part  of  the  brain  and  the  in- 
ternal portion  of  the  spinal  cord  are  composed  of  the  gray  or  ash- 
colored  tissue  ;  the  nerves  are  made  only  of  the  white  or  fibrous  matter* 
and  are  inclosed  in  a  delicate  sheath  called  neurilemma. 


the  lij 
of  th< 
vessel 
ments 


I 


Vital  Properties  of  the  Body. 

Bodies  begin  their  growth  with  a  simple  cell,  which  is  a  delicate 
.little  bladder  or  shut  sack.  Cells  take  their  rise  in  that  portion  of  the 
blood  which  is  capable  of  being  organized,  and  which  is  called  blas- 
tema. 

In  animal  bodies,  each  cell  generally  begins  as  a  minute  point  in 
the  blastema,  and  grows  until  a  transparent  bladder  or  vesicle  springs 
out  from  one  side  of  it,and  soon  appears  to  enclose  it.  The  bladder 
is  then  called  the  cell,  and  the  point  or  dot  is  its  nudeus.  Within  this 
nucleus  appears  another  dot,  which  is  called  the  nucleolus.  When 
xiiUy  ripened,  the  cell  bursts  and  sets  the  nucleus  fr^^e,  and  this,  in  its 
turn,  matures  and  yields  up  its  contents.  Thus  all  cells  have  their 
origin  in  germs  produced  by  previously  existing  parent  cells.  They 
are  multiplied  with  great  rapidity.  Having  grown  to  a  certain  extent^ 
they  lose  their  fluid  contents,  and  their  walls  collapsing  or  coming  to- 
gether, they  form  simple  membraneous  discs.  In  this  way,  with  some 
variations,  the  simple  tissues  of  the  body  begin  to  be,  and  the  foun- 
dation is  laid  for  the  noble  structure  of  man. 


Anatomy  of  the  Bones.  i' 

The  human  skeleton  is  composed  of  two  hundred  and  eight  bones, 
the  teeth  not  included. 

When  fastened  together  by  natural  ligaments,  the  bones  are  said 
to  form  a  natural  skeleton;  when  attached  by  wires,  an  artijicial  skele- 
ton. 

In  Figure 2,  —  1,  1,  represent  the  spinal  column  ;  2,  the  skull;  3, 
the  lower  jaw  ;  4,  the  breast  bone  (sternum)  ;  6,  the  ribs  ;  7,  the  col- 
lar bone  ;  8,  the  bone  of  the  upper  arm  (humerus)  ;  9,  the  shoulder 
joint ;  10,  the  radius  ;  11,  the  ulna,  12,  the  elbow  joint ;  13,  the  wrist ; 
14,  the  hand ;  15,  the  haunch  bone  ;  16,  the  sacrum  ;  17,  the  hip  joint ; 
18,  the  thigh  bone  ;  19,  the  knee  cap  (patella)  ;  20,  the  knee  joint; 
21,  the  fibula ;  22,  the  tibia ;  23,  ankle  joint ;  24,  the  foot ;  27,  28,  29, 


The  pro 
processes, 
fastened. 

The  bor 
of  the  bod 
tively  soft, 
tfiey  begin 
cation.     ~ 

periosteum 
name  of  jse 
nium. 
The  bon 


ANATOMY. 


19 


the  ligaments  of  the  shoulder,  elbow,  and  wrist ;  30,  the  large  artery 
of  the  arm  ;  31,  the  ligaments  of  the  hip  joint ;  32,  the  large  blood 
vessels  of  the  thigh ;  33,  the  artery  of  the  leg ;  34,  35,  36,  the  liga- 
ments of  the  knee  cap,  knee,  and  ankle. 


7ia.  2. 


X 


9, 


The  protuberances  or  swellings  in  certain  parts  of  bones  are  called 
processes,  and  are  the  points  to  which  muscles  and  ligaments  are 
fastened. 

The  bones  are  supplied  with  nutritive  vessels,  and,  like  other  parts 
of  the  body,  are  formed  from  the  blood.  At  first  they  are  compara- 
tively soft,  and  cartilaginous.  After  a  time,  in  the  young  animal, 
they  begin  to  change  to  bone  at  certain  places,  caXled  points  of  ossifi- 
cation. They  are  covered  with  a  strong  fibrous  memtrane  called  the 
periosteum.  A  somewhat  similar  covering  upon  the  cartilages  has  the 
name  oi perichondrium,  and  that  which  covers  the  skull  is  ^q  pericra- 
nium. 

The  bones  are  compounded  of  earthy  and  animal  matter.    From 


20 


ANATOMY. 


|l  ' 


mr> 


the  former,  —  phosphuto  uiid  carbonate  of  lime,  —  they  receive  their 
strength  ;  from  the  latter,  —  curtilage,  —  they  derive  their  life. 

Put  a  bone  fgr  a  few  days  into  dibited  muriatic  acid,  —  one  part  of 
acid  to  six  of  watcsr,  —  and  tlio  piiospbato  and  carbonate  of  lime  will 
all  be  removed,  while  the  bono  will  remain  the  same  in  shape.  It 
Fio. 3.  will   now    bo    comparatively 

sort,  and  may  be  bent,  or 
even  tied  into  a  knot,  with- 
out breaking.  Place  a  simi- 
lar bono  in  the  fire  for  a  few 
hours,  and  it  will  also  retain 
its  shape,  but  the  cartilagi- 
nous portion  will  be  gone. 
It  is  now  ))rittl(!,  and  may  be 
picked  in  pieces  with  the  fin- 
gers. 

The  bones  are  divided  into  those  of  the  head,  thirty ;  of  the  body, 
fftii-four;  of  the  upper  limbs,  sixty-four;  and  of  the  lower  limbs, 
sixty. 

Bones  of  the  Head,     v 

The  bones  of  the  head  are  divided  into  those  of  the  skidl,  the  eaVf 
and  the /ace. 

The  skull  has  eight  bones.  They  are  composed  of  two  plates, 
one  above  the  other,  with  a  porous  partition  between.  These  two 
plates  are  capable  of  giving  the  brain  very  powerful  protection  against 
injury,  the  outer  one  being  fibrous  and  tough,  —  the  inner  one,  hard 
and  glass-like,  and  hence  called  vitreous. 

The  middle  layer  has  the  name  of  diphe.  Its  spongy  nature  deadens 
the  jar  from  a  blow  inflicted  upon  the  outer  table.  In  early  life,  when 
the  bones  are  tender  and  yielding,  this  porous  layer  is  not  needed, 
and  is  not  found.  y    - 

That  the  bones  of  the  skidl   may  not  fio.4. 

easily  slip  by  each  other,  and  get  out 
of  place,  they  are  dovetailed  together  in 
curious  lines  called  sutures.  In  advanced 
years,  these  generally  close  up,  the  bones 
uniting  firmly  together.  In  early  life 
they  are  quite  open,  the  firm  bones  not 
covering  the  whole  brain.  The  opening 
of  the  coronal  suture  in  childhood  is  called 
a  fontanelle.  It  presents  a  soft  place  up- 
on the  top  of  the  head,  where  the  finger 
could  be  pressed  down  into  the  brain.  In 
Figure  4, —  1,  1,  show  the  coronal  suture 
on  the  front  and  upper  part  of  the  skull ;  2, 
the  sagittal  suture  on  the  top  of  the  skull ; 
and  3,  3,  the  lambdoidal  suture,  running  down  on  each  side  of  the 
back  part  of  the  skull. 


The  I 
parts  in 


I       In  thf 
'     back  boi 
l)reast  b< 
called  OS 
cavities. 
The  r 
hone  in 
which    ( 
heart, 
natural  f( 
1,  is  the 
hones ; 
tnie  ribs 
Mse  ril 
which  t 
tlie  swor 
constitut 
l>rt'ast  I 
tilage; 
two  lun, 
seen  bet 
left  lung 
11, the d 
12,theli 
14,  14,  t 
16j  the  u 
on  left  8i( 


)C 


I 


AKATOMT. 


21 


Figure  5  shows  the  skull  hones  sepanitcd  from  ouch  other  nt  the 
iH.  •  sutures :     1 ,    the   frontal 

bono ;  2,  the  pariotnl ; 
3,  the  occipital ;  4,  the 
temporal ;  T),  the  nasul  • 
(),  the  malar ;  7,  the  ru- 
porior  maxillary ;  8,  the 
unguis ;  1),  the  inferior 
maxillary.  Ariiott  has 
dcmonj-trated  that  the 
form  of  the  skull  is  the| 
best  possible  for  sustain- 
ing weights,  and  resist- 
ing blows.  The  summit 
of  the  head  is  a  complete 
arch,  like  that  of  a  bridge. 
The  ear  has  four  small 
bones,  'Nvhich  aid  the 
sense  of  hearing. 

The  bones  of  the  face  are  fourteen  in  number.  They  hold  the  soft 
parts  in  place,  and  aid  in  grinding  the  food. 

Bones  of  the  Trunk. 

In  the  tnnik  there  are  tweiity-foiu'  ribs  ;  twenty-four  pieces  in  the 
l)ack  bone  or  spinal  column  ;  four  bones  in  the  pelvis  and  hips  ;  one 
lu'cast  bone,  culled  sternum  ;  and  a  bone  at  the  base  of  the  tongue, 
called  OS  hyoidcs.  They  are  so  put  together  as  to  form  two  great 
cavities,  namely,  the  thorux  or  chest,  and  the  abdomen  or  belly. 

The  ribs,  connecting  with  the  back  bone  behind,  and  the  breast 
bone  in  front,  form  the  thorax. 


FlO.  S. 


which  contains  the  lungs  and 
heart.  The  Figure  (5  shows  the 
natural  form  of  the  healthy  chest : 

I,  is  the  spine;  2,  2,  the  collar 
bones  ;  3,  3,  the  seven  upper,  or 
true  ribs ;  4,  4,  the  live  lower  or 
Odse  ribs  ;  5,  the  breast  bone,  to 
which  the  true  ribs  are  united  ;  6, 
the  sword-shaped  cartilage  which 
constitutes  the  lower  end  of  the 
lireast  bone,  called  eiisiform  car- 
tilage; 7,  7,  the  upper  part  of 
two  lungs ;  8,  8,  the  right  lung  / 
seen  between  the  ribs  ;  I),  9,  the  ^k 
left  lung;  10,  10,  the  heart;  11, 

I I ,  the  diaphragm ,  or  m  id  rift' ;  1 2 , 
12,  the  liver ;  13, 13,  the  stomach, 
14,  14,  the  second  stomach,  or  duodenum;  15, the  transverse  colon; 
16,  the  upper  part  of  the  colou  on  right  side  j  17,  upper  part  of  colon 
on  left  side. 


22 


AlVATOMT. 


Upon  every 

Fig.  T. 


Pig.  «. 


Eiich  pioco  of  (lio  Hpiniil  coliiinn  \a  called  a  vertebra. 

one  of  tlH;8o  nro  sovon  projections,  called 

jtrocenaen,  —  a  piu't  of  which  mo  for  linking 

tlie  boncH  together,  and  tl»3  reHt  to  fiijniHn 

attachments  for  tlic  muscles  of  the  back. 
The   projections  are  linked  together  in 

such  a  way,  that  a  continuous  channel  oc 

opening  runs  down  through  the  whole,  in 

which  is  lodged  the  spinal  cord,  or  meilulla 

sjt'nnlis.     This  nervous  cord   is  connected 

with  the  base  of  the  brain,  and  is  a  kind  of 

continuation  of  it. 

Between  all  thovertebroj  are  certain  car- 
tilaginous cushions,  which,  when  conipresned,  spring  back,  like  India 

»'»lbber,  and  thus  protect  the  brain  from  beii\g  injuriously  jarred  by 

"unning,  leaping,  or  walking. 
^hopelvia  has  four  bones  ;  the  two  nameless  bones,  —  innominata, — 

the  sacrum,  and  the  coccyx.     In  the  side  of  each  of  the  nameless  bones 

is  a  deep,  smooth  eavity,  called 
the  areUihnliim.  Into  this  the 
round  head  of  the  thigh  bono  is 
nicely  fitted.  When  the  bono  is 
thrown  out  of  this  cavity,  the 
hip  is  said  to  be  out  of  joint. 
The  sacrum  took  its  name  from 
the  fact  that  the  heathens  used 
to  oflbr  it  in  sacriiice.  With 
them,  it  was  the  sacred  bone. 
The  coccyx  is  the  lower  termi- 
nation of  the  back  bone.  These 
bones  are  represented  in  Figure 

8  :  1,1,  being  the  innominata  ;  2,  the  si'crum  ;  3,  the  coccyx  ;  4,  4,  the 

acetabulum;  a,  a,  the  pubic  portion  of  the  nameless  bones;  d,  the 

arch  of  the  pubes ;  c,  the  union  of  the  ^"^ucrum  and  the  lower  end  of 

the  spinal  column.  >  , 

Bones  of  the  Upper  Extremities. 

The  shoulder  blade  (scapula) ,  the  collar  bone  (clavicle) ,  the  bone  of 
fheupper  arm  (humerus),  the /wo  boneft  of  the  fore-arm  (ulna  and  ra- 
dius), the  bones  of  the  wrht  (carpal  bones),  the  bnves  of  the  palms  of 
the  hand,  (metacarpal  bones),  tho  bones  nf  the  thumb  and  fingers 
(phalanges), — these  are  the  l)one8  of  the  upper  limbs. 

The  collar  bone  is  fastened  at  one  end  to  the  breast  bone,  at  the 
other  end  to  the  shoulder  l)lude.  It  keeps  the  shoulders  from  drop- 
ping forwai-d.  Many  persons  allow  it  to  fail  of  this  end  by  getting 
very  much  bent  in  early  life.  This  happens  at  school,  when  children 
are  allowed  to  sit  in  a  stooping  posture.  In  the  French,  a  race  i"e- 
markable  for  a  straight,  upright  tigure,  this  bone  is  said  to  be  longer 
than  in  any  other  people. 


Th( 

the  oil 

insert) 

are  atl 

and  m 

The 

>ty,  b) 

great  r 

of  the 

9:  1,1 

into  th 

OftI 

united ' 

bone  ol 

the  san 

with  tl 

ulna;  i 

which  t 

of  the  (I 

6,  the  f 

Fic 


L 


The  el 

being  bcf 
l^igure 
cuneifori 
zoid  boil 
four  for| 
pal  bon( 
3,  the  8c 
bones; 


\. 


ANATOMY. 


23 


Tho  shoulder  blade,  lies  upon  the  upper  part  of  the  back,  foruiing 
the  shoulder.  It  Iiub  a  shallow  cavity  (glouoid  cavity),  into  which  is 
insflrtod  tho  head  of  tho  upper  arm  bono.  Several  strong  muscles 
are  attached  to  the  (>lovations  of  this  bone,  which  keep  it  in  its  place, 
and  move  it  about  ns  circumstances  require. 

Tho  upper  arm  bone  has  its  round  head  fastened  in  the  glenoid  cav- 
ity, by  the  strong  capsular  ligament,  forming  a  joint  capable  of  a 
great  number  of  movements.  At  the  elbow  it  is  united  with  the  ulna 
of  the  fore-arm.  It  is  a  long  cylindrical  bone,  represented  by  Figure 
9:  1,  is  the  shaft  of  the  bono;  2,  the  largo,  round  head  which  fits 
into  the  glenoid  cavity  ;  3,  tho  surface  wh'ch  unites  with  the  ulna. 

Of  the  two  bones  of  the  fore-arm,  the  wia  is  on  the  inner  side,  and 
uniteii  with  tho  humerus,  making  anexcehv.;.  hinge-joint.  The  other 
bone  of  the  fore-arm,  the  radius,  lies  on  the  outside  of  the  arm,  — on 
the  same  side  with  tho  thumb,  —  and  unites,  or  articulates,  as  wo  say, 
with  tho  bones  of  tho  wrist.  In  Figure  10:  1,  is  tho  body  of  the 
ulna ;  2,  the  shaft  of  tho  radius ;  4,  the  articulating  surface,  with 
which  the  lower  end  of  the  humerus  unites ;  5,  tho  upper  extremity 
of  the  ulna,  called  tho  olecranon  process,  which  forms  the  elbow  joint ; 
6,  the  point  where  the  ulna  articulate  with  the   .'rist. 

Fio.O.  Fia.  11.  .  rio.  10. 

5 


The  eight  bones  of  the  wrist  or  carpus  are  ranged  in  two  rows,  and 
being  bound  close  together,  do  not  admit  of  very  free  motion.  In 
ligure  11 :  8,  is  the  scaphoid  bone ;  l,  the  semilunar  bone ;  c,  the 
cuneiform  bone  ;  P,  the  pisiform  bone  ;  T,  x,  tho  trapeziur.  and  trape- 
zoid bones ;  M,  the  os  magnum  ;  u,  the  cuneiform  bone.  The  last 
four  form  the  second  r- ■''•  of  carpal  bones.  11,  11,  are  the  metacar- 
pal bones  of  the  hand  ;  2,  2,  the  first  range  of  the  finger  bones ;  3, 
3,  the  second  range  of  finger  bones ;  4,4,  the  third  range  of  finger 
bones ;  5,6,  the  bones  of  the  thumb. 


S4 


ANATOMY. 


Of  the  five  metacarpal  bones,  four  are  attached  below  to  the  first 
range  of  the  finger  bones,  and  the  other  to  the  first  bone  of  the 
thumb,  while  the  whole  are  united  to  the  second  range  of  the  carpal 
bones  above. 

Bones  of  the  Lower  Extremities. 

These  are  the  thif/7i  bone  (femur),  the  knee  pan  (patella),  the  shin' 
bone  (tibia),  the  small  hone  of  the  leg  (fibula),  the  bones  of  the  instep 
(tarsal  bones),  the  bones  of  the  middle  of  the  foot  (metatarsal  bones), 
and  the  bones  of  the  toes  (phalanges). 

The  thigh  bone  is  the  longest  bone  in  the  system.  Its  head,  which 
is  large  and  round,  fits  admirably  into  the  cavity  in  the  F10.12. 
innominatum,  called  acetabulum,  and  forms  what  is 
called  a  ball-and-socket  joint.  In  Figure  12  :  1,  is  the 
shaft  of  the  thigh  bone  (femur)  ;  2,  is  a  projection  culled 
the  trochanter  minor,  to  which  some  strong  muscles  are 
attached  ;  3,  is  the  head  of  the  femur  which  fits  into  th<^ 
acetabulum  ;  6,  is  the  external  projection  (  the  femur, 
called  the  external  condyle  ;  6,  the  internal  condyle  ;»  7, 
the  surface  which  articulates  with  the  tibia,  and  on  which 
the  patella  slides. 

The  knee  pan  or  knee  cap  (^patella)  is  placed  on  the 
front  of  the  knee,  and  being  attached  to  the  tendon  of 
the  extensor  muscles  above,  and  to  the  tibia  by  a  strong 
ligament  below,  it  acts  as  a  pulley  in  lifting  up  the  leg. 
The  sliin  bone  (tibia)  is  the  largest  of  the  two  in  the 
lower  leg,  and  is  considerably  enlarged  at  each  end. 
pjjj  j3  The  small  bone  of  the  leg  (fibula)  lies  on 

the  outside,  and  is  bound  to  the  larger  bono 
at  both  ends.  Figure  13  shows  the  two 
bones  of  the  leg  :  1,  being  the  tibia  ;  5,  the 
fibula ;  8,  the  space  between  the  two  ;  6,  the 
junction  of  the  tibia  and  fibula  at  the  upper  , 
extremity  ;  3,  the  internal  ankle  ;  4,  the  lower 
end  of  the  tibia  that  unites  with  one  of  the 
tarsal  bones  to  form  the  anhie  joint  j  7,  the  upper  end  of 
the  tibia  which  unites  with  the  femur. 

The  instep  (tarsus)  has  seven  bones,  which,  like  those 
of  the  wrist,  are  so  firmly  bound  together  as  to  allow  but 
a  limited  motion. 

The  metatarsal  bones,  corresponding  with  the  palm  of 
the  hand,  are  five  in  number,  and  unite  at  one  end  with 
the  tarsal  bones,  and  at  the  other  with  the  first  range  of 
the  toe-bones. 

The  tarsal  and  metatarsal  bones  are  put  together  in  the 
form  of  au  arch,  the  spring  of  which,  when  the  weight  of 
the  body  descends  upon  it  in  walking,  prevents  injury  to 
the  organs  above.     (Fig.  14.) 

The  phalanges  have  fourteen  bones.    The  great  toe  hat 


IITATOMT. 


25 


Figure  15  gives  a 


two  ranges  of  bones  ;  the  other  toes  have  three. 

view  of  the  upper  surface  of  the  bones  of  the  foot ;  1,  is  the  surface 

of  the  astragalus  where  it  unites  with  the  tibia ;  2,  the  body  of  the 


Fir..  15. 


no.  14. 


astragalus  ;  3,  the  heel  bone  (os  cnlcis)  ;  4,  the  scaphoid  bone ;  5,  6, 
7,  the  cuneiform  bones  ;  8,  the  cuboid  ;  9,  9,  9,  the  metatarsal  bones  ; 
10,  the  first  bono  of  the  great  toe  ;  11,  the  second  bone  ;  12,  13,  14, 
three  ranges  of  bones  forming  the  small  toes. 

The  Joints. 

That  bones  may  be  of  any  use,  they  must  be  jointed  together. 
Joints  are  of  the  greatest  importance.  It  is  necessary  they  should  be 
so  constructed  that  there  shall  be  no  harsh  grating  of  the  bones  upon 
each  other,  and  no  injurious  jars  in  walking,  etc.  To  prevent  these 
things,  a  hard,  smooth,  and  yet  yielding,  cushion-like  substance  is 
required  between  them  in  joints.  Such  are  the  cartilages.  Fignre  16 
B^o-  »••  gives  a  specimen  of  these 

I  intervening  cartilages.   D, 
is  the  body  of  a  bone,  at 
I  the  end  of  which  is  a  sock- 
et;  C,  the  cartilage  lining 
the  socket,  thick  at  the  sides 

,,,,„,  '  and  thin  in  the  centre  ;  B, 

the  body  of  a  bone,  at  the  e;jd  of  which  is  a  round  head  ;  C,  the  in- 
vesting cartilage,  thin  at  the  sides  and  thick  in  the  centre. 

Cartilage  grows  thinner,  harder,  and  less  elastic  in  old  age.  Hence 
old  people  are  not  quite  as  tall  as  in  middle  life,  and  a  little  stiffer  in 
their  jomts. 

The  synovial  membrane  is  a  thin  layer  covering  the  cartilage,  and 
being  bent  back  upon  the  inner  surface  of  the  ligaments,  it  forms  a 
closed  sack.  From  its  inner  surface  a  sticky  fluid  oozes  out,  which 
helps  the  joints  to  play  easily. 


I 
I 


«^»J5* 


i 


26 


ANATOMT. 


There  nre  other  smaller  sacks  connected  with  the  joints,  called 
bursa  mucosae.  They  secrete  a  fluid  similar  to  that  from  the  syno- 
vial membrane. 

The  ligaments.  To  retain  the  bones  in  their  places  at  the  joints, 
some  strong,  flexible  straps  are  required  to  stt'etch  across  from  one  to 
the  other,  and  to  firmly  unite  them.     Such  are  the  ligaments. 

They  are  the  pearl-colored,  lustrous,  shining  parts  about  the  joints, 
in  the  form  of  straps  and  cords.  There  are  a  number  of  them  so 
woven  together  as  to  form  a  complete  covering  of  the  joint,  called  a 
capsular  ligament.  In  Figuro  17  :  1,  2,  are  ligaments  extending  from 
the  hip  bone,  6,  to  the  femu)*,  4.     In  Figure  18  :  1,  is  the  socket  of 


Via.  17. 


FiO.  18. 


FlQ.  1». 


the  hip  joint ;  2,  the  head  of  femur,  lodged  in  the  socket ;  3,  the 
ligament  within  the  socket.  In  Figure  19  :  1,  is  the  tendon  of  the 
muscle  which  extends  the  leg;  2,  the  knee  cap  (patella)  ;  3,  the  ante- 
rior ligament  of  the  patella ;  6,  the  long  external  lateral  ligan  °ini ; 
4,  4,  the  synovial  membrane  ;  5,  the  internal  lateral  ligament ;  7,  the 
anterior  and  superior  ligament  that  unites  the  tibia  with  the  fibula. 


Uses  of  the  Bones. 

The  bones  are  to  the  body  what  the  frame  is  to  the  house.  They 
hold  up  and  retain  the  other  parts  in  their  proper  places.  They  fur- 
nish points  of  attachment  for  the  muscles,  to  hold  the  body  together, 
and  to  give  it  motion.  They  also  furnish  strong,  bony  cavities  for  the 
lodgment  and  protection  of  such  delicate  orgaus  as  the  eye,  the  brain, 
and  the  heart. 

A  single  bone,  examined  by  itself,  might  not  seem  to  have  much 
beauty  or  design  about  it ;  it  might  even  look  clumsy  and  misshapen. 
But  when  all  the  bones  are  inspected  with  reference  to  each  other,  we 
immediately  discover  a  general  plan  upon  which  they  are  made,  and 
are  compellod  to  admire  their  beautiful  harmony,  and  the  symmetrical 
grace  with  which  thev  art.  They  show  us  that  God  can  command 
our  wonder,  even  in  the  i>uny  frame  of  our  bodies. 


Sha 


ANATOMY. 


27 


The    Muscles. 

That  part  of  the  animal's  body  which  we  call  lean  meat  is  com- 
posed of  muscles.  We  have  already  explained  that  muscles  are  com- 
posed of  threads,  etc. ,  put  together  in  great  numbers,  forming  bundles. 
So  numerous  are  these  threads  and  bundles  in  some  cases,  that  the  mus- 
cles which  are  composed  of  them  have  a  strength  truly  wonderful. 

Toward  the  end  of  the  muscle,  the  fibres  cease,  and  the  structure 
is  so  modified  as  to  l)ecome  a  white  cord  of  great  density  and  strength. 
This  cordy  substance  is  fastened  to  the  bone  so  strongly,  that  it  is 
impossible,  except  in  some  rare  case,  to  detach  it.  Gei  y  the 
bone  will  sooner  break  than  this  attachment  will  give  wa^  Some- 
times this  cord  spreads  out  like  a  membrane.  It  is  then  callecl /oscta 
or  aponeurosis. 

The  fibres  of  a  muscle  have  the  peculiar  property  of  contracting 
under  a  nervous  stimulus  sent  to  them  by  the  will.  These  contrac- 
tions cause  them  to  act  as  puUies,  and  to  move  the  bones,  and  conse- 
quently the  limbs  and  body,  in  such  direction  as  the  will  commands. 
This  is  the  special  use  ot  the  nujscles.  All  our  movements  are  caused 
by  them.  They  pull  us  about,  not  blindly  and  at  random,  but  under 
the  direction  of  an  intelligent  will. 

The  manner  in  which  a  muscle  acts,  with  the  cord  attached,  may 
be  seen  by  examining  the  log  or  "  drum-stick  "  of  a  fowl.  If  the  cord 
on  one  side  be  pulled,  the  claws  are  shut ;  if  that  upon  the  other 
side  be  drawn,  they  will  oi)en.  If  both  be  pulled,  they  are  held  fast 
in  one  position,  neither  opening  nor  shutting. 

An  examination  of  a  piece  of  boiled  lean  meat,  will  show  the 
threads  of  which  it  is  composed .  With  proper  instruments,  these  may 
be  unravelled,  as  it  were,  until  fibres  will  be  found  not  larger  than  a 
spider's  web.  These,  covert-d  with  sheaths  of  great  delicacy,  extend 
beyond  the  tleshy  fibre,  and  with  ihe  cell  substance  connecting  the 
fibres,  are  condensed  into  tendon. 

Millions  of  these  sheathed  fibres  are  gathered  into  a  bundle,  and 
covered  with  a  sheath,  and  thus  form  what  is  called  a  fasciculus.  A 
muscle  is  a  number  of  these  fasciculi  made  into  a  bundle,  and  covered 
with  a  sheaiu  called  a  fascia.     (Fig.  1.) 

The  arm  is  a  number  of  muscles  bundled  together,  and  covered, 
likewise,  by  a  fascia. 

The  fibres  in  a  fasciculus  being  parallel,  act  together.  Butthefas- 
ciculous  bundles,  which  make  up  a  muscle,  act  in  various  ways. 

Shape  of  the  Muscles.  —  Some  muscles  are  fusiform  or  spindle- 
shiiped,  so  that  the  attachment  occupies  but  a 
small  space.     (Fig.  20.) 

Other  muscles  are  radiate  or  fan-shaped.  (Fig.  21.) 
Such  is  the  temporal  muscle,  the  thin  edge   of  fic.  21. 

which  is  attached  to  the  side  of  the  head,  without 
producing  an  elevation  or  deformity. 

In  some  cases  the  fasciculi  are  arranged  upon 
one  or  both  sides  of  a  tendon.     In  this  way  a 


FlO.  10. 


•^mm' 


18 


ANATOMr. 


great  number  may  concentrate  their  action  upon  n  single  point.    Such 
muscles  are  called  jsenni/brm, — beini^  shaped  like  Pio.  21 

the  feather  end  of  a  pen.     (Fig.  22.)  .^^flflK^^^^ 

In  other  instances,  the  fascicJili  form  circular  ^^WBBiiB^^ 
muscles,  — orbiculares,  or  spfiinders,  as  they  are  called.     These  sur- 
round certain  openings  into  the  body,  which  they  are  designed  to 
Pio.  23.    close,  either  in  whole  or  in  part.     They  surround  the  eye- 
lids, the  anus,  the  mouth  of  the  womb,  etc.     (Fig.  23.) 

In  still  other  instances  the  fasciculi  are  ranged  side  by  side 
in  rings,  forming  muscidar  tubes.     By  the  successive  contrac- 
tion of  these  rings,  any  substance  is  driven  through  the  tube,  —  as 


food  or  drink  through  the 
gullet  of  a  cow.  Figure 
24  is  a  section  of  the  gul- 
let :  a,  b,  show  the  circu- 
lar fibres  ;  c,  the  longitudinal. 


Fir..  24. 


Fia.  25. 


Sometimes  the  fasciculi  curve  around  in  parallel  layers,  or  interlace 

with  each  other,  forming  a  bag  or 
pouch.  By  the  contraction  of  these 
fasciculi,  the  contents  of  the  bag 
will  be  turned  from  side  to  side, 
as  in  the  case  of  the  stomach, 
or  driven  out,  as  in  that  of  the 
heart.  Figure  25  shows  the  mus- 
cles of  the  stomach  ;  L,  represents 
the  fibres  running  in  one  direc- 
tion ;  c,  in  another  ;  e,  lower  end 
of  gullet ;  o,  pylorus ;  D,  begin- 
ning of  duodenum,  or  second 
stomach. 


Number  of  Hascles.  —  The  muscles  of  the  body  are  as  numerous 
as  the  ropes  of  a  ship,  — there  being  five  hundred  or  more.  Some 
anatomists  reckon  more,  some  less. 

They  are  divided  into  those  of  the  head  and  neck,  those  of  the 
trunk,  those  of  the  upper  extremities,  and  those  of  the  lower  extremis 
ties. 

They  are  too  numerous  to  be  named  and  individually  described  in 
this  brief  account  of  them.  A  part  of  them  are  voluntary,  that  is, 
under  the  control  of  the  will ;  while  another  part  are  involuntary, 
moving  without  reference  to  the  will.  The  heart  is  of  the  latter  kind, 
it  being  necessary  for  it  to  keep  moving  when  the  will  and  mind  are 
asleep. 

On  the  back  there  are  six  layers  of  muscles,  one  above  another. 
Such  a  number  are  necessary  to  perform  the  numerous  movements 
of  the  back,  neck,  arms,  etc.  Every  expression  of  the  human  face,  as 
joy,  sorrow,  love,  hate,  hope,  fear,  etc.,  is  produced  by  the  gentle  pul- 
ling of  muscles,  made  expressly  to  indicate  these  emotions. 

The  diaphragm  is  a  large  flat  muscle,  reaching  across  the  great 
cavity  of  the  body,  and  dividing  the  chest  from  the  belly.     It  is  pen- 


ANATOMY. 


29 


PlO.  26. 


etrated  by  the  food-pipe  going  to  the  stomach,  and  by  the  great  blood- 
vessels leading  to  and  from  the  heart.  It  is  shaped  like  the  covei 
of  a  dinuer-dish,  the  convex  surface  being  turned  up.  When  the 
breath  is  drawn  in,  it  sinks  down  towards  a  level,  thus  enlarging 
the  chest  at  the  expense  of  the  belly.  When  the  breath  is  thrown 
out,  the  reverse  takes  place. 

Mode  of  Action. —  The  contraclibility  of  a  muscle,  of  which  I  have 
spoken,  is  simply  its  power  of  shortening  itself.  The  hand  is  raised 
by  the  shortening  of  a  muscle  in  front,  attached  to  the  bone  above 

the  elbow,  and  to  a  bono  be- 
low the  elbow.  The  con- 
traction of  an  antagonistic 
muscle  behind,  also  attached 
above  and  below  the  elbow, 
brings  the  hand  back  to  its 
place.  Figure  26  shows  how 
all  joints  are  moved :  1,  is 
the  Irene  of  the  arm  above 
the  elbow ;  2,  one  of  the 
bones  below  the  elbow  ;  3,  the  muscle  which  bends  the  elbow;  4,  5, 
attachments  of  muscles  to  bones ;  6,  the  muscle  that  extends  the 
elbow ;  7,  attachment  to  elbow  ;  8,  weight  in  hand.  The  musele,  3, 
contracts  at  the  central  part,  and  brings  the  hand  up  to  9,  10. 

The  complication,  variety,  and  swiftness  of  motion,  executed  by 
muscles,  are  past  conception.  Every  movement  which  a  human  be- 
ing makes,  from  the  heavier  motions  of  the  farmer  in  cultivating  his 
fields,  up  to  the  magic  touches  of  the  painter's  brush,  and  the  method*' 
ical  frenzy  with  which  the  great  master's  fingers  sweep  the  piano,  are 
all  made  by  muscles  obeying  an  intelligent  will. 


The  Teeth. 

The  teeth  are  not  like  other  bones,  either  in  composition,  method  of 
nutrition,  or  growth.  When  broken  they  do  not  unite,  not  being  fur- 
nished with  the  necessary  power  of  reproduction  of  lost  parts. 

Both  the  upper  and  lower  teeth  are  set  into  bony  sockets,  called 
alveolar  processes.  These,  with  the  fibrous  gums,  give  the  teeth  a 
very  firm  setting.  ^ 

Orig^in The  teeth  have  their  origin  in  little  membraneous  pouches 

within  the  bone  of  the  jaw ;  and  in  their  interior,  have  a  fleshy  bud. 
From  the  surface  of  this  the  bone  or  ivory  exudes.  The  tooth  and 
the  bony  socket  are  developed  and  rise  up  together,  —  the  former, 
when  suflSciently  long,  pushing  itself  through  the  gum. 

Number.  —  The  first  set  of  teeth  are  only  temporary,  and  are  called 
milk  teeth.  There  are  but  twenty  of  them.  Between  the  age  of  six 
and  fourteen,  these  become  loose,  and  drop  out,  and  the  permanent 
teeth  appear  in  their  places.  Of  these  there  are  thirty-two,  sixteen 
in  each  jaw. 


■'Hf^V 


T 


30 


ANATOMY. 


Kla<nes.  —  The  four  front  teeth  in  each  jaw,  a,  b,  Figure  27,  are  the 
cutting  teeth  (incisors)  ;  the  next  one,  c,  is  an  eye  tootfi  (cuspid)  ;  the 


next  two,  d,  e,  are  sinall  grinders  (bicuspids)  ;  the  last  three,/,  g,  A, 
are  grinders  (molars).  One  appears  late  on  each  side,  from  the  age 
of  twenty  to  twenty-four,  and  is  called  vnadom  tooth. 

Composition.  —  A  tooth  is  composed  of  ivory  and  enamel.  The 
internal  part  is  ivory,  which  is  harder  than  bone.  The  coating  tpon 
the  surface  is  enamel^  which  is  still  harder  than  ivory.  That  part 
which  rises  above  the  jaw  bone  is  called  the  crown;  it  is  this  only 
which  is  covered  with  enamel.  The  part  within  the  jaw  is  called  the 
root  or  fang;  this  is  composed  of  bony  matter,  through  which  small 
vessels  pass  in  to  nourish  the  tooth.  Small  white  nerves  also  pass 
into  the  tooth,  — of  the  presence  of  which  we  have  terrible  evidence 
in  tooth-ache. 

Use  of  tha  Teeth. 

Thb  incisors  cut  the  food  asunder;  the  molars  break  down  its 
solid  parts,  and  grind  it  to  a  fineness  which  fits  it  for  the  stomach. 

In  masticating  the  food,  the  lower  jaw  has  two  movements,  the  up 
and  down  motion,  like  a  pair  of  shears,  and  the  lateral  or  grinding 
motion.  These  two  movements  are  performed  by  different  sets  of 
muscles.  Flesh-eating  animals  have  only  the  up  and  down  motion ; 
vegetable  eating  animals  have  only  the  lateral  or  grinding  motion  ; 
while  man  has  both  the  up  and  down  and  the  lateral.  This  seems 
a  pretty  clear  intimation  that  he  is  to  eat  both  flesh  and  vegeta- 
bles. 

The  teeth  aid  us  in  articulating  words,  and  they  give  a  roundness 
and  symmetry  to  the  lower  part  of  the  face.  When  well  formed,  and 
kept  in  good  condition,  they  add  much  to  the  beauty  of  the  face,  and 
their  decay  is  an  irreparable  loss.  Their  proper  care  and  treatment 
are  spoken  of  in  another  place. 


The  a; 
the  phar; 
tines),  c 
(pancres 

Thep 
place  in  1 
the  salivi 

The  P 

opening 
jaw.     T 
Hence  tb 

TheSn 


lary;  4, 
The 

mouth,  ai 
soft  pala 
Itiie  nose 
to  the  sto 
going  to 
all  meet 
is  the  tra^ 
phagus ; 
5,  muse 
which  su 
cle  formii 

The  St 

the  firemi 
wind-pip( 
the  diaph 
laid  toget 


ANATOMY. 


31 


The  Digestive  Organs. 

The  alimentary  organs  are  the  mouth,  the  teeth,  the  salivary  glands, 
the  pharynx,  the  stomach-pipe  (cBSophagus),  stomach,  bowels  (intes- 
tines), chyle  vessels  (lacteals),  thoracic  duct,  liver,  and  sweet  bread 
(pancreas) . 

The  preparatory  process  of  digestion,  the  mastication  of  food,  takes 
place  in  the  mouth,  where  the  food  is  mixed  with  saliva,  a  secretion  of 
the  salivary  glands.     Of  these  glands  there  are  six,  three  on  each  side. 

The  Parotid  Gland  lies  in  front  of  the  external  ear.  It  has  a  duct 
opening  into  the  mouth  opposite  the  second  molar  tooth  of  the  upper 
jaw.  This  is  the  gland  that  swells  in  the  disease  called  mumps. 
Hence  the  disease  is  also  called  parotitis. 

The  Sabmaxillary  Gland  is  inclosed  within  the  lower  jaw,  in  front  of 

its  angle.  Its  duct  opens 
into  the  mouth  by  the  sido 
of  the  bridle  of  the  tongue 
(frsenum  linguae). 

On  each  side  of  this  string 
or  bridle,  and  under  the  mu- 
cous membrane  of  the  floor 
of  the  mouth,  lies  the  sublin- 
gual gland,  which  pours 
its  saliva  into  the  mouth 
through  seven  or  eight  small 
ducts.  A  disease  called  the 
Jrog,  consists  in  the  swel- 
ling of  this  gland.  Figure 
28  :  1 ,  the  parotid  gland ; 
2,  its  duct ;  3,  the  submaxU- 


FIO.28. 


FlO.  29. 


lary ;  4,  its  duct ;  5,  the  sublingual. 

The  Pharynx  is  a  continuation  of  the 
mouth,  and  is  the  cavity  just  below  the 
soft  palate.  The  two  passages  going  to 
Ithe  nose  (posterior  nares) ,  the  one  going 
to  the  stomach  (oesophagus) ,  and  the  one 
going  to  the  lungs  (larynx  and  trachea), 
all  meet  in  this  cavity.  In  Figure  29  :  1, 
is  the  trachea  ;  2,  the  larynx  ;  3,  the  oeso- 
phagus ;  4,  4,  4,  muscles  of  the  pharynx ; 
5,  muscles  of  the  cheek ;  6,  the  muscle 
which  surrounds  the  mouth ;  7,  the  mus- 
cle forming  the  floor  of  the  mouth. 

The  Stomach  Pipe  is  a  long  tube,  like 
the  fireman's  hose,  descending  behind  the 
wind-pipe,  the  lungs ,  and  the  heart,  through 
the  diaphragm  into  the  stomach.     It  is  composed  of  two  membranes 
laid  together,  like  two  pieces  of  cloth.     The  inner  one  is  mucous,  the 


32 


ANATOHT. 


outer  muscular.     The  two  sets  of  fibres  composing  the  muscular  coat 
are  arranged  circularly  and  longitudinally.     (Fig.  25.) 

The  Stomach  lies  in  the  upper  part  of  the  belly,  to  the  loft,  and  di- 
rectly under  the  diaphragm.  It  has  an  upper  opening,  where  the 
stomach-pipe  enters  it,  called  the  cardiac  orifice.  This  is  the  larger 
end  of  the  stomach,  and  lies  ou  the  left  side ;  the  smaller  end  con- 
nects with  the  upper  bowel,  at  which  point  it  has  an  opening  called 
the  pyloric  orifice.  In  addition  to  mucous  and  muscular  coats,  simi- 
lar to  those  which  compose  the  oesophagus,  the  stomach  has  still 
another  over  both,  a  serous  coat,  very  strong  and  tough,  to  give  this 
working  organ  additional  endurance.  Within,  it  has  many  glands  to 
secrete  the  gastric  juice. 

The  Intestines,  or  alimentary  tube,  or  bowels,  are  divided  into  the 
small  and  the  large  intestines. 

The  small  intestine  has  a  length  of  about  twenty-five  feet,  and  is 
divided  into  three  parts,  —  the  duodenum  iho  Jejunum  tmd  the  ileum. 

Of  these  three  divisions,  the  duodenum  is  the  largest,  and  is  about 
a  foot  in  length.  It  begins  at  the  pyloric  orifice  of  the  stomach,  and 
passes  backward  to  the  under  surface  of  the  liver,  whence  it  drops 
down  perpendicularly  in  front  of  the  right  kidney,  and  passes  across 
the  belly  behind  the  colon,  and  ends  in  the  jejunum.  v.    ' 

The  Jejunum  continues  the  above,  and  terminates  in  the  ileum. 

The  Ileum  is  a  continuation  of  the  jejunum,  and  opens,  at  an  obtuse 
angle,  near  the  haunch  bone,  into  the  colon.  A  valve  is  located  here, 
to  prevent  the  backward  passage  of  substances  from  the  colon  into 
the  ileum. 

At  this  point  the  large  intestines  begin,  and  here  is  situated  the 
ccecum,  a  blind  pouch,  or  cul-de-sac,  attached  to  which  is  the  appen^ 
dix  vermi/ormis,  a  worm-shaped  tube,  of  the  size  of  a  goose  quill, 
and  from  one  to  six  inches  long. 

The  Colon,  or  large  intestine,  is  divided  into  the  ascending  colon,  th^ 
transverse  colon,  and  the  descending  colon. 

The  Ascending  Colon  rises  from  the  right  haunch  bone  to  the  under 
surface  of  the  liver,  whence  it  bends  inward,  and  crosses  the  upper 
part  of  the  belly,  below  the  liver  and  stomach,  to  the  left  side.  This 
poitioa  which  crosses  over  is  the  transverse  colon.  From  this  point, 
on  the  left  side,  it  turns  down  to  the  left  haunch,  and  has  the  name 
of  the  descending  colon.  Here  it  makes  a  curve  like  the  letter  S, 
which  18  called  the  sigmoid  fiexure.  ^    *  '■ 

The  Rectum  is  the  lower  portion  of  the  large  intestine,  terminating 
at  the  anus. 

The  Lacteals  are  small  vessels  which  begin  in  the  villi,  upon  the 
mucous  membrane  of  the  small  bowels.  From  here  they  pass  be- 
tween membranes  of  the  mesentery  to  small  glands,  from  which  larger 
vessels  run  to  another  collection  of  glands ;  and  after  passing,  for  a 
space,  from  one  collection  of  glands  to  another,  at  each  stage  of  their 
progress  increased  in  size  and  diminished  in  number,  the  lacteals  pour 


their  cc 
the  dia{ 
forwarc 
right  b( 


and  swol 
the  thora 
away  wi 

The  LI 

BJde,  beic 
is  convex 
and  cone 
is   comp( 
Its  office 
weighs  : 
iiig    the 
body.    F: 
iiver:  1, 
2,  left  lob 
10,  gall  1 
into  whic 
fitted. 

The  Ga 

it  is  supi 
mms.  It 
pours  it  ii 

The  Pa 


ANATOMY. 


33 


•  s, 


Fia.ao. 


Fio.  31. 


their  contents  into  the  thoracic  dvct.  This  having  passed  up  through 
the  diaphragm, out  ol  the  belly,  iiiiikes  a  sudden  turn  downward  and 
forward,  and  empties  its  burden  into  a  large  vein  which  ends  in  the 
right  heart.     Figure   '60 :   1,  is   the   bowfd  ;  2,  3,  4,  the   mesenteric 

glands  tiirough  whieh  the  lacteals  pass ; 
5,  the  thoracic  duet ;  7,  the  spinal  column  ; 
8,  the  diaphragm. 

By  tlie  help  of  a  magnifying  glass,  all 
inlinite  number  of  these  small  vessels  rtiay 
be  seen  starting  from  the  rough,  shaggy  in- 
ternal coat  of  the  bowel. 

The  mesentery  \n  a  thick  sheet  of  mm? 
brane,  formed  of  several  folds  of  the  peri 
toneum,  and  spread  out  from  the  vertebrte 
like  a  fan.  The  bowels  are  attached  to 
its  edge,  and  are  held  by  it  in  their  place, 
and  at  the  same  time,  have  free  motion. 
Between  its  layers  are  a  great  number  of 
glands,  whieh  sometimes  become  diseased 
and  swollen  in  childnood,  and  prevent  the  chyle  from  passing  along  to 
the  thoracic  duct.  Thus  affected,  children  are  not  nourished,  and  waste 
away  with  a  disease  sometimes  called  mesenteric  consumption. 

The  Liver  is  a  large  gland,  lying  under  the  short  ribs  on  the  right 
pide,  below  the  diaphragm.  It 
is  convex  on  the  upper  surface 
and  concave  on  the  under,  and 
is  composed  of  several  lobes. 
Its  ollice  is  to  secrete  bile.  It 
weighs  about  four  pounds,  be- 
ing the  largest  .)rgan  in  the 
body.  Figure  31  represents  the 
liver :  1,  being  the  right  lobe ; 
2,  left  lobe  ;  3,  4,  smaller  lobes ; 
JO,  gall  bladder ;  17,  the  notch 
into  which  the  spinal  column  is 
fitted. 

The  Gall-Bladder  lies  on  the  under  side  of  the  liver,  and  receives, 
it  is  supposed,  the  surplus  bile,  which  is  reserved  for  special  occa- 
f<ions.     It  opens  into  the  gall  duct,  which  carries  the  bile  along,  and 
pours  it  into  the  duodenum. 
The  Pancreas,  Figure  32,  is  a  long,  flat  gland,  something  like  the  sali- 
vary glands.     It  lies  trans- 
versely across  the  back  wall 
of  the  abdomen,  behind  the 
stomach.   It  secretes  a  fluid 
called  the  pancreatic  juice, 
a  peculiar   kind  of  saliva, 
the   ollice  of  which  is  to 
emulsion  fat,  so  that  the 


FiQ  32. 


34 


ANATOMY. 


facteitiM  oil)  absorb  it.     Tliis  fluid  is  carried  by  a  duct,  and  pourcu 
iiilo  the  liiiodcnuin  jn.st  where  the  l)ile  duct  ent  th. 

The  Spleen  or  viUt,  \\;\n  \\n  ohioug,  flattened  form.  It  lies  on  the 
left  Hi(l«',  jurtt  under  the  dia|)lirugni,  e.nd  close  to  the  stomach  and  pan- 
creas. It  is  supposed  to  be  a  reservoir  for  holding  the  surplus  bk)od 
of  the  liver.  It  was  thought  by  the  ancients  to  be  the  seat  of  nx^lan- 
choly.  The  blood  in  passing  through  it  loses  a  portion  of  iU*  red 
globules. 

The  Ollieiltiiiii  or  cnul  is  a  doubling  and  extension  of  the  peri 
toneum.     It  is  a  kind  of  fatty  body,  which  lies  upon  the  surface  of 
the   bowels,  and   is  attached  to  the  stomach.     Its  use  seems  to  be  to 
mbricatc  the  bowels,  and  especially  to  protect  and  keep  them  warm. 

Ueiice  it  is  often  called  the  apron, 

■  t 

The  Urinary  System. 

The  organs  of  thic  system  are  devoted  to  separating  the  urine  from 
the  blood,  and  carrying  it  out  of  the  body.  These  organs  are  the 
kidneys,  the  vrelcrs,  the  bladder,  and  the  urethra. 

The  Kidneys  lie  one  on  each  side  of  the  back  bone,  in  the  lumbar 
region,  behind  the  peritoneum.  They  are  four  or  five  inches  long, 
and  two  and  a  half  broad.  They  are  in  shape  like  the  kidney  bean, 
and  weigh  about  half  a  pound  each.  In  the  centre  there  is  a  bag 
called  the  pelvis,  which  tapers  like  a  funnel,  and  forms  the  ureter 
which  conveys  the  urine  to  the  bladder.  The  texture  of  the  kidney 
is  dentse,  presenting  in  its  interior,  two  structures,  i««i  external  or 
cortical,  and  an  internal  or  medullary.  The  cortical  portion  has  the 
blood  vessels,  the  medullary  is  composed  of  tubes  which  carry  away 
the  urine. 

Tlie  Ureters  are  membranous  tubes  of  the  f?ize  of  a  goose  quill, 
and  eighteen  inches  long,  which  run  down  the  back  wall  of  the  abdo- 
men, behind  the  peritoneum,  to  the  bladder,  ii;to  each  side  of  which 
they  empty  their  contents. 

Tlie  Bladder  is  located  in  the  pelvis  or  basin,  in  front  of  the  rec- 
tum. It  is  composed  of  three  coats ;  the  external  is  serous,  the  middle 
muscular,  and  the  internal  mucous.  The  external  coat  is  strong  and 
fibrous ;  the  internal  is  drawn  into  wrinkles,  which  makes  it  thick  and 
shaggy  ;  it  secretes  a  mucus  which  prevents  it  from  being  injured  by 
the  corrosiveness  of  the  ine.  The  urine  is  retained  in  the  bladder  by 
means  of  a  circular  muscle,  called  a  sphincier,  ^vhich  draws  the  mouth 
of  the  organ  together.  When  the  quantity  of  urine  is  so  increased 
as  to  give  some  uneasiness  or  pain,  this  muscle,  by  a  sort  of  instinct, 
relaxes  and  lets  it  out. 

The  bladder  is  attached  to  the  rectum,  to  the  hip  bones,  to  the  peri- 
toneum, and  to  the  navel,  by  several  ligaments.  In  the  female  the 
bladder  ha'ls  the  womb  between  it  and  the  rectum. 

This  organ  is  wisely  provided  as  a  receptacle  for  the  urine;  which, 
without  it,  would  produce  great  inconvenience  by  being  constantly 
dribbling  away. 


Till 

of  tll( 

tic  fib 
urine 


T/,E 

dirisio 
liirhls. 

The 

voice,- 

<'!lll.-d 

(I'sophn 
posed  11 

TJie  1 

number 
merous. 

Tlie  \ 

ends  of 
passes  ir 

The  L 
other  on 
these  ord 
Each  1 
resting 
They 
vex  on 
The 
f^ach  oth 
iastinum 
form  this 
ill  the  ce 
Jobes;  t 
Each 
arc  conn 
into  very 
coiTipose( 
plied  wit 
In  the 
are  solid  _ 
have  been 
^xceedin 

In  cases 
desirable  t( 

afterwards 
will  oftcj 


are 


■«      I  !'■ 


ANATOMY. 


35 


Tin*  rrrtliru  i«  a  inetnbraiious  cnnal  which  leads  from  the  iicck 
of  ihi'  bhiddcr.  It  i«  composod  of  two  layers,  a  mneoiis,  and  an  eliis- 
tic  fibroiift.  ThiouRh  thin  channel,  which  is  curved  in  its  course,  the 
urine  passes  out  of  the  body. 


lich, 
intly 


The  Respiratory  Org^ans. 

TiiESR  organs  consist  of  the  winil-pipe  (trachea)  ;  divisions  and  sub- 
divisions of  the  wind  pipe  (bronchia);  air  cells;  and  the  L'.n^s  or 
li<^lils. 

The  WilKlpipe  (trachea)  extends  from  the  fnn/nx,  —  the  seat  of  the 
voice,  —  to  the  third  dorsal  vertebra,  where  it  divides  into  two  tubes, 
ciillcd  l)roncliia.  It  runs  down  the  front  uar^  of  the  throat,  with  the 
a-sopliagns  behind  and  between  it  and  the  ^pinal  column.  It  is  com- 
posed mainly  of  rings  of  cartilage,  cne  above  another. 

Tlie  Rruiicliial  Tllbcs  are,  at  the  division  of  the  windpipe,  two  in 
number,  but  they  divide  and  subdivide  until  they  become  very  nu- 
merous. 

Tlic  Air  Cells  or  Vesicles  are  small,  bladder-like  expansions  at  the 
ends  of  the  tubes.  They  are  elastic,  and  swell  out  when  the  air 
passes  in. 

• 

The  LuiljTS  fill  the  greater  part  of  the  chest,  the  heart  being  the  only 
other  organ  which  occupies  much  space  in  the  cavity.  The  size  of 
these  organs  is  large  or  small,  according  to  the  capacity  of  the  chest. 
Each  lung,  —  for  there  are  two,  —  is  a  kind  of  cone,  with  its  base 
resting  upon  the  diaphragm,  and  its  apex  behind  the  collar  bone. 
They  are  concavt.  .a  the  bottom,  to  fit  the  diaphragm,  which  is  con- 
vex on  its  upper  side. 

There  are  two  lungs,  a  right  and  a  left.  These  are  separated  fron' 
each  other  by  a  partition  formed  from  the  pleura,  and  called  the  7n  d- 
iastinum.  Two  portions  of  the  pleura,  coming  off  from  the  spine, 
form  this  partition  ;  and  the  heart,  covered  by  the  pericardium,  lies 
ill  the  centre,  between  them.  The  right  lung  is  divided  into  three 
lobes ;  the  left  into  two. 

Each  lobe  of  the  lungs  is  divided  into  a  great  many  lobules^  which 
are  connected  by  cellular  tissue.  These  lobules  are  again  divided 
into  very  fine  air-cells.  Beside  these,  the  substance  of  the  lungs  if 
composed  likewise  of  blood  vessels,  and  lymphatics,  and  is  well  sup 
plied  with  nerves. 

In  the  fetal  state,  before  the  lungs  have  been  filled  with  air,  they 
are  solid  and  heavy,  something  like  other  flesh,  but  after  all  their  cells 
have  been  filled  with  air,  and  breathing  has  been  established,  they  are 
"ixceedingly  light  and  spongy,  and  float  upon  water. 

In  cases  where  the  murder  of  children  is  suspected,  and  where  it  is 
dc&irablc  to  know  whether  they  were  still-born,  or  born  alive  and  killed 
afterwards,  the  specific  gruxnty  of  the  lungs,  compared  with  watei; 
will  oftcj.  s^^-tlc  the  question. 


— 


J) 


'  / 


% 


ANATOMY. 


/* 


The  Organs  of  Circulation. 

TiiR  food  hnviiig  bt'cn  digested,  (ilian^cd  to  chyle,  abnorbed  by  th« 
liU'tciilw,  curried  to  tin*  vt-iiif*.  poured  into  the  right  heart,  Bent  up  to 
lh«;  luiiffH,  iiiid  |)re|)nred  for  iioiirishiiig  the  l)ody,  will  still  be  UHciesH, 
if  not  JiHtributcd  to  every  part  of  the  Hy«tein.  The  orgtina  for  eftect- 
iiii;  thi»  diatributioii,  are  the  heart,  the  arteries,  the  veins,  and  the  cap- 
illiiriis. 

The  llciirt  is  plarrd  obliquely  in  the  ohent,  with  one  lunp[  on  each 
■side,  and  is  enclosed  between  the  two  folds  of  tlie  niediantinnrn.  Its 
inn  is  sotiiething  like;  a  cone.  Itn  base  is  turned  u|)ward  and  back- 
,<  ird  in  \\w  direction  of  the  right  shoulder;  the  apex  forward  and  to 
llie  left,  occupying  the  apace  between  tiic  fiflii  and  sixth  ribs,  about 
lliree  inches  from  the  breast-bone.  It  ia  aurruunded  by  a  niunibranoua 
L-ase  or  sac,  called  the  perirnri/iiiin. 

'Vhr  heart  is  a  nius(;ular  l)ody,  and  has  its  fibres  so  interwoven  that 
it  is  endowed  with  great  stn-ngt'i.  It  is  a  rlouble  organ  having  two 
sides,  a  right  and  a  left,  which  are  divided  fi-om  each  other  by  a  mus- 
I'ular  partition,  called  a  septuuK  The  right  heart  sends  the  bio  d  to 
the  lungs;  the  left  heart  distributes  it  to  the  general  system.  Each 
side  is  tlivided  into  two  coiupartinents,  an  auricle  and  a  ventricle. 

The  Awrlcles  have  thinner  walls  than  the  ventricles,  being  only  reser- 
voirs lo  hold  the  blood  until  the  ventrieles  force  it  along  to  other  parts. 

• 

The  Veiitrk'les  have  within  thern  fleshy  columns,  called  columrue 
carnefc.  The  walls  of  the  left  ventricle  are  thicker  than  those  of  the 
right,  being  recjuired  to  contract  v/ith  more  force.  Each  of  the  four 
c  vities  will  contain  from  one  and  a  half  to  two  ounces  of  blood. 

'file  TrI-cuspId  valves  are  situated  between  the  auricle  and  ventricle 
on  tne  right  side,  and  consist  of  three  folds  of  a  thin,  triangular 
membrane.  The  viilral  valves  occupy  the  same  ])osition  on  the  left 
side.  Small  white  cords,  called  chord<c  teiuliiuc,  pass  frt)m  the  floating 
edge  of  these  to  the  columnie  carneiE,  to  prevent  the  backward  pressure 
of  the  blood  from  carrying  the  valves  into  tlu^  auricles. 

The  pulmonary  artery  is  the  outlet  of  the  right  ventricle ;  the  large, 
artery,  called  aorta,  of  the  left  ventricle.  At  the 
opening  of  these  arteries,  are  membranous  folds, 
called  semilunar  valves.  Figure  33  gives  a  tine 
view  of  the  heart :  1,  is  the  right  auricle ;  tl,  the 
i^ft  auricle  ;  3,  the  right  ventricle ;  4,  the  left  ven- 
tricle ;  6,  6,  7,  8,  9,  10,  the  vessels  which  bring  the 
blood  to  and  carry  it  away  from  the  heart. 

The  Arteries  are  the  round  tubes  which  carry 
the  red  Hood  from  the  left  side  of  the  heart  to 
every  part  of  the  body. 

The  sides  of  arteries  are  stiff  and  hard,  and  do 
not  fall  together  wlH>n  empty.  They  may  often 
be  secji  open  in  a  piece  of  boiled  beef. 

The  arteries  have  three  coats,  —  an  external,  which  ia  cellular,  firm 


Fio.  as. 


and  M 
which 
the  hei 
which 

Tlie 

c.pe/iinj 
»rch,  V. 
other  tf 
they  en 
becomii 
around 

The  J 

In  the  c 
arteries 
into  the 
the  abdi 
to  each  ( 
red  blooi 

The  V 

vit"l  by 
every  pai 
tlie  capill 
purple,  a  I 
nearer  tl 
walls,  an 
in  the 
larger,  aij 
into  the 
to  those 
delicate, 
aid  in  cir 
The  lal 
pours  it  il 
one  whicf 
is  the  ver. 
The  pti 
aur.cle,  al 
tvhich  ca[ 

.  Tlie  Cij 

the  ends 
They  in( 
one  end, 
industrioj 
fe*!,  and  . 
take  the 
and  vitalil 
beginning 


ANATOMT. 


37 


unci  Htroiig ;  n  iniddlc,  which  in  fibroiiH  and  chistic ;  nnd  nu  intt'rniil, 
which  in  Hcroiis,  and  smooth,  l>cing  a  continuation  of  tlic  lining  of 
the  heart.  They  arc  wurroundcd  hy  a  ceil  rt'stjncnt  called  a  sheath, 
which  Hcparatea  thcn>  from  surrounding  organs.  , 

Tin"  Piiliiioiiiiry  Artery  starts  from  the  right  ventricle  in  front  of  the 
<i|)cning  of  the  aorta,  and  ascends  to  the  under  surface  of  tlie  aortic; 
arch,  v.liere  it  parts  into  two  branches,  Hcnding  one  to  tlie  right,  tho 
other  to  tlic  left  lung.  Having  divided  and  subdivided  to  a  gn*at  extent, 
they  end  in  the  capillary  vessels,  uniting,  joining  their  mouths,  and 
becoming  continuous  with  the  pulmonary  veins  just  where  tliey  pass 
around  the  air-cells. 

Tlie  Aortii  is  the  largest  artery  in  the  body.  It  takes  a  slight  turn 
ill  the  chest,  called  the  arch  of  the  aorta,  from  which  are  given  off  the 
arteries  which  carry  the  blood  to  the  head,  etc. ;  thc-nce  it  descends 
iato  the  belly  along  the  side  of  the  back  bone,  and  at  the  bottom  of 
the  abdomen  it  divides  into  two  arteries,  called  the  iliacs  —  one  going 
to  each  of  the  lower  limbs.  The  branches  the  aurta  gives  off  supply 
red  blood  to  every  part  of  the  body.  <:.  "• 

The  Veins  carry  the  dark  or  purple  blood.  Being  made  red  and 
vitnl  by  Hunrting  atmospheric  air  in  the  lungs,  and  then  conveyed  to 
every  part  of  the  body  in  the  arteries,  the  blood  lostis  its  redness  in 
the  capillaries,  and  comes  back  to  the  heart  in  tho  veins,  cark  and 
purple,  and  unfit  to  support  life.  Tho  veins  are  more  immerons  and 
nearer  the  surface  than  the  arteries.  They  have,  likewise,  thinner 
walls,  and  when  empty,  they  collapse  or  fall  together.  They  begin 
in  the  small  capillaries,  and  running  together,  they  grow  larger  and 
larger,  and  finally  form  the  great  trunks  which  pour  the  dark  blood 
into  the  right  auricle.  The  veins  are  composed  of  thrc  coats,  similar 
to  those  of  the  arteries,  with  the  exception  of  being  thinner  and  more 
delicate.  These;  vessels  have  valves  all  along  their  inner  surface,  to 
aid  in  circulating  the  blood. 

The  large  vein  which  receives  all  the  dark  blood  from  above,  and 
pours  it  into  the  right  auricle,  is  called  the  vena  cava  descemlens ;  the 
one  which  takes  it  from  below,  and  disposes  of  it  in  the  same  manner, 
is  the  vena  cava  ascendens. 

The  pulmonary  veins  bring  the  red  blood  from  the  lungs  to  the  feft 
aur'cle,  and  thus  are  exceptional  in  their  use,  —  being  the  only  veins 
which  carry  red  blood. 

.  The  CapUltiries  are  the  extremely  fine  net-work  of  vessels  between 
the  ends  of  the  arteries  on  the  one  side,  and  of  the  veins  on  the  other. 
They  inosculate,  or  join  their  mouths  to  the  very  small  arteries  at 
one  end,  and  to  the  equally  small  veins  at  the  other.  They  are  the 
industrious  little  builders  of  the  human  frame.  Receiving  the  blood, 
red,  and  full  of  life,  from  the  terminal  extremities  of  the  arteries,  they 
take  the  living  particles  out  of  it,  and  apply  them  to  the  renewing 
and  vitalizing  of  the  body,  and  then  pass  it  along  into  the  hair-like 
beginnings  of  the  veins,  dark  and  bereft  of  vitality,  to  be  carried  up  for 


rm 


^m 


88, 


ANATOMY. 


another  freight  of  chyle,  and  to  be  again  vitalized  by  being  touched 
in  the  lungs  by  the  breath  of  heaven. 

In  Figun^  34  we  iiave  a  good  ideal  illustration  of  the  whole  circu- 
lation. From  the  right  ventricle 
of  the  heart,  2,  the  dark  blood  is 
thrown  into  the  pulmonary  arte- 
ry, 3,  and  its  branches,  4, 4,  carry 
it  to  both  lungs.  In  the  capillary 
vessels,  6,  6,  the  blood  cornea  in 
contact  with  the  air,  and  becomes 
red  and  vitalized.  Thence  it  is 
returned  to  the  left  auricle  of  the 
heart,  9,  by  the  veins,  7, 8.  Thence 
it  passes  into  the  left  ventricle, 
10.  A  forcible  contraction  of  this 
sends  it  forward  into  the  aorta,  11. 
Its  branches,  12, 1£|,  13,  distribute 
it  to  all  parts  of  tlie  body.  The  I 
arteries  terminate  in  the  capilla- 
ries, 14, 14.  Here  the  blood  loses 
its  redness,  and  goes  back  to  the 
right  auricle,  1,  by  the  vena  cava 
descendens,  lo,  and  the  vena 
cava  ascendens,  16.  The  tricus- 
pid valves,  17,  prevent  the  reflow 
of  the  blood  from  the  right  ven- 
tricle to  the  right  auricle.  The 
semilunar  valves,  18,  prevent  the 
blood  from  passing  back  from  the 
pulmonary  artery  to  the  right  ventricle.  The  mitral  valves,  19,  pre- 
vent its  being  forced  back  from  the  left  ventricle  to  the  left  auricle. 
The  semilunar  valves,  20,  prevent  the  backward  flow  from  the  aorta 
to  the  left  ventricle. 

By  a  careful  examination  of  this  diagram,  with  these  explanations, 
the  reader  may  understand  the  circulation  very  well. 

The  passage  of  the  blood  from  the  right  heart,  through  the  lungs, 
and  back  to  the  left  heart,  is  called  the  lesser,  or  puf manic  circulation ; 
its  passage  from  the  left  heart  through  all  parts  of  the  body,  and  back 
to  the  right  heart,  is  the  greater  or  systemic  circulation. 

The  Absorbent  Vessels. 

The  vessels  which  absorb  the  chyle  from  the  small  intestines,  and 
convey  it  onward  towards  the  blood,  are  the  lacteals.  They  have 
been  described.  The  veins  are  al^o  supposed  to  have  the  pov/er  of 
absorption,  particularly  the  small  commencement  of  vhe  veins.  These 
have  likewise  been  described. 

The  Lyiupliatic  vessels  resemble  the  lacteals.  They  abound  in  the 
skin,  the  mucous  membranes,  and  the  lungs.  They  are  very  small  at 
their  origin,  and,  like  the  veins,  they  incfease  in  size,  as  they  diminisb 


in  numbe 
their  con 
coats;  til 
into  valv( 
These 
called  lyi 

neck,  ches 
some  exte 
the  body, 
single  lyn 
magnified 
the  valves 
lymphatic 
shows  a  ly 
the  vessels 

Fio.  38. 


Figure 
lymphatic 
1,2,3,4,5 
sels  of  the 
inguinal  g 
mencement 
duct,  into  w 
of  the  lym 
9,  the  lym 
'leys;  lb, 
afh;    11,  t 
12,  12,  thos( 
14,  15,  those 


ANATOMY. 


39 


Fia.  35. 


ill  numbers.     Like  the  veins,  too,  they  travel  towards  the  heart,  and 

their  contents  are  poured  into  iL     Their  walls  are  composed  of  two 

coats ;  the  external  is  cellular,  and  distensible  ;  the  internal  is  folded 

into  valves,  like  that  of  the  veins. 

These  vessels,  on  their  way  to  the  heart,  pass  through  soft  bodies, 

called  lymphatic  gljinds^  which  bear  to  them  the   relation  that  the 

mesenteric   glands   do   to  the    lac- 
teals.    These  glands  are  a  collection 
'of  small  vessels.      The   lymphatic 
glands  are    most    numerous  in  the 

neck,  chest,  abdomen,  arm-pits,  and  groins.     They  are  also  found,  to 

some  extent,  in  other  parts  of 

the  body.    Figure  35  shows  a 

single  lymphatic  vessel,  much    . 

magnified;  Figure  36  exhibits 

the  valves  along   one  of  the  \3Eil^^^'* 

lymphatic  trunks ;  Figure  37     i  ^E^^^*'' 

shows  a  lymphatic  gland,  with  lB^HK-18 

the  vessels  passing  through  it.  *  '^^ 


Fia.  i 


Fio.  37. 


Figure  38  represents  the 
lymphatic  vessels  and  glands. 
1,  2,  3,  4, 5,  6,  show  these  ves- 
sels of  the  lower  limbs ;  7,  the 
inguinal  glands;  8,  the  com- 
mencement of  the  thoracic 
duct,  into  which  the  contents 
of  the  lymphatics  are  poured ; 
9,  the  lymphatics  of  the  kid- 
neys ;  10,  those  of  the  stom- 
ach;  11,  those  of  the  liver; 
12,  12,  those  of  the  lungs;  13, 
14, 15,  those  of  the  arm ;  16,  17, 


^ 


40 


ANATOMY. 


20,  the  large  veins' ;  21,  the  thoracic  duet;  26,  the  lymphatics  of  the 
heart. 

A  cold  will  often  cause  lymphatic  glands  to  swell.  These  swell- 
ings are  called  kernels.  They  often  swell,  also,  without  the  irritation 
from  cold,  and  become  very  mtieh  and  permanently  enlarged,  particu- 
larly in  scrofula.  In  scrofulous  subjects  they  sometimes  suppurate 
anci  break,  forming  bad  .'<ores  upon  the  neck.  ..^  ^^ 

The  Organs  of  Secretion. 

Thk  exhalanls,  the  fullicles,  and  the  glands  are  the  organs  of  secre- 
tion. 

The  Exlialaitts  are  the  sweat-glands.  These  have  external  termina- 
tions iij)on  the  skin,  thus  communicating  with  the  air,  and  internal 
terminations  upon  the  surfaces  of  organs  not  having  an  outward  ex- 
posure. 

The  Follicles  are  small  sacs,  located  in  the  true  skin  and  mucous 
membranes.  The  pores  of  the  skin  are  the  mouths  or  outlets  of  these 
little  bags.     Veins  and  organic  nerves  are  sent  to  these  vessels. 

Glands  are  soft  organs,  having  a  variety  of  structure,  and  perform- 
ing many  kinds  of  secretion.  A  gland  is  fio. sa, 
made  up  of  several  lobules,  united  in  one 
mass,  and  each  of  these  lobules  has  a  small 
duct  communicating  with  a  main  duct 
which  forms  the  outlet  Figure  39  shows  a 
gland ;  2,  the  smalt  ducts  spread  through  its 
body,  and  running  together ;  1,  the  large 
duct,  through  which  the  secreted  substance 
is  carried  away. 

The  mesenteric  and  lymphatic  glands 
merely  modify  the  fluids  which  pass  through  them ;  others  secrete 
from  the  blood  either  iluids  to  be  used  in  the  body,  or  such  as  are  to 
be  cast  away.  ' 

The  Vocal  Organs. 

No  sounds  touch  the  heart  like  those  of  the  human  voice,  for  no 
mechanic,  "however  scientific  and  skilful,  has  ever  been  able  to  make 
an  iiif^trument  which  could  produce  sounds  as  beautiful,  tones  as 
varied,  a  timbre  as  melodious,  and  inflexions  as  manifold  and  agree- 
able. It  has  been  compared  to  wind,  reed,  and  stringed  instruments. 
In  touching  expression,  it  is  most  resembled  by  the  concert-horn,  the 
bassoon,  and  the  hautboy. 

Vocal  sounds,  past  alt  question,  are  produced  in  the  larynx,  but 
these  sounds  are  grouped,  or  formed  into  articulate  speech,  by  the 
pharynx,  the  nasal  cavities,  the  tongue,  the  teeth,  etc. 

The  Liirj'UX  is  a  kind  of  cavity  or  tube  at  the  top  of  the  windpipe, 
formed  by  the  union  of  five  cartilages,  namely,  the  thyroid,  the  cricoid, 
the  two  arytenoid,  and  thi  epiglottis.  Ligaments  bind  these  together, 
imd  muscles  move  them. 


^m 


ANATOMY. 


41 


Fia.  4(X 


Tlie  ThjTold  Ctlltilas^e  is  compoacd  of  two  parts,  and  has  a  con- 
nection witii  the  bone  of  the  tongue  abore,  and  with  the  cricoid  car- 
tilage below. 
The  Cricoid  Cartilnire  is  shaped  like  a  ring,  and  hence  its  Greek 
name.     It  is  narrowest  in  front,  and  broadest  be- 
hind.   It  connects  with  the  thyroid  cartilage  above, 
and  with  the  first  ring  of  the  trachea  below.     Fig- 
ure 40  gives  a  side  view  of  the  cartilages  of  the 
larynx  :  1,  bone  at  the  base  of  the  tongue  (os  hyo- 
ides) ;  2,  the  ligament  connecting  hyoid  bone  and 
the  thyroid  cartilage  ;    3,  the  front  of  the  thyroid 
cartilage ;  4,  the  thyroid  cartilage ;   6,  the  cricoid 
cartilage  ;  7,  the  windpipe. 

Figure  41  is  a  back  view  of  the  cartilages 
ligaments  of  the  larynx  :  1,  is 
the  back  surface  of  the  epiglot- 
tis ;  3,  3,  the  os  hyoides  ;  4,  4, 
the  lateral  ligaments  connect- 
ing the  os  hyoides  and  the  thyroid  cartilage ;  5, 
5,  the  back  face  of  the  thyroid  cartilage ;  6,  6, 
the  arytenoid  cartilages  ;  7,  the  cricoid  cartilage ; 
8,  the  first  ring  of  the  windpipe. 


nd 


Fia.  41. 


Fl0.4a. 


Tlie  Arytenoid  Curtllag:es  are  upon  the  back 
part  of  the  cricoid,  and  are  connected  with  the 
thyroid  cartilage  by  the  vocal  cords. 

Tlie  E|iijt;luttis  is  a  fibro-cartilaginous  lid,  shaped 
like  a  leaf  of  parsley,  which  covers  the  upper  open- 
ing of  the  larynx.  It  is  connected  by  a  cartilage 
to  the  bone  of  the  tongue  (os  hyoides)  and  to  the  thyroid  cartilage. 
Breathing  opens  and  shuts  it ;  and  in  swallowing,  it  closes  down  upon 
the  top  of  the  larynx,  to  prevent  food  and  drink  from  passing  down 
the  windpipe. 

The  Vocal  Cords  are  two  ligament.s,  formed  of  elastic  and  parallel 

fibres,  enclosed  in  a  fold  of  mucous  mem- 
brane. They  are  about  two  lines  in  width, 
I  and  inserted  behind  into  the  anterior  pro- 
jection of  the  arytenoid  cartilages,  and 
passing  forward,  are  fixed  to  the  anterior 
angle  of  the  thyroid.  There  are  four  liga- 
ments crossing  the  larynx,  two  superior, 
and  two  inferiors — the  latter  being  called 
vocal  cords.  The  interval  between  them 
is  the  glottis.  The  ligaments  themselves 
are  sometimes  called  the  lips  of  the  glottis. 
The  depression  between  the  superior  and 
inferior  ligaments  is  the  ventricle  of  the 
larynx. 

Figure  42  represents  a  view  of  the  larynx  from  above  :  a,  b,  c,  the 
thyroid   cartilage,  enclosing  the  ring  of  the  cricoid ;   h,  h,  e,  e,  the 


42 


ANATOMY. 


arytenoid  cartilages  ponnected  by  the  transverse  arytenoid  muscle : 
I,  t,  the  vocal  cords ;  o,  o,  the  crico-arytenoid  ligaments. 

The  mnsdes  which  are  attached  to  the  cartilages,  have  the  power 
of  pulling  th(?m  about  so  as  +o  change  in  various  ways  the  shape  of 
the  laryngeal  cavity  ;  to  eni.  ge  or  diminish  the  size  of  the  glottis ; 
and  to  relax  or  tighten  the  vocal  cords.  By  these  means,  and  some 
others,  the  sounds  of  the  voice  receive  their  various  modificationa. 
Tightening  the  cords,  for  example  raises  the  pitch. 


Fia.  43. 


The  Skin. 

The  skin  is  a  membrane  composed  of  two  layers,  covering  the 
entire  person.  The  outer  layer  is  the  scarf-skin  or  cuticle ;  the  inner 
is  the  true  skin  or  cutis  vera.  These  layers  differ  in  their  structure 
and  uses. 

Tlie  Scarf-Skin,  called  also  cuticle,  and  epidermis,  is  a  thin  mem- 
brane, partially  transparent,  like  a  thin  shaving  of  horn.  Having  no 
blood  vessels  or  nerves,  and  conse- 
quently no  feeling,  it  appo;us  +^  be 
a  simple  covering  to  protect  the 
true  skin  from  injury  by  external 
agents.  It  is  thickest  on  those 
parts  most  exposed  to  friction. 

The  scarf-skin  is  the  production 
of  the  true  skin,  —  an  exudation 
from  it  in  the  shape  of  a  fluid 
which  is  spread  out  as  a  thin  layer, 
and  dries  up  into  flattened  scales. 
The  cuticle  is  composed  chiefly  of 
these  scales,  and  i .  constantly  be-  'j 
ing  rubbed  off  as  scurf,  while  new 
layers  are  forming  underneath. 

The  lower,  softer,  and  more  newly-formed  layers  of  the  scarf-skin, 
are  the  seat  of  color.  In  this  part,  the  cells  contain  a  pigment,  incor- 
porated with  the  elementary  granules,  which  gives  to  the  variou.s 
races  their  several  shades  of  color.  The  depth  of  hue  is  dependent 
entirely  on  the  amount  of  this  coloring  matter. 

Some  physiologists  describe  the  skin  as  composed  of  three  layers 
—  reckoning  this  colored  part  of  the  cuticle  as  one,  and  naming  it 
rele  vwcosuin,  or  the  mucous  coat. 

The  Trae  Skin,  which  is  called  cutis  vera,  and  corium,  is  a  kind  of 
web,  woven  of  small  fibres  collected  into  strands.  In  the  upper  por- 
tion, the  web  is  fine  and  firm,  but  grows  coarser  below.  Connected 
with  its  under  surface  is  a  fibrous  web  in  which  the  fat  is  deposited. 
Upon  its  upper  surface  is  the  sensitive  or  papillary  layer,  composed 
of  blood  vessels  and  nerves,  doubled  into  loops,  which  give  little 
prominences  called  papillfc.  Figure  43  gives  an  ideal  view  of  the.se 
elevations,  composed,  as  tliey  are,  of  a  nerve,  an  artt-ry,  and  a  vein, 
iying  side  by  side  :  1,  1,  represent  the  true  skin ;  2,  2,  the  papiliar> 


>,A 


L. 


ANATOMY. 


43 


layer ;  3,  3,  the  arteries  ;  4,  4,  the  veins  ;  and  5,  5,  the  nerves  of  the 
papilliE. 

The  arteries,  veins,  and  nerves  are  spread  over  the  true  skin  in 
great  numbers,  —  so  profusely,  that  it  is  impossible  to  push  the  point 
of  the  finest  needle  into  it,  ^»'ithout  piercing  a  blood  vessel  and  a 
nerve. 

Figure  44  gives  a  view  of  the  skin  :  a,  a,  the  cuticle ;  6,  b,  the  col- 
ored layer  of  the  cuticle  ;  c,  c,  d,  df  the  true  skin  ;  e,  e,  e,  fat  cella, 
ft  Ufi  »w<'  it  tubes. 

Fio.  44. 
iff 


rta.4B. 


The  lymphatics  are  very  numerous,  in  the  skin,  beside  which  there 
are  oil  glands  and  tuhes^  and  sweat  glands  and  tubes.  i 

The  Oil  GlaildM  are  imbedded  in  the  skin,  and  communicate  with 
the  surface  by  small  tubes.  They  are  most  abundant  on  the  face, 
nose  and  ears.  Figure  45  shows  an  oil  gland,  —  ft,  being  the  gland, 
6,  the  tube,  and  c,  its  mouth. 

The  Sweat  Apparatus  consists  of  small  tubes  which  pass  down 

^..= — —^. II 


I 


.  f:; 


m 


Tvs^imi': 


44 


ANATOMY. 


throngh  the  true  skin,  and  terminate  in  the  meshes  at  the  bottom, 
where  it  coils  upon  itself  into  a  kind  of  bu  jdle,  called  the  perspiru' 
tory  gland.  Figure  46  gives  one  of  these  tubes,  with  the  gland,  mag< 
nified  forty  diameters :  1,  being  the  coiled  tube  or  gland ;  2,  3,  the 
two  excretory  ducts  from  the  gland.  These  uniting,  form  one  spiral 
tube,  which  opens  at  4,  which  is  the  surface  of  the  cuticle ;  3,  are  the 
fat  cells. 

The  hair  and  the  nails  are  appendages  of  the  skin. 


The  Nervous  System.     ,     ,    ,  ' 

The  Nervous  System  consists  of  the  brain  and  spinal  cord,  connected 
with  each  other,  and  called  the  cerebrospinal  axis ;  the  cranial  nerves  ; 
the  spinal  nerves  and  the  si/mpathetic  nerve. 

The  Brain  is  that  mass  of  nervous  matter  lodged  within  the  t>kull 
bones.  It  is  made  up  of  three  parts,  —  the  cerebrum,  the  cerebellum, 
and  the  medulla  oblongata.  These  are  nioely  covered  and  protected 
by  three  membranes,  the  dura  mater,  the  arachnoid,  and  thepta  mater. 

Figure  47  shows  a  considerable  portion  of  the  brain,  —  the  skull 
bones  and  membrane;-"  being  re- 
moved. The  scalp  turned  down  is  '"'  '^ 
represented  by  a,  a  ;  e,  e,  e,  show 
the  cut  edge  of  the  bones ;  c,  is  the 
dura  mater,  drawn  up  with  a  hook  ; 
F,  the  convolutions  of  the  brain. 


Tlie  Cerebroni  is  the  upper  and 
larger  portion  of  the  brrfin,  and  is 
divided  into  two  hemispheres  by  a 
fissure.  A  portion  of  the  dura  mater 
dips  into  this  cleft,  and  from  its  re- 
semblance to  a  sickle,  is  called  the 
falx  cerebri.  The  design  of  this 
seems  to  be  to  support  each  half  of 
the  brain,  and  to  prevent  it  from 
pressing  upon  tke  other  half  when 
the  head  reclines  to  one  side. 

The  undulating  sur''ice  of  the 
cerebrum  is  produced  .<y  what  are  called  convolvlions.  The  lower 
surface  of  this  organ  is  divided  into  three  lobes,  —  the  anterior,  the 
middle,  and  the  posterior. 

The  surface  of  the  cerebrum  is  of  a  gray  color,  called  cortical,  or 
cinerilious ;  the  central  portion  is  white,  and  is  called  medullary. 

The  €erebelluni  is  about  one-sixth  the  size  of  the  cerebrum.  It 
lies  just  under  the  posterior  lobe  of  the  cerebrum,  and  is  separated 
from  it  by  an  extension  of  the  dura  mater,  called  the  tentorium.  It 
is  composed  of  white  and  gray  matter ;  when  the  former  is  cut  into, 
there  is  presented  the  appearance  of  the  tnink  and  branches  of  a  tree., 
called  arbor  vitce. 


The  Hi 

in  the  ei 
oonsittta  ( 

The  m 

and  spini 
and  for\x 
and  spini 

The  Ar 

branes,  is 
ihira  mat 

The  Pii 

the  whol 
furnishes 

The  Cn 

In  readin 
ure48. 

The  Fir 


TheFw 

muscle  of 

TheFif 

roots,  an( 
heavl^  anc 
eye,  the 
and  the  t 
jaw,  and 
the  branc 
aifection 

The  Six 

which  the 
external 


▲NATOHT. 


45 


The  HeUiJ*o  Oblongata  is  the  top  of  the  spinal  cord ;  but  being  with* 
in  the  encloHure  of  the  skull,  it  passes  for  a  portion  oi  the  brain.  It 
consists  of  three  pairs  of  bodies,  united  so  as  to  form  a  bulb. 

The  Dura  Hater  is  a  strong,  fibrous  membrane  which  lines  the  sknU 
and  spinal  column,  and  sends  processes  inward  to  s'ipport  the  brain, 
and  forward,  as  sheaths  for  the  nerves  which  go  out  from  the  brain 
and  spinal  cord. 

The  Arachnoid  is  a  serous  membrane,  and  like  all  other  serous  mem* 
hranes,  is  a  closed  sac.  It  is  reflected  upon  the  inner  surface  of  the 
ilura  mater. 

The  Pia  Hater  is  a  vascular  membrane,  and  lies  next  to  and  invests 
the  whole  surface  of  the  brain,  —  dipping  into  its  convolutions.  It 
furnishes  nutriment  to  the  brain. 

The  Criinial  Nerves  which  go  out  from  the  brain  are  in  twelve  pairs. 
In  reading  a  description  of  them,  let  the  reader  keep  his  eye  on  Fig« 

ure  48. 

The  First  Pair,  olfactory  (6),  passes  through  several  small  open* 
Via.  48.  ings  in  the  ethmoid  bone,  and 

is  distributed  to  the  mucous 
membrane  which  lines  the 
nose.  Destroy  this,  and  the 
sense  of  smell  is  gone. 

The  Second  Pair,  optic  nerve, 

(7),  passes  through   the  base 

of  the  skull,  and  enters  the 

I  cavity  of  the  eye  where  it  is 

'expanded  upon  the  retina.    It 

is  a    disease    of  this    nerve 

which    occasions    a   gradual 

loss  of  sight,  called  anumrosis. 

The  Third  Pair,  motores  oc- 

ulorum  (9),  passes  through  the 

sphenoid  bone  to  the  muscles 

of  the  eye. 

The  Fourth  Pair.,  patheticus  (10),  passes  to  the  superior  oblique 
muscle  of  the  eye. 

The  Fifth  Pair,  trifacial  nerve  (11),  like  the  spinal  nerves  has  two 
roots,  and  divides  into  three  branches,  one  going  to  the  eye,  fore* 
heav!<  and  nose,  and  called  the  qpthalmic  branch ;  another  going  to  the 
eye,  the  teeth  of  the  upper  jaw,  etc.,  called  the  superior  maxillary ; 
and  the  third  going  to  the  ear,  the  tongue,  and  the  teeth  of  the  lower 
jaw,  and  called  the  inferior  maxillary.  It  is  a  painful  condition  of 
the  branches  of  the  fifth  pair,  which  constitutes  the  terrible  neuralgic 
affection  called  tic  douloureux. 

The  Sixth  Pair,  abducentes  (12),  passes  through  the  opening  by 
which  the  carotid  artery  enters  the  cavity  of  the  skull,  and  goes  to  the 
external  straight  muscle  of  the  eye. 


'     i 


•^i; 


IP 


i 

I 

■J:l 
■II 


46 


ANATOMY. 


Tlie  Sfveutli  Pair,  portio  mollis  (13),  is  distributed  upon  the  inter 
nal  cur. 

The  Eiffhth  Pnlr,  facial  nrrvc  (14),  is  distributed  over  the  face.  It 
sends  nervous  filainenta  to  the  muscles. 

Tlie  !\Ilnth  Pair,  glosso-plmryngcal  nerve  (14),  passes  through  the 
name  op<M)ing  with  the  jugular  vein,  and  is  distributed  upon  the  mu- 
cous membrane  of  the  tongue  and  throat. 

The  Tenth  Pair,  pneumogastric  nerve  (15),  sends  its  branches  to  the 
pharynx,  larynx,  stomach-pipe,  lungs,  spleen,  pancreas,  liver,  stomach, 
iiid  bowels. 

Tlie  Eleventh  Pair,  spinal  accessory  nerve  (16),  connects  with  the 
ninth  and  tenth  pairs,  and  is  distributed  to  the  muscles  of  the  neck. 

The  Twelfth  Pair,  hypo-glossal  nerve  (17),  goes  to  the  tongue,  and 
is  its  motion-producing  nerve.  It  is  a  nerve  of  great  energy  in  those 
who  talk  much. 

The  Spinal  Cord  extends  from  the  medulla  oblongata,  where  it  is  in 
connection  with  the  brain,  down  to  the  second  lumbar  vertebra.  The 
upper  end  of  the  cord  presents  a  bulbous  swelling,  or  enlargement. 
Another  swelling  is  found  where  the  nerves  are  given  off  which  go  to 
the  upper  extremities ;  and  a  third  near  the  end  of  the  cord,  where 
the  nerves  begin  which  go  to  the  lower  extremities. 

Fi?sure8  dip  into  the  cord  before  and  behind,  and  divide  it  into  two 
lateral  parts,  which  are  united  by  a  thin  layer  of  white  substance; 

These  lateral  columns  are  divided  by  furrows  into  anterior,  lateral^ 
and  posterior  columns;  —  the  anterior  being  supposed  to  be  the 
motor  column,  the  posterior  that  of  sensation,  and  the  lateral  divided 
in  function  between  motion  and  sensation. 

Tlie  Spinal  Hfenes,  connecting  with  the  cord,  are  in  pairs,  of  which 
there  are  thirty-one. 
Each  pair  has  two 
roots,  —  a  motor 
root,  C,  Figure  49, 
ariLing  from  the 
anterior  columns  of 
the  cord,  and  a 
sensitive  root,  D, 
springing  from  the 
posterior    columns.  „ 

A,  is  a  section  of 
the  cord,  surround- 
ed   by   its    sheath. 

B,  is  the  spinal  nerve,  formed  by  the  union  of  the  motor  and  sensitive 
roots.  After  the  union,  the  nerve,  with  its  motor  and  its  sensitive 
filaments,  divides  and  subdivides  as  it  passes  on,  and  is  distributed  to 
the  tissues  of  the  several  organs. 

The  thirty-one  pairs  of  spinal  nerves  are  divided  into  eight  pairs  of 
cervical,  twelve  pairs  of  dorsal,  five  pairs  of  lumbar,  and  six  pairs  of 
sacral  nerves. 


Fio.48. 


Figure  50 
eiveri  ofT  by 
3,  y,  the  cere 
pair;  8,  the 
portion   of  tl 
the  spinal  ne 
aacral  plexus. 
Fia 


J^r^t;^.' 


Ut 


Tlie  Brachi 

cervical  and 
which  are  dis 

The  Lumba 

lumbar  nerve 
lower  extremi 
nerves  are  sen 

ties. 

The  Sympai 

along  on  each 
There  is  a  knc 
knots  are  com 


■ra 


ANATOMY. 


47 


Figure  50  gives  a  view  of  the  brain  and  spinal  eord,  with  the  nerves 
given  off  by  the  latter :  1,  1,  being  the  two  hemispheres  of  the  brain  ; 
3,  3,  the  eerebellum  ;  4,  the  olfaetory  'rre  ;  5,  tiie  optic ;  7,  the  third 
pair ;  8,  the  pons  varolii,  so  called ;  9,  the  fourth  pair ;  10,  the  lower 
portion  of  the  medulla  oblongata;  11,  11,  the  spinal  cord;  12,  12, 
the  spinal  nerves;  13,  13,  the  brachial  rjlexus;  14,  14,  the  lumbar  and 
lacral  plexus. 

Fio.ea  '^  Fio.  Bt. 


Tlie  Brachial  Plems  is  formed  by  the  interlacing  of  the  four  lower 
cervical  and  upper  dorsal  pairs  of  nerves.  It  gives  off  six  nerves, 
which  are  distributed  to  the  muscles  and  sicin  of  the  upper  extremities. 

The  Lumbar  and  Sacral  Plexus  is  formed  by  the  last  dorsal  and  five 
lumbar  nerves,  from  which  nerves  go  to  the  muscles  and  skin  of  the 
lower  extremities,  and  the  last  lumbar  and  four  sacral,  from  which 
nerves  are  sent  to  the  muscles  and  skin  of  the  hips  and  lower  extremi- 
ties. 

The  Sympathetic  Hferve  consists  of  a  series  of  knots  (ganglia),  lying 
along  on  each  side  of  the  spinal  column,  and  forming  a  knotted  chain. 
There  is  a  knot  for  each  intervertebral  space,  the  neck  excepted.  These 
knots  are  composed  of  both  cineritious  and  medullary  matter. 


I 


i 


m 


a:1S 


:'  n 


I'l 


m 


'f    -  -Jf- 


48 


ANATOMT. 


Each  knot  is  a  distinct  centre,  and  gives  off  branches  upward, 
downward,  externally,  and  internally.  All  the  internal  organs  are 
supplied  with  brunches  from  the  Hympathetic  nerve.  It  is  called  the 
nerve  of  organic  life,  and  is  supposed  to  preside  over  nutrition,  secre- 
tion, etc.,  as  the  nerves  of  the  brain  and  cord  preside  over  motion  and 
sensation. 

Figure  51  is  a  fine  represehtation  of  the  great  sympathetic,  with 
its  knots,  ?.iid  connections  with  other  nerves.  A,  A,  A,  is  the  semihn 
nar  ganglion  and  solar  plexus,  lying  just  under  the  diaphragm  and 
behind  the  stomach.  Its  presence  in  this  region  is  th»!  reason  why  a 
"blow  upon  the  pit  of  the  stomach  sometimes  destroys  life.  D,  D,  D, 
are  the  thoracic  ganglia ;  E,  E,  the  external  and  mternal  branches 

of  the  Biune  ;  G,  F,  the  right  and  left  coro- 
nary plexus  upon  the  heart ;  I,  N,  Q,  the 
inferior,  middle,  and  superior  cervical  gan- 
glia ;  J,  the  renal  plexus  around  the  kid- 
neys ;  2,  the  lumbar  ganglion ;  3,  the  inter- 
nal branches  ;  4,  the  external  branches ;  5, 
the  aortic  plexus. 

Figure  52  represents  a  plexus,  showing 
how  the  filaments  of  one  nerve  pass  to  be  enclosed  in  the  sheath  of 
another.  In  this  way  they  change  at  once  the  direction  of  their  jour- 
ney, and  their  companioAs  upon  the  way. 


Fiu.  62. 


Fio.68. 


The  Organs  of  Sight. 

The  organs  of  vision  are  the  optic  nerve,  the  globe  of  the  eye,  the 
muscles  of  the  eye.,  and  the  organs  of  protection. 

Tlie  Optic  Nerve  begins  by  two  roots  at  the  base  of  the  brain,  the 
fibres  from  each  of  which  meet,  as  they 
come  forward,  and  some  of  them  cross 
each  other.  The  two  nerves  then  sepa- 
rate, and  enter  the  back  part  of  the 
globe  of  the  eyes,  and  then  spread  out 
into  a  kind  of  membrane.  In  Figure 
53 :  1,  1,  show  the  globe  of  the  eye ; 
2,  the  crossing  of  the  optic  nerve ;  8, 
the  origin  of  two  pairs  of  cranial  nerves. 

The  Globe  of  the  Eye  is  a  better  con- 
structed optical  instrument  than  man 
ever  made.  Its  interior  is  filled  with 
what  are  called  refracting  humors  or 
mediums,  which  are  surrounded  and  held  in  their  place  by  membranes, 
called  coats. 

The  Coats  are  the  sclerotic  and  cornea;  the  choroid,  iris,  and  ciliarf 
processes  ;  and  the  retina. 

The  Sclerotic  Coat  is  a  fibrous  membrane,  covering  the  largest  portioq 


of  the  gloh 
is  called  t 
which  the 

The  Con 

iihont  one- 
bJood-vessc 

The  Choi 

nnlly,  and  \ 
tcriiaily,  ar 
layers. 

The  Iris 

persons.     Ij 
bers  of  the 
pupil.     Of  i 
and  dilate  tl 
its  contracti 

The  Cillai 

nal layer  of 

The  Refin 

middle  is  r 
internal  is  v 
vessels. 

The  divic 
namely,  the  i 
the  iris ;  4,  i 


The  Hnnw 

I'UreouJi. 

^he  A(|ue(i 

*>y-     It  is  an 
cihc  gravity  i 


ANATOMY. 


49 


of  the  globe.  To  this  the  iimscirs  are  attached.  It  ia  the  part  which 
is  called  the  white  of  the  eye.  It  has  a  beveled  edge  in  front,  into 
which  the  cornea  is  fitted. 

The  Cornea  is  a  transparent  lover  which  projects  in  front,  and  forms 
about  one-litth  of  the  globe.  It  is  shaped  like  a  watch  glass.  It5 
blood-vessels  are  too  small  to  receive  th(^  red  particles  of  blood. 

Tlie  riioroid  Toat  is  a  vascuhu  membrane.  Its  color  is  brown  exter- 
niilly,  and  black  within.  It  is  connected  with  the  sclerotic  coat  i<x- 
tcnially,  and  internally  wich  the  retina.     It  is  composed  of  three 

liiyers. 

The  Iris  is  named  from  its  having  a  variety  of  color  in  diffcrenl 
persons.  It  is  the  partition  between  the  anterior  and  poste.'i>r  cham- 
bers of  the  eye,  and  has  a  circular  opening  in  the  centre  called  the 
pupil.  Of  its  two  layers,  the  fibres  of  the  anterior  one  are  radiating, 
and  dilate  the  pupil,  while  those  of  the  other  are  circular,  and  cauae 
its  contraction.  ^ 

The  Ciliary  Processes  are  a  number  of  folds  formed  from  the  int«r- 
nal  layer  of  the  choroid  coat. 

Tlie  Retina  has  three  layers.  The  external  is  extremely  thin  ;  the 
middle  is  nervous,  being  an  expansion  of  the  optic  nerve ;  the 
internal  is  vascular,  and  consists  of  a  ramification  of  minute  blood 
vessels. 

The  divided  edge  of  their  coats,  may  be  seen  in  Figure  54, 
namely,  the  sclerotic,  the  choroid,  and  the  retina ;  2,  is  the  pupil ;  3, 
the  iris  ;  4,  the  ciliary  process  ;  <5,  the  scolloped  border  of  the  retina. 


Fio.64. 


Pia.U^ 


i 


Tlie  Humors  of  the  Eye  are  the  agueous,  the  crystalline,  and  the 

vitreous. 

Tlie  Aqueous  or  watery  humor  is  situated  \n  the  chambers  of  the 
tve.  It  is  an  albuminous  fluid,  with  an  aiKaline  reaction,  and  a  sp*. 
cihc  gravity  a  little  greater  than  distilled  watet 


50 


AK ATOMY. 


ly 


The  CryNtalline  Haiiior  \h  iminodiHtoly  behind  the  pupil.  It  is  a 
lens,  and  in  convex  both  on  tho  ponterior  and  the  anterior  surface. 

The  Yltreoas  Uumor  is  also  an  albumiuoua  fluid,  something  like  the 
aqueous  humor,  but  more  dense. 

In  Figure  55  we  hiivo  in  E  a  good  view  of  tho  cornea  fitted  into 
the  sclerotic  coat ;  A,  is  the  choroid  ;  B,  tho  pignientura  nigrum  ;  (J, 
tho  retina;  K,  the  vitreous  humor;  D,  the  optic  nerve  ;  I,  tho  lens  ; 
C,  tho  iris,  painted  on  tho  back  side  with  pigment ;  F,  the  aquooun 
humor. 

Tho  muscles  of  the  eye,  six  in  number,  are  attached  to  tho  bono.'* 
of  tho  orbit  behind,  and  to  tho  cornea  in  front,  by  their  tondou;*. 
Tlieso  tendons  give  the  eyo  its  pearly  appoaranco.  In  Figiu-o 
56,  five  of  tho  muscles  are  indicated  by  a,  6,  c,  d,  e;  /is  the  optic 
nerve. 

If  tho  internal  muscle    be  •''"  ''^• 

too   short,  tho  eye  is  drawnl 
in  towards  tho  nose,  and  thej 
squinting  called  "  cross  eye 
is  produced. 

The  Orbits  are  bony  sock- 
ets which  enclose  tho  eye.  Thcl 
optic  nerve  passes  through  iil 
largo  hole  at  the  bottom. 

The  Eyebrows  are  the  pro-j^ 
jecting  arches  above,  covered" 
with  short  hair.     They  prevent  the  sweat  from  running  down  into  the 
eyes,  and  also  shade  them  from  strong  light. 

The  Eyelids  are  the  curtains  which  rise  and  full  in  front.  The 
smooth  membrane  which  lines  them  is  called  tho  conjunctiva.  It 
secretes  a  fluid  which  makes  the  eyelids  open  and  shut  easily. 

The  Lachrymal  Gland  is  at  the  upper  and  outer  angle  of  the  orbit. 
Several  small    '  "^tfl  open  from  it  upon  the 
I  upper  eyelid  a  which  the  tears  run  down 

[uponth*-  va. 

The  <iiai  Canals  begin  near  the  inter- 

Inal  au^        .  the  eye,  by  two  small  tear  points, 
which  communicate  with  the  sac  at  the  upper 
I  part  of  the  nasal  duct. 

The  Nasal  Duct  is  a  canal  about  three-quur- 
I  tors  of  an  inch  long,  which  mns  down  to  the 
infeilor  channel  of  tho  nose. 


Via.  ()T. 


Figure  57  shows  these  organs :    1,   bemg 

I  the  lachrymal  gland;   2,  the   ducts  leading 

to  the  upper  eyelid ;  3,  3,   the  tear  points 

(pimcta  lachrymalis)  ;  4,  the  nasal  sac }  £       t  termination  of  the 

nasal  duct. 


Tliel 

and  the 

TJie  1 

out  froit 

file  I 


The  Liil 

of    chaml 
petrous    I) 
the  vestibu 
cavity  witi 
the  semi-ci\ 
municatin 
bule,  and 
makes  t\v<| 
around   aif 
nodiolvs. 

In    Fig, 
pavilion  o 
auditory  c 
braiia  tym 
panum;  g, 
ear;  b,  thel 
"a's ;  /,  th{ 
vestibule; 

In  FiguJ 
fiighly  mai 
^ind  arouril 
rotundum  ;  f 


ANATOMY. 


61 


If 


The  Organs  of  Hearing. 

Tlie  Extcninl  EHr  is  coinposojl  of  flic  pnvilioii  of  the  ear  (the  pinna), 
and  th«'  uiulitory  caiml  (Un-  incatus  aiulitoriiiH  rxtcriius). 

Tlie  IMnilii  siirronnds  the;  cntrimcc  to  the  tinditory  cnnal.     It  Htands 
out  from  thu  lirad,  and  is  in  (-omiiioti  laiigu.^g'^  calii'd  the  car. 

'file  Ncatlis  Aiiiliturilis  is  u  canal  about  nn  iiicli  long,  partly  bony 
iiu. 68.  iiiid    partly    cartilaginourt,   wliicli 

yocs  iVoiu  tlw  pavilion  of  the  ear 
;<>  ilic  (/nun  of  the  ear. 

V.w  Dniiii  of  tlM>  Eiir  (iiioin- 
biiiiiii  tyiiipani)  is  an  oval-tiliaped 
tiiin  nil  iiii)ninc,  inserted  into  a 
groove  around  the  auditory  ca- 
nal. 

The  T\lMp.iiluill  is  a  eavity 
within  the  temporal  bone. 

The  EiisttM-liiuii  Tiihe  is  a  ehanr 
nel  orconnniMiiiatioii  between  the 
tvnil)aiMuu,  and  the  upper  part  of 
the  pharynx.  The  oljjeet  of  this 
is  \o  convey  air  to  the  drum  of 
the  ear,  an  without  air,  no  sound  can  be  |)rodueed. 

The  Lttbyrliith  is  a  scri.s '•'"'  ™- 

of  chainbera  through  tiie 
petrous  t)one,  —  embraeing  , 
the  vestibule  a  three-cornered 
cavity  within  the  tympanum ; 
the  semi-circufar  fowrt/.v,  com- 
municating with  the  vesti- 
bule, and  the  cochlea,  which 
makcK  two  and  a  half  turns 
aronnd  an  axis,  called  the 
modiolus. 

In  Figure  58,  a,  is  the 
pavilion  of  the  ear;  r,  the 
auditory  canal;  ^,  the  niem- 
brana  tympani ;  A',  the  tym- 
panum ;  e,  the  bones  of  the 
ear ;  ft,  the  semicircular  ca- 
nals ;  /,  the  cochlea  ;  //,  the 
vestibule  ;  t,  the  eustachian  tube  ;  rf,  the  auditory  nerve. 

In  Figure  59,  we  have  a  view  of  the  labyrinth  laid  open,  and 
highly  magnified:  1,  1,  being  the  cochlea;  2^3,  the  channels  that 
wind  around  the  central  point  (5);  7,  7,  the  vestibule  ;  8,  the  foramen 
rotundum  ;  9,  the  fenestra  ovalis  ;  4,  G,  10,  the  semicircular  cauals. 


PHYSIOLOGICAL  LAWS  OF  LIFE  AND  HEALTH....HYGIBNE. 


other  m 
part  to  V 


Life,  the  Infancy  o^     eing. 

It  may  be  stated  at;  a  general  iruth  that  man  has  but  just  learned 
to  live  when  he  is  reauy  to  die.  We  expend  a  large  portion  of  our 
lives  in  searching  out  our  mistakes,  and  in  striving  to  undo  the  mis- 
chiefs they  have  occasioned.  This  is  true  in  reference  both  to  our 
moral  and  our  phy  ical  life ;  and  I  draw  from  it  the  conclusion  that 
the  present  must  1  e  only  the  infancy  of  our  being,  and  that  our  blun- 
ders and  consequent  suflTerings  here,  will  cause  us,  in  the  great  here- 
after, to  place  a  higher  value  upon  knowledge,  and  to  struggle  wi+h 
new  fortitude  to  rid  ourselves  of  every  bondage. 

A  life  which  has  just  begun  to  take  shape  and  symmetry,  cannot 
be  permitted,  I  think,  under  the  rule  of  a  benevolent  Creator,  to  be- 
come extinct  We  shall  certainly  be  perniitted  to  take  up  the  broken 
thread  of  life,  and,  in  the  clearer  light  of  the  future,  with  the  warning 
experience  of  the  past,  and  surrounded  by  better  guards,  to  try  again. 
In  the  mean  time,  while  here,  the  sooner  we  become  acquainted  with 
the  laws  of  life,  and  the  better  we  obey  them,  the  more  we  shall  en- 
joy- 

The  Nervous  System. 

Man  is  brought  into  connection  with  the  outward  world  through 
the  senses  of  feeling,  seeing,  hearing,  etc.  Those  cornmunicate  with 
the  brair.  and  mind  through  the  nerves  of  sensation. 

The  nervous  system  is  divided  into  two  great  conrral  portions, 
tlic  brain  and  the  spinal  cord ;  and  these  together  are  called,  by  tlie 
learned,  the  cerebrospinal  centre.  There  are  nuincrons  pulpy  white 
cords,  called  nerves,  which  at  one  end  are  connected  with  this  great 
axis  ov  centre,  and  from,  thence  run  to  all  j)arts  of  the  system.  A 
portion  of  these  nerves  start  from  the  base  of  the  brain  and  run  to 
the  eye,  the  ear,  the  tongue,  etc.  (Fig,  48.) ;  while  another,  and  a 
larger  part  spring  from  the  cord  which  runs  through  the  back-bone, 
and  are  distributed  over  the  body,  and  the  lower  extremities.  (Figs. 
50  and  60.)  One  portion  of  these  cords'  produce  feeling ;  another 
part,  motion.  The  former  we  call  sensitive ;  the  latter,  motor.  Bot'^ 
kinds  are  widely  distributed  over  the  body.  Those  which  spring 
from  the  soinal  cord  have  two  roots,  one  uniting  with  the  back,  the 


How  the . 
the  external 
ttmiicute  w3 
I  0"  by  exterj 
sations.  W 
the  intellige 
nerves  of 
injury. 

Compa 


HTGIENE. 


63 


0 


;r 
le 


other  with  the  Jront  part  of  the  cord.     Cut  off  the  back  root,  and  the 
part  to  which  it  in  distributed  loses  its  feeling.     As  we  say  in  com- 

Fio.  «a  .  rno "    language,    it    be- 

comes numb,  though  it 
may  move  as  well  as 
before.  Cut  the  front 
root,  which  is  motion- 
producing,  and  the  part 
to  which  it  goes  cannot 
move.  It  is  palsied, 
though  it  may  still  feel 
acutely.  The  numerou.«* 
nerves  that  spring  from 
the  spinal  column  are 
pretty  well  represented 
in  cut  60. 

If  the  cranial  nerves 
of  motion  which  go  to 
the  face  be  cut,  no  emo- 
tion or  passion  can  be 
expressed.  The  features 
will  ail  be  immovable, 
ike  statuary.  To  smile, 
to  laugh,  to  frown,  to 
give  expression  to  the 
feeling  of  pity,  or  an- 
guish, or  love,  is  alike 
impossible.  And  yet  a 
breath  of  air  upon  the 
face  will  he  felt  as  readi- 
ly as  before.  Paralysis, 
or  palsy,  as  it  is  called, 
partial  or  general,  is  the 
result  of  injury  upon  few 
or  many  of  these  motion- 
producing  nerves.  Neu- 
ralgia, tic  douloureux,; 
etc.,  arise  from  some  dis- 
ease, perhaps  inflamma- 
tion, of  the  nerve*}  of 
sensation. 

How  the  Mind  Gets  Knowledge.— Everything  the  mind  know  of 
the  external  world,  it  leams  through  the  organs  of  sense,  which  t  ./m- 
niunicate  with  it  through  these  nerves.  Thus,  the  nerves  are  acted 
Oil  by  external  agents,  and  th^n  they  act  on  the  brain  and  cause  sen- 
sations. When  the  hand  is  burned  the  nerves  ot-  sensation  run  with 
the  intelligence  to  the  brain,  which,  quick  as  thought,  through  the 
nerves  of  motion,  despatches  orders  to  the  muscles  to  repel  the 
injury. 
Comparison. — The  arrangement  and  operation  of  the  nervous  sys- 


^ 


nTGIENE. 


tein  are  like  those  of  the  electric  fire-alarm  system  of  Boston.  The 
brain  is  the  intelligtmt  centre,  like  the  central  office  at  City  Hall.  The 
nerves  of  sensation  which  carry  to  the  brain,  with  electric  speed,  in- 
telligence of  what  is  going  on  outside,  are  like  the  wires  which  run 
to  the  City  Hall  from  the  several  station-boxes.  The  quick  carrying 
to  the  brain  of  any  information  of  injury  done  to  some  part  of  the 
body,  is  like  sending  to  the  City  Hail  from  a  station-box  the  intelli- 
gence of  fire  in  one  of  the  districts.  The  rapid  transmission  of  orders 
from  the  mind  to  the  muscles,  is  like  flashing  the  alarm  over  the  wires 
to  every  part  of  the  city.  And,  finally,  the  powerful  action  of  the 
muscles  Ln  warding  off  danger,  is  like  the  dashing  of  firemen  over  the 
pavements,  and  the  energetic  plying  of  the  engines. 

■  I 
Sensations. 

An  efTect,  produced  on  the  mind  through  a  nerve,  is  called  a  sensa- 
tion. Hunger  is  a  sensation.  It  is  an  eftVct  produced  upon  the  mind 
through  a  certain  nerve  by  the  condition  of  the  stomach.  Thirst, 
pain,  heat,  cold,  are  sensations  in  a  similar  sense.  Nausea  is  a  sensa- 
tion produced  by  some  injurious  substance  acting  upon  the  coats  of 
the  stomach. 

Streii|;th  of  Sensation.  —  Some  pensationn  are  much  stronger  than 
others ;  some  are  very  intense.  A  very  strong  sensation  is  called  a 
feeling.  It  is  common  to  say,  "  I  feel  cold,"  or,  "  I  feel  hot."  We 
simply  mean  by  this,  that  the  temperature  of  the  weather  makes  a 
very  powerful  impression  upon  us. 

Kinds  of  Sensation.  —  Sensations  are  either  pleasurable  or  painful. 
Pleasurable  sensations  arise  from  the  proper  exercise  of  some  healthy 
part  of  the  body ;  and  they  are  a  suitable  reward  for  any  care  the 
mind  may  take  of  the  corporeal  organs. 

The  sensations  arising  from  a  proper  amount  of  exercise  are  pleas- 
urable. The  muscles  find  a  sort  of  enjoyment  in  action.  He  who 
leads  a  sedentary  life,  either  from  choice  or  necessity,  loses  much  enjoy- 
ment. Hence  there  is  pleasure  in  labor;  and  the  working  man, 
though  often  pitied  by  the  wealthy,  is  generally  the  happiest  of  men. 
Thfc  eye  and  the  ear,  when  directed  to  agreeable  sights  and  sounds, 
derive  the  most  agreeable  sensations  from  exercise.  The  air  of  a 
beautiful  spring  morning  gi/es  impressions  which  none  can  describe, 
but  which  all  know  to  be  delightful.  These  impressions  are  well 
fitted  to  reward  us  for  taking  at  that  season,  in  the  open  air,  the  ex- 
ercise we  so  much  need. 

Moral  Uses  ol  Sensntions.  —  How  little  we  reflect  upon  the  amount 
of  happiness  it  is  in  our  power  to  create  by  making  agreeable  impres- 
sions upon  others.  A  civil  and  polite  address  makes  a  pleasant  im- 
pression. A  kind  word,  fitly  spoken,  makes  the  heart  glad.  Heads 
of  families  might  do  much  to  increase  the  happiness  of  their  domes- 
tics in  the  kitchen  by  meeting  them  with  a  pleasant  countenance,  and 
dropping  in  their  ear,  now  and  then,  a  word  of  approval.     Such  little 


acts  of  b 
agreeable 
of  life,  — 
and  whic 
us  like  sp; 


In  aimir 
be  governe 
of  happinc 
stairs,  —  si 
refining  inl 
or  for  recre 
to  wear  a  1 
flowers  of 
Every  hi 
ism  of  whi( 
urable  or  p 
iife,  it  shou 
Wives  ma] 
tion  of  the 
heart  of  the 
the  husban< 
pressions  uj 
fully.  Mos 
the  heads 
saying,  or  di 
other.  A  \| 
loved  eitherl 
who  desires] 
li/p,  the  whc 
sions  upon 

A^reeablel 

not  only  be/ 
health.     Th 
Travelling 
variety  of  A 

Cure  of  tl 

portant  thai 
agreeable  sJ 
/iced  to  the  \ 
from  diseasfl 
these  impreJ 
We.  TotreJ 
is  broken,  irj 


HYGIENE. 


5o 


acts  of  benevolence  are  easily  performed,  and  they  make  the  most 
agreeable  and  lasting  impressions  upon  persons  in  the  lower  stations 
of  life,  —  creating  attachments,  in  fact,  which  end  only  with  death, 
and  which  in  hours  of  future  sorrow,  which  come  to  all,  may  refresh 
us  like  springs  of  v/ater  in  the  desert 

Full  many  a  shail  at  random  sent, 
Finds  mark  the  archer  little  meant ; 
Full  many  a  word  at  random  spoken, 
May  heal  a  wounded  heart  that 's  broken. 

Waltu  Soorr. 

In  aiming  to  make  agreeabie  impressions  upon  domestics,  we  should 
be  governed  by  the  simple  desire  to  create  happiness.  Their  sources 
of  happiness  are  comparatively  few.  They  spend  their  days  below- 
stairs,  —  shut  out  from  a  portion  cf  the  light  of  day,  and  from  the 
refining  influences  of  the  drawing-room,  —  having  little  time  for  rest 
or  for  recreation.  How  unfeeling  to  treat  such  persons  with  harshness, 
to  wear  a  frowning  face  in  their  presence,  and  thus  wither  the  few 
flowers  of  happiness  which  bloom  around  them ! 

Every  human  being  is  endowed  with  the  beautiful  nervous  organ- 
ism of  which  I  have  spoken,  aud  is  daily  receiving  impressions,  pleas- 
urable or  painful,  from  thousands  of  sources.  In  all  the  relations  of 
life,  it  should  be  our  aim  to  touch  delicately  this  sensitive  structure. 
Wives  may  add  much  to  the  happiness,  and  I  may  say,  to  the  affec- 
tion of  their  husbands,  by  always  wearing  a  pleasant  face ;  and  the 
heart  of  the  wife  may  be  made  light  and  glad  by  gentle  words  from 
the  husband.  We  cannot  but  love  those  who  make  pleasurable  im- 
pressions upon  us,  and  we  necessarily  dislike  such  as  impress  us  pain- 
fully. Most  of  the  coldness  and  alienations  which  grow  up  between 
the  heads  of  families,  spring  from  the  habit,  of  one  of  the  parties,  of 
saying,  or  doing,  or  looking  something  which  painfully  impresses  the 
other.  A  woman  who  habitually  wears  a  "sour"  face,  cannot  be 
loved  either  by  her  husband  or  her  children.  The  man  or  the  woman 
who  desires  to  be  loved,  must  cultivate  a  manner,  a  look,  a  speech,  a 
life,  the  whole  scope  of  which  is  fitted  to  make  pleasurable  impres- 
sions upon  others.     It  is  against  nature  to  love  what  gives  us  pain. 

Agreeable  Sensations,  a  Source  of  Health.  —  Pleasurable  sensations 
not  only  beget  love,  aad  increase  happiness,  but  they  add  much  to 
health.  They  exhilarate  the  spirits  and  drive  away  melancholy. 
Travelling  promotes  health  and  prolongs  life,  by  the  number  and 
variety  of  the  pleasing  impressions  it  makes  upon  the  mind. 

Cure  of  the  Sick.  —  If  the  above  statements  be  correct,  how  im- 
portant that  the  sick  should  be  so  dealt  with  as  to  have  none  but 
agreeable  sensations  made  upon  them.  Many  a  life  has  been  sacri- 
ficed to  the  peevish  temper  of  a  nurse.  When  the  nerves  are  weak 
frotn  disease,  even  slight  causes  make  powerful  impressions ;  and  if 
these  impressions  are  of  a  painful  kind,  the  results  are  most  deplora- 
ble. To  treat  harshly  the  sick,  especially  those  whose  nervous  system 
is  broken,  implies  either  great  thoughtlessness,  or  extreme  cruelty.    A 


iliirViirt-«it'^  I 


i  i 


n 


r^f 


_s.  ■"  ■  g^yf 


56 


HYGIENE. 


single  harsh  word,  which  would  scarcely  move  one  when  well,  may 
Bend  the  same  person,  when  sick,  almost  to  distraction.  Every  word" 
spoken  to  persons  in  sickness  should,  therefore,  be  gentle  and  sooth- 
ing. Every  feature  of  the  face  should  express  either  cheerfulness, 
or  tenderness  and  pity. 

As  the  painful  impressions,  which  disease  is  making,  tends  to  de- 
press the  spirits  and  create  melancholy,  it  is  not  expected  that  persons 
when  sick  will  exhibit  as  amiable  tempers  as  when  well;  and  for 
this,  all  due  allowance  must  be  made. 

Effect  upon  the  Disposition.  —  This  leads  me  to  say  that  pleasura- 
ble sensations  improve  the  temper  and  disposition.  This  is  a  fact  of 
very  great  importance,  and  parents  should  never  lose  sight  of  it  in 
dealing  with  their  children.  There  are  few  children  but  would  grow 
up  amiable  and  useful  members  of  society,  were  they  dealt  with  in 
the  gentle  and  tender  manner  which  their  young  and  impressible 
natures  require.  From  the  moment  the  young  mind  wakes  to  intt^l- 
ligence,  it  will  be  ocrcnpied  with  something.  Parents  and  guardians 
should  aim,  therefore,  to  turn  it  to  all  those  things  which  will  impress 
it  pleasantly,  and  at  the  same  time  do  it  no  harm.  Exercise,  songs, 
playthings,  flowers,  —  to  the  and  other  entertainments  it  should  be 
led  by  gentle  hands.  No  thoughtful  parent  will  ever  pain  a  child  by 
harsh  threats  and  denunciations,  or  shock  it  by  an  oath. 

Bud  Effect  of  Unpleasant  Sensations.  —  If  pleasurable  sensations 
improve  the  health  and  temp('r,  unpleasant  ones  do  just  the  opposite. 
They  break  down  the  health,  and  spoil  the  disposition. 

They  are  intended  to  give  us  a  warning  of  impending  injury. 
Thus,  we  have  painful  sensations  when  we  have  overworked  the  body 
or  mind.  The  sensation  of  weariness  tells  us  that  the  muscles  have 
worked  as  long  as  their  good  requires,  and  that  they  need  rest.  Were 
this  sensation  unheeded,  exhaustion  and  entire  prostration  would  be 
the  result. 

When  fatigue  begins  to  be  felt,  either  of  body  or  mind,  the  sensa- 
tion may  be  dissipated  by  strong  tea,  or  intoxicating  drink,  or  opium; 
but  to  drive  it  away  in  this  manner,  for  the  purpose  of  working  longer, 
is  wrong,  and  leads,  in  the  end,  to  disease  or  exhaustion.  It  is  said 
t'lat  one  of  the  most  brilliant  advocates  of  our  time  is  dependent 
upon  opium  for  the  stimulus  to  carry  him  through  his  extraordinary 
flights  of  elocpienee  ;  but  his  restless  motion  and  nervous  face  remind 
us  that  he  has  bent  his  bow  very  hearly  to  the  snapping  point,  and 
that  a  sudden  collapse  of  his  vital  powers,  at  no  distant  day,  may 
be  feared  as  the  result  of  such  tension. 

Persons  in  aflliction,  whose  spirits  are  depressed  and  broken  by 
sorrow,  should  have  their  thoughts  turned  away  from  all  sombre  ob- 
jects and  contemplations.  They  should  be  taken  into  the  open  sun- 
light, and  be  diverted  by  the  beautiful  things  of  nature.  They  should 
visit  cheerful  society,  and  open  their  hearts  to  pleasurable  impres- 
sions. 

When  we  permit  any  part  of  the  body  to  remain  idle,  neglecting 
to  use  it  as  much  as  we  ought,  unpleasant  sensations  remind  us  of 


our  fault. 
This  is  SI 
says  to  us 
for  exercis 

Meed  of 

of  the  exte 
the  organs 
mind,  slion 
atrnrnents 
and  will  m 
tiuice,  then 

linpropei 

herit  disea 

brain,  is  ofl 

spring  are  < 

the  wealth; 

nervous  dis 

groat  part,  : 

under  whic 

wisdom  of 

degrees  of  ( 

philosopher 

the  folly  of 

or  his  child 

nervous  disc 

sound  mine 

marriages 

Need  of 

I    its  duties, 
than  any  C/ 
to  this  iUi 
lessened  or 
loss  of  blc 
charged  wi 
well,  the  b 
and  unconsi 
or  have   its 
breathed  ov 
the  result 
Minting,  hyi 

Ventilutifl 

churches,  ai 
Were  a 
ministers  w 
tion  sitting 
single  aften 
are  in  a  lifet 
clearnesB, 


HTGIKNK. 


67 


our  fault.  The  muscleg,  when  iiimsed,  waste  away  and  become  feeble. 
Tliis  is  sure  to  produce  an  uneasy,  nervous  state  of  fueling,  which 
siiys  to  us  as  plainly  as  a  sensation  can,  that  the  muscles  are  hungry 
for  exercise,  and  that  it  is  injurious  to  let  them  rest  longer. 

IV'eed  of  a  Ilenltiiy  Brain. —  In  order  that  we  may  get  correct  ideas 
of  the  external  world,  it  is  necessary  that  the  brain,  the  nerves,  and 
the  organs  of  sense  through  which  sensations  are  made  upon  the 
mind,  should  be  in  a  healthy  condition.  It  is  evident  that  if  the  in- 
struments of  sensation  be  diseased,  the  sensation  cannot  be  natural, 
and  will  make  a  false  report  to  the  mind.  It  is  of  the  highest  impor- 
tiuice,  therefore,  that  the  brain  should  be  sound. 


Improper  Illtermarrlajfes.  —  This  organ,  like  every  other,  may  in- 
herit disease  from  parents.  Insanity,  which  springs  from  a  diseased 
brain,  is  often  hereditary.  When  both  parents  are  diseased,  the  oil- 
spring  are  of  course  more  liable  to  partake  of  their  defects.  Among 
the  wealthy,  and  particularly  among  the  royal  families  in  Euro|H', 
nervous  diseases  and  sterility  are  very  common.  This  arises,  in  a 
great  part,  from  intermarriages  among  blood  relations,  —  a  practice 
under  which  any  people  will  degenerate,  and  finally  perish.  The 
wisdom  of  the  Old  Testament  prohibition  of  marriage  within  certain 
degrees  of  consanguinity,  has  been  established  by  the  observations  of 
philosophers,  and  the  experience  of  mankind.  When  a  man  commits 
the  folly  of  marrying  his  first  cousin,  he  generally  either  has  no  issue, 
or  his  children  are  afflicted  with  deafness,  or  some  shocking  form  of 
nervous  disease.  Let  those  who  will  transmit  to  their  descendants  a 
sound  mind  in  a  sound  body,  observe  the  laws  of  life,  and  avoid  all 
marriages  with  blood  relations. 

Need  of  a  Good  Supply  of  Blood.  —  For  a  proper  performance  of 
its  duties,  the  brain  requires  and  receives  a  larger  supply  of  blood 
than  any  C/ther  part  of  the  system.  One  tenth  of  all  the  blood  goes 
to  this  important  organ.  If  the  quantity  or  quality  be  materially 
lessened  or  changed,  great  disturbance  of  the  brain  follows.  A  large 
loss  of  blood  occasions  dizziness  and  fainting.  If  an  atmosphere 
charged  with  too  much  carbonic  acid  gas  be  breathed,  as  in  a  de 
well,  the  blood  is  not  vitalized  in  the  lungs,  so  as  to  sustain  the  brain, 
and  unconsciousness  soon  follows.  If  the  air  be  vitiated  in  any  way, 
or  have  its  oxygen  extracted,  as  in  large  assemblies,  where  it  i.s 
breatiied  over  several  times,  it  becomes  unfit  to  support  the  brain,  and 
the  result  is  languid  feelings,  inability  to  apply  the  mind,  headache, 
feinting,  hysterics,  and  other  nervous  manifestations. 

Ventilation.  —  This  shows  the  great  necessity  of  having  dwellings, 
churches,  and  school-houses  well  ventilated. 

Were  a  good  system  of  ventilation  adopted  in  all  our  churches, 
ministers  would  seldom  preach  to  sleeping  audiences.  A  congrega- 
tion sitting  in  one  of  our  places  of  public  worship,  where  the  air  in  a 
single  afternoon  is  as  many  times  used  over  as  the  minister's  sermons 
are  in  a  lifetime,  can  neither  hear  with  attention,  nor  comprehend  with 
clearness.  '        - 


58 


HYGIENE. 


V   - 


In  our  school-housps,  the  ventilation  is  quite  as  bad,  and  the  consc- 
ruencTs  worse,  because  they  are  occupied  six  hours  in  the  day  instead 
ol  ihree,  and  six  days  in  the  weeit  in  place  of  one.  In  the  small  school- 
houses  which  our  children  filled  to  overflowing  in  former  years,  in 
which  there  was  Wi  ventilation,  unless  thev  happened  to  be  blessed 
with  an  old-fashioned  chimney  and  fire-place,  the  effects  upon  the 
nervous  system  of  the  children  was  deplorable.  Many  of  the  dis- 
eases which  afflict  the  present  generation  of  men  and  women,  had 
their  origin  in  the  bad  air  of  those  crowded  nurseries  of  education. 

Our  dwellings  were  partly  ventilated  in  olden  time,  when  the  open 
fire-place  received  the  "  back-log,"  the  "  top-stick,"  the  "  fore-stick," 
and  other  sticks  to  match ;  but  since  we  have  been  warmed  by  the 
stove  and  the  furnace,  we  have  known  little  of  the  luxury  of  pure  air 
at  the  domestic  hearth. 

Need  of  Exercise  for  the  Brain.  —  Health  requires  that  the  brain 
should  be  properly  occupied  with  vigorous  thought.  The  same  rea* 
sons  may  be  given  for  this  as  for  the  exercise  of  the  muscles.     It  is 

fovemed  by  the  same  laws  which  apply  to  other  parts  of  the  system. 
Ise  improves  its  strength  and  vigor,  —  idleness  causes  it  to  grov/ 
feeble.  Of  course  the  labor  it  is  put  to  should  be  only  reasonable  in 
amount,  and  should  not  be  too  long  continued  at  any  one  time. 
With  the  weakening  of  the  brain,  the  whole  bodily  forces,  and  indeed 
the  whole  mental  and  moral  character,  fall  into  feebleness  and  decay. 
It  is  a  great  mistake  to  suppose  that  the  cultivation  and  even  vigorous 
use  of  the  mind,  impairs  health  and  shortens  life.  Just  the  opposite 
is  true.  Many  of  the  most  eminently  intellectual  men,  who  have 
worked  their  brains  hard  ail  their  lives,  have  been  distinguished  for 
long  life. 

Bad  Effects  of  Change  in  Circumstances.  —  No  class  of  persons 
suffer  more  from  nervous  diseases  and  general  ill  health,  than  those 
who,  having  worked  hard  in  early  life,  with  little  or  no  cultivation  of 
the  mind,  are  suddenly  raised  to  wealth,  and  immediately  drop  all 
exercise,  and  fall  into  habits  of  indolence  and  luxury.  The  condition 
of  such  persons  would  be  much  less  pitiable,  did  they  take  up  books 
when  they  lay  by  the  hoe  or  the  broom.  But  they  seldom  do  this. 
Many  a  woman,  in  early  life,  has  felt  the  glow  of  health  in  every 
limb,  and  a  thrill  of  pleasure,  too,  while  scrubbing  the  floor  upon  her 
hands  and  knees,  w^ho  has,  in  subsequent  years,  reclined  »n  misery 
upon  her  damask-covered  lounge,  and  wondered  that  she  could  not 
have  the  health  of  other  days.  Let  her  cultivate  her  brain,  live  tem- 
perately, and  exercise  in  the  open  air,  and  life  may  again  have  real 
pleasures  for  her. 

Discretion  in  Exercising  tlie  Brain.  —  In  exercising  the  brain  we 
must  use  discretion.  We  must  not  sit  down  in  the  morning,  and  ply 
it  with  work  during  the  whole  day,  without  rest.  This  would  soon 
bring  upon  it  disease,  or  premature  decay.  It  should  be  worked  only 
until  it  begins  to  show  symptoms  of  fatigue.  Then  it  should  be  per- 
mitted to  rest ;  or,  what  is  better,  be  turned  to  some  new  sabject,  of 


a  lighter,  o 
than  to  ent! 

Ovenrorli 

not  to  exert 
the  system, 
erfion.  As 
made  to  wo 
Hource.  Ch 
it  is  no  un( 
equal  in  siz 
in  developm 
alating  and 
In  such  chi 
We  need  no 
Hpite  of  us. 
constitution, 
and  sustain. 
Yet  paren 
this  rule.  1 
could  they  s 
folly.  Could 
the  brain,  ep 
of  undescrib( 
without  a  na 

Old  People 

larly  careful 
easily  from  g 
cry  are  feeble 
age  should  I 
journey  of  tj 
stages,  throutf 

A  Supply  . 

needs  and  n 

this,  it  is  tor 

particular  pa 

forest  in  ext 

ground,  or  b^ 

body;  and  ii 

of  blood.     1 

gins  earnestlj 

which  the 

vessels,  and 

that  it  draw] 

force,  it  dimi] 

""fits  them 

other  workinl 

From  this  [ 

effectively  atl 

to  hard  work 


HYGIENE. 


59 


a  lighter,  or  a  different  character.     This  often  rests  the  brain  better 
than  to  entirely  suspend  its  action. 

Ovenrorkins:  the  Brnin  in  ChildluNxl.  —  Great  cnrc  should  be  used 
not  to  exercise  the  brain  too  much  in  early  life.  Like  other  parts  of 
the  systtnn,  it  is  tender  in  childhood,  aiid  will  not  bear  prolonged  ex- 
ertion. As  a  general  thing,  children  are  put  to  school  too  early,  and 
made  to  work  their  brains  too  hard.  Great  mischief  arises  from  this 
source.  Children  are  born  with  larg«'r  brains  now  than  formerly;  and 
it  ia  no  uncommon  thing  to  see  upon  a  child  of  ten  years,  a  head 
equal  in  size  to  that  of  an  adult.  Children  run  to  brain.  Precocity 
in  development  of  brain  and  mind  is  common.  The  results  of  stim- 
nlating  and  hastening  the  unfolding  of  such  minds  are  deplorablo. 
In  such  children,  the  brain  should  be  the  last  thing  to  be  cultivated. 
We  need  not  urge  its  growth.  It  will  come  forward  fast  enough  in 
spite  of  us.  Our  chief  aim  should  be  to  harden  and  fortify  the  general 
constitution,  so  that  the  noble  brain  which  it  is  required  to  bear  up 
and  sustain,  may  long  be  its  crown  and  glory. 

Yet  parents  are  proud  of  their  precocious  children,  and  often  reverse 
this  rale.  They  do  it  thoughtlessly,  and  would  be  terribly  startled, 
could  they  suddenly  look  into  the  future,  and  see  the  results  of  their 
folly.  Could  they  do  so,  they  would  see  inflammation  and  softening  of 
the  brain,  epilepsy,  insanity,  paralysis,  apoplexy,  with  all  the  horrors 
of  undescribcd  and  indescribable  nervous  affections,  which,  though 
without  a  name,  have  a  terrible  reality. 

Old  People's  Brnins.  —  Persons  in  advanced  life  should  be  particu- 
larly careful  not  to  overwork  the  brain.  In  middle  life  it  recovers 
easily  from  great  fatigue.  In  the  decline  of  life,  its  powers  of  recov- 
ery are  feeble.  A  single  exhaustion  may  cause  its  fatal  collapse.  Old 
age  should  be  distinguished  for  gentleness  and  moderation.  The 
journey  of  the  down-hill  of  life  should  be  made  by  short  and  easy 
stages,  through  regions  of  diversified  beauty. 

A  Supply  of  Blood.  —  Every  part  of  the  system,  when  hard  at  work, 
needs  and  mu  have  a  very  large  supply  of  pure  blood.  Without 
this,  it  is  torpid  and  inactive.  To  cause  the  blood  to  flow  to  any 
particular  part,  it  must  be  exercised.  The  lumberman,  when  in  the 
forest  in  extreme  cold  weather,  stamps  his  feet  violently  upon  the 
ground,  or  beats  them  against  a  log,  and  whips  his  hands  around  his 
body ;  and  in  this  way  makes  them  red  and  warm  with  a  new  supply 
of  blood.  The  stomach,  when  it  has  received  a  supply  of  food,  be- 
gins earnestly  to  turn  it  over;  and  by  this  exercise,  and  the  stimulus 
which  the  food  supplies,  it  invites  large  quantities  of  blood  to  its 
vessels,  and  thus  increases  its  power  to  work.  But  just  in  proportion 
that  it  draws  Mie  vital  current  xo  its f/f,  and  augments  its  own  vital 
force,  it  dimini.-hes  the  blood  in  other  organs,  and,  for  the  time  being, 
unfits  them  for  work.  The  same  may  be  said  of  tne  brain  and  all 
other  working  organs. 

From  this  it  follows  that  only  one  organ,  or  set  of  organs,  can  work 
efl'ec'tively  at  the  same  time,  and  that  it  is  improper  to  put  the  brain 
to  hard  work  immediately  after  a  full  meal,  because  the  stomach  then 


1 


60 


HTCIENE. 


wants  the  blood  to  enable  it  to  digest  the  food  ;  and  if  the  blood  bt; 
called  oir  to  the  brain,  digestion  will  stop.  Nor  should  the  stornacl' 
be  loaded  with  food  direetly  after  long  and  hard  thinking ;  for  the 
brain  will  yield  up  the  blood  to  it  only  after  its  own  excitement  has 
had  time  to  subside. 


Sympathetic  Nervous  System. 

The  objeet  of  this  system  seems  to  be  to  bind  all  parts  of  the  body 
together,  and  to  combine  and  harmonize  their  actions.  It  takes  care 
that  no  part  of  the  system  acts  in  such  a  way  as  to  injure  any  othtr 
part.  It  exerts  a  controlling  influence  over  digestion,  nutrition,  nh- 
sorption,  the  circulation,  etc.  These  are  natural  processes  whicli 
need  to  go  on  while  the  brain  is  asleep  and  cannot  attend  to  them. 
The  nervous  system,  of  which  I  speak,  presides  over  all  those  func- 
tions which  are  called  involuntary,  —  so  called  because  no  act  of  the 
will  is  needed  for  their  performance.  Secretion,  absorption,  digestion, 
and  the  circulation  of  the  blood,  all  have  to  go  on  while  we  sleep,  as 
well  as  while  we  wake.  Were  an  act  of  the  will  necessary  to  tliiir 
performance,  as  in  walking,  eating,  conversing,  etc.,  then  they  would 
have  to  cease  the  moment  the  brain  fell  asleep,  and  death  would  be 
the  result. 

The  sympathetic  nerves  apprize  dch  part,  of  the  system  of  the 
condition  and  wants  of  every  other  part.  When  the  lungs  are  in- 
flamed, the  stomach  seems  to  be  aware  of  it,  and  will  receive  no  food, 
because  this  would  aggravate  the  disease  of  the  neighboring  organs. 
Well  would  it  be  if  human  beings  would  exercise  a  like  forbearance, 
and  abstain  from  those  acts  of  self-gratihcation  which  they  know  will 
injure  their  neighbors. 

Eflfects  of  Xervous  Disensos.  —  Before  closing  these  observations,  I 
wish  to  add  a  few  words  respecting  the  terrible  ell'ects  of  nervous  dis- 
eases which  characterize  the  present  time. 

That  they  are  far  more  numerous  and  afflictive  than  in  former 
years,  must  be  apparent  to  the  most  careless  observer.  They  are 
nothing  more  nor  less  than  the  price  we  ))ay  for  a  high  civilization, 
and  especially  for  our  republicanism.  Among  us,  every  man  feels  his 
individuality,  and  has  a  motive  for  thinking  and  doing  his  best. 
Thought  and  action  are  here  unf«'(tered  ;  and  if  the  race  is  not  to 
the  swift,  nor  the  battle  to  the  stroiig,  every  man  acts  as  though  lie 
thought  it  was.  The  great  excitement  which  the  struggle  for  wealth 
kindles  and  inflames,  deranges  and  shatters  the  nervous  system  to  a 
shocking  degree. 

And  wealth,  when  obtained,  does  its  full  share  to  weaken  the  nerves. 
It  brings  with  it  high  living,  indolence,  loss  of  energy,  dissipation,  and 
a  weakening  of  the  whole  moral  and  physical  powers.  It  need  not 
do  this ;  but,  in  most  cases,  it  does. 

The  result  is,  that,  at  least,  every  other  person  has  some  nervous 
disease,  which  makes  life  a  misery  rather  than  a  blessing.  The  brain 
and  nerves  are  too  much  developed  in  comparison  with  the  develop- 


ment of  the 
as  men  and  ^ 
ing  and  acti 
they  imperfe( 
natural  to  t\ 
acts  and  thoi 

Whnt  is  r< 

(10  man  can  f 

that  that  whl 

it-;  destructioi 

^  !V('  us  but  tl 

V  r  the  system 

siicli  a  strain  i 

to  counterbal 

States.     We  I 

health,  or  we  i 

of  what  is  ht 

ill  their  own 

doom. 

Hopefnl  Coi 

here  presented 
others  of  a  mc 
I'hysiology  i 
any  former  pe 
schools,  and  a 
health  has  aln 
it,  —  such  as  ( 
encourage  anc 
propose  to  dev] 


From  the  ea| 
bodies  are  con^ 
^re  worn  out, 
Were  this   thel 
«\\ay,  and  that! 
rials  are  throw/ 
ojl  of  our  foocl 
In  order  that^ 
into  small  partil 
citation.     Durij 
^pitde,  called  s| 
glands,  and  mi: 
condition,  it  is 
pharynx.     Herd 
upon  the  open] 
trance  into  the 
a  tube  which  ri 


HYGIENE. 


61 


meiit  of  the  muscles.  Half  our  boys  and  girls  have  heads  as  large 
as  men  and  women.  It  is  common  to  see  a  boy  or  a  girl  at  ten  talk- 
ing and  acting  like  a  man  or  woman.  I  do  not  mean  by  this,  that- 
they  imperfectly  imitate  the  actions  of  older  persons.  It  seems  to  be 
natural  to  them.  Their  brains  are  prematurely  developed,  and  their 
ai'ts  and  thoughts  have  the  maturity  of  adult  life. 

Whnt  Is  ronillljf  ?  —  What  will  be  the  result  of  this  state  of  things, 
no  nian  can  predict.  I  sometimes  think  the  race  will  break  down; 
tliiit  that  which  was  intended  to  be  its  ornament  and  strength,  will  be 
it-;  destruction.  I  hope  not.  Yet  there  is  danger  of  it.  Nothing  cm 
;  ivc  lis  but  the  wisdom  to  adopt  such  means  as  will  develop  all  parts 
vt  I  lie  system  alike.  No  race  of  men  can  stand  for  many  generations 
Mvh  a  strain  upon  the  nervous  system,  unless  better  means  are  adopted 
to  counterbalance  its  evil  eflects  than  are  now  used  in  the  United 
Stales.  We  have  got  to  pause  in  our  swift  career,  and  look  after  our 
health,  or  we  shall  become  a  nation  of  maniacs.  No  proof  is  needed 
of  what  is  here  said.  There  is  sctirce  a  man  or  a  woman  but  has 
in  their  own  person  the  foreshadowing  evidence  of  our  impending 
(loom. 

Ifopefnl  Considerations.  —  It  is  proper  to  say  the  considerations 
here  j)resented,  terrible  as  they  are,  are  mitigated  in  some  measure  by 
others  of  a  more  hopeful  character. 

I'hysiology  and  the  laws  of  life  are  now  better  understood  than  at 
any  former  period.  These  subjects  are  getting  into  our  common 
schools,  and  are  engaging  the  attention  of  our  youth.  Declining 
health  has  already  made  us  think  more  of  the  means  of  preserving 
it,  —  such  as  diet,  exercise,  bathing,  travelling,  and  amusement.  To 
encourage  and  intensify  this  hopeful  direction  of  the  public  mind,  I 
propose  to  devote  a  few  pages  to  these  subjects. 


Food  and  Digestion. 

From  the  earliest  dawn  of  existence  to  the  last  moment  of  life,  our 
bodies  are  constantly  changing.  Old  particles  of  matter,  when  they 
are  worn  out,  leave  their  places  and  are  thrown  out  of  the  system. 
Were  this  the  whole  of  the  matter,  our  bodies  would  soon  waste 
away,  and  that  would  be  the  end  of  us.  But  as  fast  as  the  old  mate- 
rials are  thrown  away,  new  ones  take  their  places ;  and  it  is  solely 
out  of  our  food  that  these  new  materials  are  formed. 

in  order  that  the  food  may  be  well  digested,  it  must  first  be  broken 
into  small  particles  in  the  mouth.  The  act  of  chewing  it,  is  called  mas- 
tication. During  this  act,  if  it  be  well  performed,  a  large  quantity  of 
spitde,  called  saliva,  flows  out  of  a  number  of  glands,  called  salivary 
glands,  and  mixes  with  the  food,  forming  with  it  a  soft  mass.  In  this 
condition,  it  is  thrown  backward  into  the  top  of  the  throat,  called  the 
pharynx.  Here,  a  little  cartilage,  called  the  epiglottis,  drops  down 
upon  the  opening  into  the  top  of  the  windpipe,  and  prevents  its  en- 
trance into  the  breath  passage ;  and  it  is  pushed  along  into  the  gullet, 
a  tube  which  runs  down  behind  the  windpipe  and  lungs,  and  which 


•it 


62 


HYGIENE. 


pliysirinriH  mil  the  a*Hophagus.  Here  a  B'jcccssion  of  muacular  baiid^, 
III  circuliir  shape,  contract  U|x)n  it,  one  after  another,  and  fouiu  it 
down  into  tlu'  stotnncii. 

It  is  important  that  two  thincfx  Hhonl<\  be  Hpoured  while  the  food  in 
in  the  mouth,  namely,  that  it  should  be  reduced  to  a  poml  decree  ot" 
fineness  by  chewing,  and  that  a  proper  amount  of  saliva  should  bo 
mixed  with  it.  If  the  chewing  were  not  necessary,  teeth  would  not 
have  been  given  us  ;  and  the  salivary  glands  would  certainly  not  have 
been  put  in  the  vicinity  of  the  mouth,  if  the  mixing  of  water  with  our 
food  would  servo  the  purposes  of  digestion  as  well. 

Eating  too  Rapidly. — The  Americans  have  fallen  into  a  pernicious 
error  in  eating  their  food  too  rapidly.  Time  is  not  given  to  chow  it 
sufficiently  to  excite  a  full  flow  of  saliva;  and  as  it  cannot  bo  swal- 
lowed in  a  dry  state,  it  is  not  uncommon  to  see  persons  taking  a  sip 
of  water  after  every  second  mouthful  to  enable  them  to  force  it  into 
the  stomach.  It  is  a  habit  we  Americans  have  of  cheating  ourselves 
both  of  the  pleasures  and  the  benefits  of  eating ;  for  the  only  real 
pleasure  of  eating  arises  from  the  flavor  of  food  while  retained  in  the 
mouth,  and  the  only  benefit  we  can  derive  comes  in  consequence  oi 
its  proper  digestion. 

The  food  when  received  iwto  the  stomach  is  in  the  same  condition 
as  when  taken  into  the  mouth,  except  that  it  is,  or  should  be,  ground 
fine  by  the  teeth,  and  well  mixed  with  saliva. 

The  Gastric  Juice.  —  The  stomach,  like  the  mouth,  the  windpipe, 
and  the  gullet,  is  lined  by  a  irmcous  membrane.  The  chief  olFice  of 
this  membrane  is  to  secrete,  or  take  out  of  the  blood,  a  fluid  which 
we  call  gastric  juice,  which  means  stomach  juice ;  for  the  Greek  name 
of  stomach  is  yaa-Tt}p  (gaster).  This  fluid  has  not  much  smell  or 
taste,  and  looks  like  spring  water.  It  has  a  powerful  eff"ect  upon  food, 
which,  when  mixed  with  it,  soon  undergoes  an  important  change, 
which  is  apparent  to  the  taste,  the  smell,  and  the  sight.  What  the 
nature  of  tlie  gastric  juice  is,  or  how  it  produces  its  effect  upon  food, 
is  not  certainly  known. 

Too  Much  Cold  Water  at  Heals. —  There  are  some  interesting  facts 
connected  with  the  formation  of  this  fluid,  of  which  it  is  important 
that  every  person  should  be  apprized. 

Its  quantity  and  quiility  depend  on  the  amount  and  hcalthfnlnest 
of  the  blood  which  flows  to  the  stomach  during  the  first  stage  of 
digestion.  It  is,  therefore,  injurious  to  drink  large  quantities  of  very 
coid  water  with,  or  immediately  after,  our  meals ;  as  this  will  chill 
the  stomach,  and  repel  the  blood  from  its  vessels,  so  that  but  little  of 
the  juice  can  be  formed.     Digestion,  in  such  case,  must  be  imperfect 

Tliis  Fluid  not  Secreted  Without  Limit.  —  This  fluid  does  not  flow 
into  the  stomach  continuously,  but  only  when  we  swallow  food,  and 
then,  not  as  long  as  we  please  to  cat,  but  merely  till  we  have  taken 
what  the  system  requires.  If,  in  the  amount  we  take,  we  go  beyond 
the  wants  of  nature,  there  will  not  be  fluid  enough  formed  to  dissolve 
It,  and  the  whole  will  be  imperfectly  digested,  and  be  a  source  of  in- 


jury rathi 
food  be  o 

Not  Se( 

either  not 
be  our  fe 
need  food 
gested,  ai 
slight,  the 
in  proporl 

Its  Scciv 

;  l).i|)|)y,  I 

of   tile  ga 

iiilciise   til 

iiatunil  flo 

This  she 

make  the  1 

tind  joyous 

nny  of  the 

lucnt,  wo  E 

our  faces. 

tiililo  it  is  I 

will  throw 

if  habituall 

half  a  doze 

The  ston 

they  can  ta 

of  the  pow 

filling  then 

the  substar 

with  the  si< 

How  al 

view,  the 
trie  juice  i 
held  in  ot 
had  it  not 
Ktoinach  to 
A  young  n 
but  then  in 
and  a  hole 
dental  disc 
recover  id 
grow  toget 
the  breach 
tain  grew 
Dr.  Beaum 
series  of 
various  ar 


V 


Horemei 


iMe: 


i 


HTOIENB. 


63 


jury  rather  than  bonrfit.     This  ithould  teach  ua  to  be  careful  that  our 
food  be  only  reaMonablc  in  amount. 

Not  Secreted  in  Sickness. —  Wh'Mi  we  are  sick,  the  gnstric  juice  is 
either  not  formed  at  all,  or  only  in  small  quantities.  Whatever  may 
be  our  feelings  of  hiHsitudc,  and  however  much  we  may  appear  to 
need  food,  at  such  times,  it  is  useless  to  take  it,  for  it  cannot  be  di- 
gested, and  will  only  aggravate  our  disease.  If  the  illness  be  only 
slight,  the  fluid  will  be  formed  to  some  extent,  and  food  may  be  taken 
in  proportion. 

Its  Secretion  Favored  hy  flieerfnlness. —  A  cheerful  disposition,  and 

!  Ii  ippy,  lively  frame  of  mintl,  are  highly  favorable  to  the  prodiietioM 

of  the  giislritr  juice;   while  melancholy,  ;ind   an'^er,  and   gri(;f,  and 

iiiicuse  tiioiight  of  business  at  the  hour  of  meals,  greatly  hinder  ii^' 

natural  flow. 

This  should  teach  us  to  go  to  our  meals  with  light  hearts,  and  to 
make  the  family  board  a  place  of  cheerful  co.iversation,  and  of  a  light 
Hnd  joyous  play  upon  tho  mirthful  feelings  of  all  present.  Should 
finy  of  the  family  circle  be  in  the  habit  of  using  vinegar  as  a  condi- 
ment, wo  should  never  boguilty  of  compelling  them  to  extract  it  from 
mir  faces.  A  vinegar  face  is  not  easily  excused  anywhere ;  at  the 
t!il)lc  it  is  unpardonable.  A  single  countenance  of  this  description 
will  throw  a  gloom  over  a  tableful  of  naturally  cheerful  persons  ;  and 
if  habitually  present  at  tho  board,  may  finally  spoil  the  digestion  of 
half  a  dozen,  and  entail  dyspepsia  upon  them  for  life. 

Tho  stomachs  of  tho  sick  pour  out  but  very  little  of  this  fluid,  and 
they  can  take  but  a  small  amount  of  food.  It  is  cruel  to  deprive  them 
of  the  powers  of  digesting  that  little  by  treating  them  harshly,  :md 
filling  them  with  gloomy  and  desponding  feelings.  I  therefore  repeat 
tho  substance  of  the  advice  given  on  a  previous  page  :  Deal  gently 
with  the  sick. 

now  all  this  is  Kno\iii.  —  As  the  stomach  is  wholly  concealed  from 
view,  the  reader  will  very  naturally  ask  how  it  is  known  that  the  gas- 
tric juice  is  poured  into  it  in  certain  states  of  the  mind,  etc.,  and  with- 
held in  others.  It  certainly  could  not  have  been  so  accurately  known, 
had  it  not  been  for  an  accident  which  opened  the  living  and  working 
Btoinach  to  the  inspection  of  Dr.  Beaumont,  a  United  States  Surgeon. 
K  young  man  by  the  name  of  Alexis  St.  Martin,  a  Canadian  by  birth, 
but  then  in  the  State  of  Michigan,  had  a  large  part  of  his  side  torn  away, 
and  a  hole  of  considerable  size  made  into  his  stomach,  by  the  acci- 
dental discharge  of  a  gun.  To  the  surprise  of  his  surgeon,  St.  Martin 
recover  ^d ;  and  the  edges  of  the  wound  in  the  stomach  refused  to 
grow  together,  preferring  rather  to  fasten  themselves  to  the  borders  of 
the  breach  in  the  side,  thus  leaving  the  passage  open.  A  kint^  of  cur- 
tain grew  down  over  this,  which  prevented  the  food  from  falling  out. 
Dr.  Beaumont,  taking  advantage  of  this  state  of  things,  instituted  a 
series  of  valuable  experiments,  by  lifting  the  curtain,  and  inserting 
various  articles  of  food,  and  witnessing  the  process  of  digestion. 

MoTement  of  the  Stomach.  —  The  presence  of  food  in  the  stomach 


1: 


\- 


\\»tu^^.^x>:ii^^^,^ 


-'.i  *  .  . 


64 


HYOIKNB. 


eantea  ita  muBcnlar  coat  to  contract  and  ihrow  it  about  from  Hidp  to 
aiile,  mixing  it  thoroughly  with  the  gantric  juice,  and  reduoiug  it  to  u 
pulpy  masn,  called  chyme.  This,  aH  fnflt  as  it  is  properly  prepnrrd, 
paHseit  through  the  pylorus  into  the  upper  bowel,  or  duodenum^  cullccl 
also  the  second  stomach, 

€hyillf. —  A  certain  witty  professor  of  anavomy  and  ph''?!ology,  '\n 
in  the  habit  of  asking  his  class  if  they  ever  saw  any  chyme;  iind 
when  they  answer  no,  as  they  often  do,  he  calls  their  attontiuii  to 
what  they  occasionally  see  ;n  the  morning,  upon  the  Bidewalkf",  when- 
drunken  men  have  held  themselves  up  by  lamp-posta,  and  left  the 
eontents  of  their  stomachs. 

The  pylorurt,  or  opening  into  the  bowel,  has  a  very  singular  and 
wise  instinct,  which  is  worthy  of  remark.  When  a  piece  of  food, 
which  has  not  been  digesti^d,  attempts  to  pass  into  the  bowel,  tlie 
moment  it  touches  the  inner  surface  of  this  orifice,  it  is  instantly 
thrown  back  by  an  energetic  conlracticn  ;  though  a  portion  of  well- 
prepared  chyme  touching  the  same  opening  immediately  after,  is 
allowed  to  pass  on  unchallenged. 

Chyle.  —  The  chyme,  when  it  reaches  the  duodenum,  seems  to  cause 
the  liver  to  secrete  bile,  and  the  pancreas  to  produce  the  pancreatic 
juice.  These  two  fluids  are  conveyed  into  the  upper  portion  of  the 
second  stomach,  and  are  there  mixed  with  the  chyme,  and  cause  it  to 
separate  into  a  delicate,  white  fluid,  called  chyle,  and  a  residuum, 
which,  being  worthless,  is  pushed  onward,  and  thrown  out  of  the 
body. 

Bile  in  the  Stomach. —  Most  persons  suppose  that  bile  is  generally 
found  in  the  ston  ach;  but  this  is  a  mistake.  It  is  thrown  up  by 
vomiting,  because  in  that  act,  the  action  both  of  the  first  and  the 
second  stomach  is  reversed,  and  the  bile  is  forced  up  from  the  duode* 
num,  —  taking  a  direction  the  opposite  of  its  usual  course. 

Destination  of  the  Chyle.  —  The  chyle  being  separated  from  tho 
dregs,  is  pushed  onward  in  its  course 
by  the  worm-like  motion  of  the  in- 
testine ;  and  as  it  passes  along,  it  is 
gradually  sucked  up  by  thousands 
of  very  small  vessels,  whose  mouths 
open  upon  the  inner  surface  of  the 
bowel.  These  little  vessels  are  called 
laclenls,  from  the  Latin  word  lac^ 
which  means  milk,  because  they 
drink  this  white,  milky  fluid.  Fig- 
ure 01  shows  a  section  of  the  small 
bowel,  turned  inside  out,  and  covered 
with  the  villi,  or  root-like  filaments, 
closely  set  upon  its  surface,  for  ab- 
sorbing the  chyle,  and  at  the  bottom 
of  which,  the  lacteals  take  their  rise. 

In  these  lacteals,  and  in  the  mesenteric  glands,  the  chyle  is  gpradu- 


Fio.  61. 


irf 


»rn  Bidp  ♦" 

;iug  it  to  II 

'  prepnrr(' 
turn,  culled 

''S'ology,  i' 
fiyme; 
ttciition  to 
iilk?,  when- 
iiid  left  the 

ingulnr  and 
>ce  of  food, 
;  bowel,  tlie 
is  iiiHtaiitlv 
ion  of  well- 
tely  after,  is 


ems  to  cause 
le  pancreatic 
ortion  of  the 
id  cause  it  to 
a  residuum, 
a  out  of  the 

e  is  generally 

hrown  up  by 

first  and  the 

m  the  duode- 

rse. 

ted  from  the 


chyle 


^•!5IP«B^I^P**^»" 


■•W^wpfM 


HYOIKXK. 


i; 


ally  changod,  ho  as  to   appror    \  nearer  and   nrarcr  to   th«'   nature? 
t•^a  at  o«    <'"'    hlood  ;    but  prccisrly  wliiil   thi* 

<himg('  irt,  or  how  it  is  oUcctcd,  is  not 
known.  S«'vwrid  men  have  publislit'd 
their  tlu'oricrt  upon  thcHO  points,  and 
th«!  writer  has  opinions  upon  them ; 
but  it  is  not  worth  while  to  troubh; 
the  reader  with  them.  It  is  Huilicient 
to  Kay  that  the  fhiid  is  rarried  by  the 
laeteals  to  the  thoraei«r  duet,  through 
which  it  is  conveyed  into  a  large  ve.n 
at  the  lower  ])art  of  the  neck,  wlieie  ii 
is  poured  into  the  blood,  and  becoiaes, 
after  going  through  the  lungs  and  ex- 
periencing another  and  a  vital  change, 
the  mau'rial  out  of  which  our  bodies 
are  daily  anil  hourly  new-created. 

Figure  6ti  gives  a  general  idea  of 
the  stomach,  bowels,  etc.:  9,  being  the 
stomach;  10,  10,  the  liver;  1,  the  gidl 
bladder;  2,  the  duct  which  conveys  the 
bile  to  4,  which  is  the  duodenum  ;  3,  is 
the  pancreas ;  5,  the  a'sophagus ;  A, 
the  duodenum ;  B,  the  bowels ;  C,  the 
junction  of  the  small  intestines  with 
the  colon  ;  D,  the  appendix  vermifor- 
mis ;  E,  the  coecum ;  F,  the  ascending 
colon  ;  G,  the  transverse  colon  ;  H,  the 

descending  colon  ;  I,  the  sigmoid  flexure  ;  J,  the  rectum. 

Nature  and  Destination  of  Food. 

The  food  which  man  requires  for  his  tiupport  and  development  is 
of  two  kinds,  the  inorganic,  and  the  organic.  The  first  of  these  em- 
braces certain  mineral  substances,  as  common  salt,  sulphur,  phospho- 
rus, iron,  and  lime,  either  in  combination  or  separate. 

These  are  not  gcnera'ly  reckoned  as  aliments,  and  yet  no  human 
being  can  live  without  them.  In  their  absence,  the  body  decays,  dis- 
integrates, and  perishes.  Common  salt  is  composed  of  muriatic  acid 
and  soda.  The  first  is  an  important  ingredient  in  the  gastric  juice, 
una  the  latter  promotes  the  secretion  of  bile.  Sulphur  is  found  in 
several  of  the  tissues,  particularly  in  the  muscles.  Phosphorus  united 
to  fatty  matter,  is  highly  honored  in  forming  a  ])ortion  of  the  brain 
and  nerves,  and  is  also  combined  with  oxygen  and  lime  to  make  the 
earthy  or  hard  jjart  of  bones. 

Found  in  Food.  —  These  articles  it  is  not  necessary  often  to  intro- 
duce into  the  system  in  a  .separate  state.  They  arc  contained,  in 
larger  or  smaller  proportions,  in  most  articles  of  food ;  and  man  always 
^uHers,  as  all  animals  do,  from  their  absence.     Common  salt  is  found 

9 


''A 


..il 


If: 


in  the  flesh  of  animals,  in  milk,  and  in  eggs.  It  is  not  very  abundant 
in  plants ;  and  we  all  know  how  eagerly  domestie  animals  d»!vour  it 
when  it  is  given  to  them,  and  how  constantly  wild  cattle  resort  to  the 
salt  springs,  which,  in  the  great  West,  are  called  "  buffalo  licks." 
Lime  exists  in  nearly  all  anim.al  and  veg«!table  substances.  In  wheat 
flour  we  get  it  in  combination  with  phosphoric  acid,  that  is,  as  phos- 
phate of  lime.  Lime  exists,  too,  in  the  state  of  carbonate  and  sul- 
phate, in  all  hard  water.  Iron  is  found  in  the  yolk  of  eggs,  in  milk, 
in  animal  flesh,  in  jiotatoes,  pears,  cabbages,  mustard,  and  other  arti- 
cles. Sulphur  we  get  in  flesh,  eggs,  and  milk  ;  and,  as  sulphate  of 
lime,  in  spring  and  river  water.  Phosphorus  is  derived  from  eggs  and 
milk ;  and  flesh,  bread,  fruits,  and  husks  of  grain,  commonly  called 
bran,  contain  even  a  larger  proportion  than  we  need  in  our  diet. 

Organic  Food. —  The  organic  elements  of  man's  food,  which  in  bulk 
embrace  almost  the  whole  of  it.  remain  to  be  considered.  In  th? 
animal  economy  they  serve  two  great  purposes.  A  part  of  the  arti- 
cles which  compose  them  are  blood-formers,  out  of  which  all  the 
tissues  are  made, — the  other  part  produce  fat,  which  serves  to  warm 
the  body  by  being  burned  with  oxygen.  These  articles  are  derived 
partly  from  the  vegetable  and  partly  from  the  animal  kingdom. 


-  For  convenience,  these  articles  may 
For  the  first, 


Divided  into  Four  Groups 

be  divided  into  four  groups, 
sugar  stands  as  a  typv"?.  We  therefore  call 
it  the  saccharine  group.  It  embraces  starch, 
gum,  and  the  fibre  of  wood.  These  arti- 
cles may  all  be  converted  into  sugar  by  a 
simple  chemical  process.  Figure  63  gives  a 
microscopic  view  of  the  granules  of  starch. 

The  second  group  we  call  the  oleagimms. 
It  is  composed  of  oily  substances,  from 
whatever  source  derived,  whether  the  ani- 
mal or  the  vegetable  world. 

The  third  group  is  the  albuminous.  A 
good  type  of  it  is  the  white  of  egg. 

The  fourth  is  the  gelatinous,  or  jelly  group. 

First  and  Second  Groups,  Supporters  of  Respiraiion. — The  articles 
composing  the  first  and  second  groups  are  analogous  in  composition, 
all  containing  ox//gen,  hydrogen,  and  carbon.  They  are  what  Liebig 
calls  supporters  of  respiration  ;  the  meaning  of  which  is,  in  mce 
comprehensible  terms,  that  they  are  supporters  of  covibustion.  They 
are  the  fuel  which  warms  us.  They  keep  the  fires  going,  from  which 
arises  all  the  heat  we  have  in  our  bodies.  But  they  are  destitute  of 
nitrogen,  and,  on  this  account,  they  are  not  blood-formers,  and  cannot 
be  worked  into  flesh.     Hence,  man  cannot  live  on  them. 

The  food  articles  embraced  in  the  third  and  fourth  groups,  also 
contain  oxygen,  hydrogen,  and  carbon  ;  and  to  these  they  add  nitro' 
gen.  This  fourth  component  part,  which  forms  only  a  small  portion 
of  them,  gives  them,  for  some  reason  never  explained,  the  jieculiar 


ciiffi, 
havii 
g.eat 


11 


"^H 


mndiiiit 
!Vour  it 
■t  to  the 
,  lick=«." 
n  wht".>t 
as  phos- 
and  snl- 
iu  milk, 
ther  arti- 
phate  of 
ecrga  and 
ily  called 
liet. 

•h  in  bulk 
1.  Ill  thp 
F  the  arti- 
:.h  all  the 
3  to  warm 
re  derived 
lorn. 

tides  may 


:hc  articles 
lomposition, 
Ihat  Liebig 

is,  in  mo>e 
ition.     They 

from  which 

Idestitute  of 

and  cannot 

Igroups,  also 
\y  add  nitro- 
liiall  portion 
[the  pcculiat 


HYGIENE. 


67 


qualitj  of  producing  blood  and  flesh.     They  are  the  raw  materials, 
out  of  which  our  bo<li('s  arc  rcconstructtnl  from  day  to  day. 

Feed  a  man  ever  so  largely  u|X)n  sugar,  starch,  gum,  and  oil.-*,  and 
he  will  starve  as  certainly  as  if  he  were  allowed  nothing  but  water. 

Knnies  of  'Hvo  Great  Divisions  of  Food.  —  The  possession  or  non- 
possession  of  nitrogen,  then,  is  what  distinguishes  from  each  other 
the  two  great  classics  of  footl-articles.  Those  which  contain  nitrogen 
have  been  called  nifrog-enized,  and  those  which  are  destitute  of  it, 
iwn-nitrog-enized  comjwunds.  As  nitrogen  is  often  called  azote,  the 
former  class  are  more  frequently  named  azolized ;  the  latter,  now- 
azotized. 

Let  the  reader  now  fix  it  in  his  mind  that  the  azotized  articles  of 
food  prtxiuce  blood  and  flesh;  the  non-azotized,  heat ;  and  he  will 
iiave  the  key  to  understand  much  of  what  is  to  be  said,  and  likewise 
to  unlock  many  of  the  mysteries  of  diet 

Nutrition  Table.  —  Taking  human  milk  as  the  standard,  and  ex- 
pressing the  amount  of  nitrogen  it  contains  by  100,  the  following 
table  shows  the  relative  amount  of  nitrogen  in  the  prindipal  flesh- 
producing  articles  of  food,  and  consequently  their  power  of  forming 
the  tissues : 


Rice,  ..... 

Rye, 

Corn,          -        -        -        .        . 
Barley,  ..... 
Oats,           ..... 
Wheat, 144 


VEGETABLE. 

81  Totatoes, 

-  106  Turnips, 
125  Carrots, 

-  125  Peas, 
188  Beans,    • 


84 
106 
150 
239 
820 


Human  Milk, 

Cows'  Milk, 

Oyster, 

Yolk  of  Eggs, 

Cheese, 

Eel,    - 

Pork-Ham. 

Salmon, 


ANIMAL. 

-  100  White  of  Egg,        -        -        -        -  845 
237  Herring, 910 

-  805  Haddock, 816 

305  Pigeon, 756 

331-447  Lamb, 833 

428  Mutton, 852 

-  807  Veal, 911 

610  Beef, 042 


Otiier  standards  of  Value. —  "We  must  not  infer  that  those  articles 
which  have  most  nitrogen  are  necessarily  best  adapted  for  human 
di«t  because  they  are  the  most  effective  blood-producers.  In  deciding 
the  value  of  an  article  for  food,  other  things  are  to  be  looked  at  be- 
side its  nutritive  qualities.  Those  which  are  poor  in  nitrogen,  are 
rich  in  carbon  and  hydrogen,  and  are  well  fitted  to  serve  the  double 
purpose  of  nourishing  and  warming  the  body  at  the  same  time.  The 
fitness  of  an  article  for  diet,  depends  very  much  u^^  ■  the  ease  or 
difficulty  with  which  it  is  digested  and  assimilated,  if  an  article, 
having  a  great  deal  of  nitrogen,  and  being  very  nutritive,  is  with 
givat  ditliculty  reduced  in  <lie  stomach  by  the  digestive  process,  it 


^i^''. 


08 


HYGIENE. 


may  Ix*  much  less  dortirablo  f<»r  foo<l  than  one  which  is  digested  and 
assimilated  easily,  but  is  nuicii  poorer  in  nutritive  qualities. 

Ilent-j^eiU'nitiilg:  Fooil  Articles.  —  The  reader  has  before  him  the 
principal  blood  and  tissue-lorrning  f(xxl  articles.  Those  which  we 
reckon  as  fuel,  or  heat-generators,  are  chiefly  oils,  sugar,  starch,  farina, 
sago,  arrow-root,  tapi(x-a,  gums,  etc.  These  are  less  essential  than  the 
t  thcrs  ;  for  the  blotxl-forming  articles  have  within  them  the  elements, 
<  lit  of  which  fat  is  formed  in  the  process  of  assimilation  ;  for  many 
of  them  contain  starch  ;  and  this,  in  the  human  organism,  is  changed 
into  fat.  The  amount  of  starch  in  some  of  these  articles  is  as  fol- 
lows : 

AVhcat  flour,  good  quality,  100,  contains  65  to  66  parts  in  100  ptire  starch. 


Wheat, 

-     108 

tt 

J3  "  56 

u 

II 

II 

Barley  meal. 

119 

t4 

61   "   6.) 

14 

II 

It 

Barley, 

-     130 

it 

37  "  37 

(4 

II 

« 

Rye,          -        - 

111 

14 

44  "  47 

.1 

11 

i( 

Buckwhea*,  - 

-     108 

44 

43  "  44 

H 

II 

<( 

Indian  Com, 

138 

44 

65  "  60 

a 

II 

It 

Rice,    - 

-     171 

44 

85  "  86 

II 

II 

II 

Peas. 

69 

Ik 

38  "  39 

II 

II 

II 

White  Beans, 

-       59 

44 

37  "   .".S 

It 

11 

II 

III  the  Nutritive  Food  Articles,  there  is  a  fixed  relation  existing  be- 
tween the  elements  of  the  ti^sue-formers  and  the  heat-producers, 
which  they  contain.  Out  of  a  few  of  them  Baron  Liebig  has  con- 
structed the  following  table : 

For  every  ten  parts  of  blood  and  tissue-formers  there  are,  — 


In  Wheat  flour. 

10 

46 

In  Barley, 

10 

57 

In  Rye  meal. 

10     - 

-       57 

In  Rice, 

10     - 

-     123 

In  Oatmeal, 

lOv 

60 

In  White  potatoes, 

10 

8b 

In  Buckwlieat, 

10     - 

-     130 

In  Blue  potatoes, 

10     - 

-     130 

Diet  n  Complex  Subject. —  From  the  facts  and  tables  now  presented, 
it  appears  that  the  question  of  diet  is  one  of  complexity ;  and  thct 
the  determination  of  its  several  points,  require  that  a  number  of  things 
should  be  taken  into  the  account.  First,  in  deciding  the  usefulness 
of  any  article,  we  may  inquire  respecting  ; 

Its  Dijfestibllitj'. —  If  an  article  be  not  digestible,  u  is  of  little  con- 
sequence how  much  or  how  little  albumen,  starch,  or  nitrogen  it  may 
contain.  The  first  and  most  important  inquiry  recpc;:ti;i.«r  ii  i»,  i';  it 
digeslible  ?  If  not,  it  is  to  be  rejected;  for,  whatever  othf  qualities 
it  may  have,  it  can  only  injure  the  stomach,  and  embarrass  thv,  whole 
system. 

The  following  table  will  be  useful  to  the  reader,  though  I  do  not 
set  it  down  as  reliable  in  all  cases.  There  is  often  a  great  difTercnoe 
in  the  ease  with  which  ditterent  stomachs  will  digest  the  same  f(xxl. 
Many  stomachs  are  afflicted  with  what  is  called  an  idiosyncrasy,  —  a 
habit,  peculiar  to  itself,  of  rejecting,  or  refusing  to  digest,  some  one, 
or  more,  articles  which  are  acceptable  to  all  other  stomachs.     This 


■'"'"-"^f' 


— 11 


ted  aiul 


him  ihe 
/hich  we 
•h,  farina, 

than  the 
oleinciits, 
for  many 
i  changeil 

is  as  fol- 


gtarch. 
(( 

(( 


existing  he- 
t-protlucers, 
ig  has  con- 


57 
.    123 

8ti 
-    130 

presented, 
-  and  th:^. 
;r  of  things 
le  usefulness 


>f  little  con- 

[•ogen  it  may 

[nff  ii  i»i '''  '* 
St'r  ,yaalities 

[ss  V':.-  vUole 


,agh  I  do  not 
lat  difference 
le  same  food, 
lyncrasy,— -* 
^kt,  some  one, 
nachs.     This 


HYGIENE. 


69 


table  shows  the  length  of  time  required  for  digesting  the  several  arti- 
cles in  the  stomach  of  St.  Martin,  as  shown  by  the  experiments  of 
Dr.  Beaumont : 


Article!. 


Rice 

rii;'s  feet,  soused  .... 

Tripe,  soused 

Trout,  salmon,  fresh .  , 

Ai)])K's,  sweet,  mellow 

Venison,  steak 

Sa;;o 

A|)|ilt'.s,  sour,  mellow 
(';ilit)a<;e,  with  vinegar 
Codtish,  cured,  dry 

E''fi»,  fresh 

Liver,  beef's  fresh. 

Milk 

Tapioca 

Milk 

Turkey,  wild  .... 

"        domesticated 

Potatoes,  Irish 

Parsnips 

Pji;,  sucking 

Meat    hashed    with ) 

vegetables ) 

Lamb,  fresh 

Goose 

Cak"  iponge  

Ci.  u.,p,j-head 

Beans,  pod 

Custard 

Chicken,  full-crown  .  . 
Apples,  sour,  hard  .  .  . 

Oysterp,  fresh 

Kass,  s  riped,  fresh.  .  . 
Bfccf,  I'resn,  lean,  rare 

"     steak 

Corn  cake 

Dumpling,  apple 

Efjcs,  fresh 

Mutton,  fresh . . . , 


Preparations. 


P.oiled  .  .  . 
Boiled  .  .  . 
Boiled  .  . . 
Boiled  .  .  . 
Fried.  .  .  . 

Ilaw 

Broiled.  .  . 
Boiled  .  .  . 

Ilaw 

Raw 

Boiled  .  .  . 

Raw 

Broiled.  .  . 
Boiled  .  . . 
Boiled  .  .  . 

Raw 

Roasted  .  , 
Boiled  .  .  . 
Roasted  .  . 
Baked  .  .  . 
Boiled  .  . . 
Roasted  .  . 

Warmed.  . 

Broiled.  . . 
Roasted  .  . 
Baked  .  .  . 

Raw 

Boiled  .  .  . 
Baked  .  .  . 
Fricasseed 

Raw 

Raw 

Broiled.  .  .. 
Roasted  . . 
Broiled.  .  . 
Baked  . . . 
Boiled  .  . . 
Boiled  soft 
Broiled.  .  . 
1  Boiled  .  .  . 


Time. 

Ii.  m. 
1  — 
1  — 
1  — 
1  30 
1  30 
1  30 
1   35 

1  45 

2  — 
2  — 
2  — 
2  — 
2  — 

2  

2  

2 


Article*. 


Pork,  rect'titly  salted 

Soup,  chicken 

Oysters,  fresh 

Pork,  recently  salted 

Pork  steak 

Corn  bread 

Mutton,  fresh 

Carrot,  orange 

Sausage,  fresh 

Beef,  fresh,  lean,  dry 
Bread  wheat,  fresh .  . . 

Butter 

Cheese,  old,  strong.  .  . 
Eggs,  I'resh 


I'reparatioiia.     Time. 


15 
2   18 


25 
30 
30 
30 
30 


2  30 


30 
30 


2  30 


30 
30 
45 
45 
50 
55 


3  — 

3  — 

3  — 

3  — 


Flounder,  fresh.  .  . . 

Oysters,  fresh 

Potatoes,  Irish  .... 

'Soup,  mutton 

"     oyster 

Turnip,  flat 

Beets 

Corn,  green,  and  beans 
Beef,  fresh,  lean. .  . 
Fowls,  domestic  .  .  . 


Veal,  fresh 

Soup,   beef,  vegeta- ) 
bles,  and  bread  .  .  J 

Salmon,  salted 

Heart,  animal 

Beef,  old,  hard,  salted 
Pork,  recently  salted 
Cabbage,  with  vinegar 

Ducks,  wild 

Pork,  recently  !?alted 

Suet,  mutton 

Veal,  fresh 

Pork,  fat  and  lean  .  . 
Suet,  beef,  fresh .... 
Tendon  


Raw 

Boiled 

Roasted  .  . . 
Broiled.  . .  . 
Broiled.  .  .  . 

Baked  

Roasted  .  .  . 

Boiled 

Broiled.  .  .  . 
Roasted  .  .  . 

Baked 

Melted . .  .  . 

Raw 

Hard  boiled 

Fried 

Fried .  .  . .  . 
Stewed.  .  .  . 

Boiled 

Boiled 

Boiled 

Boiled 

Boiled  .  .  .  . 

Boiled 

Fried 

Boiled 

Roasted  .  .  . 
Broiled.  .  .  . 

Boiled 

Boiled 

Fried 

Boiled 

Fried 

Boiled  ... 
Roasted  .  .  . 

Boiled 

Boiled  .  .  .  . 

Fried 

Roasted  .  .  . 

Boiled 

Boiled 


li.  m. 
3  — 
3  — 
3  15 


3 

3 

3 

3 

3 

3 

3 

3 

3 

8 

3 

3 

3 

3 

3 

3 

3 

3 

3 

3 

4  — 

4  — 

4  -^ 

4  — 

4  — 

4  — 
4  — 
4 

4 
4 
4 
4 
4 
4 
5 


15 
15 
15 
15 
15 
20 
30 
30 
30 
30 
30 
30 
30 
30 
30 
30 
30 
30 
45 
45 


15 
15 
30 
30 
30 
30 
30 
15 
80 
30 


This  table  may  be  considered  as  giving  a  general  idea  of  the  rela- 
tive digestibility  of  the  food-articles  contained  in  it.  If  not  found 
exactly  right  in  each  iiidividual  case,  it  can  be  rectified  by  experience. 
The  experience  of  no  other  individual's  stomach  will  ever  be  found 
precisely  like  that  of  St.  Martin's,  —  though  in  its  general  features,  it 
may  be  sufficiently  similar  to  make  his  valuable.  The  general  prin- 
ciples of  conduct  may  be  learned  from  the  experience  of  others.  The 
particular  application  must  come  from  our  own  experience  and  reason. 

Dig:estibility  Influenced  by  Amount. — The  rapidity  with  which  any 


"-»TRf": 


jirficic  i.s  digested  will  vjiry  witli  the  amount  taken.  A  larger  quan- 
tity than  is  called  for  by  the  wants  of  the  system,  will  be  digested 
more  slowly  tiian  the  proper  amount ;  while,  on  the  other  hand,  an 
insuftieient  supply  begets  an  inability  to  reduce  in  the  tstomach  even 
the  small  quantity  taken.  We  may  err  in  taking  too  little  food  as 
well  as  in  taking  too  much  ;  though  the  former  error  is  much  lesi 
likely  to  occur  than  the  latter. 

Choosing  Food  in  111  lleaUli.  —  But  in  deciding  the  kind  and 
amvhitl  of  food,  we  must  be  guided  not  only  by  its  digestibility,  but 
by  the  state  of  the  health. 

If  we  find  the  stomach  apparently  in  good  working  condition,  capa- 
ble of  dissolving  properly  whatever  is  submitted  to  its  action,  and 
yet  we  are  for  some  cause  losing  flesh  and  strength,  we  should  resort 
not  only  to  the  most  nutritious  of  the  albuminous  group  of  the  azo- 
ti/ed  articles,  but  likewise  to  the  oleaginous  group  of  the  non-azotized. 
We  want  a  great  amount  of  nutriment,  and  we  need  oils  to  make  fat. 
This  is  the  kind  of  food  generally  wanted  in  constitutional  consump- 
tion. 

In  fevers,  but  little  food  can  be  disposed  of  at  best ;  and  that  little 
must  be  chosen  with  reference  to  its  mildness  and  its  unstimulating 
(lualities.  Generally  the  farinaceous  or  starchy  articles  are  most  suit- 
able, because  they  have  no  stimulating  and  irritating  qualities,  and 
especially  because  they  furnish  fuel  to  be  burned  with  oxygen,  and 
thus  take  the  place  of  the  animal  tissues,  which  are  being  rapidly 
consumed  with  this  devouring  element.  In  fever,  oxygen  is  literally 
burning  up  the  body.  In  this  state  of  the  system,  this  element  ac- 
quires, by  some  means,  a  singular  alfinity  for  the  tissues ;  and,  uniting 
with  them  rapidly,  forms  a  true  combustion.  The  physician  who 
throws  to  this  devouring  agent  some  of  the  mild,  non-azolized  articles 
which  oft'er  it  stronger  affiiiities  than  it  finds  in  the  tissues,  is  as  wise 
as  he  who  tosses  his  dog  to  a  hungry  lion  to  avoid  being  devoured 
himself. 

FAerci.se  to  be  Considered.  —  In  deciding  the  diet,  the  amount  of 
exercise  is  not  less  important  to  be  considered  than  the  health.  The 
farmer,  who  vorks  in  the  open  air,  and  uses  his  musciles  a  great  deal, 
wants  considerably  more  nutritive,  as  well  as  more  combustive,  food 
than  one  who  leads  a  sedentary  life.  Of  course  there  is  a  great  deal 
more  waste  of  the  tissues,  and  he  requires  more  of  the  llesh-forming 
articles;  and  as  he  breathes  deeper,  and  takes  in  more  oxygen,  he 
needs  more  of  the  supporters  of  respiration,  —  the  sugars,  oils,  and 
starchy  aliments. 

Beans.  —  By  turning  to  the  table  which  shows  the  amount  of  nitro- 
,gen  in  the  diflerent  food-articles,  the  reader  will  see  that  beans  are 
rich  in  this  element.  They  are,  therefore,  excellent  food  for  working 
men,  who  are  obliged  to  make  great  use  of  their  muscles.  Our 
fathers,  who  broke  and  subdued  the  rocky  soil  of  New  England, 
showed  wisdom  even  in  their  instincts  in  taking  so  large  a  portion  of 
their  aliment  from  the  bean,  —  especially  as  they  oi/ed  it  with  the  fat 


%i 


IIYCJir  'E. 


71 


irger  quan- 
je  digested 
it  hand,  an 
mach  even 
ttle  food  as 
much  less 


;  kind  and 
tibility,  but 

lition,  capa- 
action,  and 
lould  resort 
of  the  azo- 
on-azoti/ed. 
\o  make  fat. 
lI  consump- 

:l  that  little 
istimulating 
e  most  suit- 
lalities,  and 
oxygen,  and 
3in g  rapidly 
I  is  literally 
element  ac- 
and,  uniting 
y^siciau  who 
jzed  articles 
;s,  is  as  wise 
ifiT  devoured 

o 

:  amount  of 
leulth.  The 
a  great  deal, 
burttive,  food 
a  great  deal 
llesh-forming 
J  oxygen,  he, 
;ars,  oils,  and 

)unt  of  nitro- 
lat  beans  are 
for  working 
luscles.  Our 
ew  England, 
!  a  portion  of 
,  with  the  fat 


of  pork.  But  for  th(!  hard-working  student,  who  daily  makes  heavy 
drafts  upon  his  brain  and  iK'rvous  system,  beans  and  peas  are  an  im- 
proper diet.  They  contain  no  phosphorus,  in  the  shape  of  phospliate 
of  lime ;  and  no  brain  can  work  hard  without  a  due  supply  of  phos- 
phorus, which  forms  a  part  of  its  substance. 

I'lihoUed  Wheat  Flour.  —  For  the  man  who  uses  his  brain  a  great 
deal,  there  is  no  other  owe  article  of  food  equal  to  bread  made  from 
unbolted  wheat  flour.  Fine  wheat  flour  is  little  better  for  him  than 
beans,  because  the  miller  has  robbed  it  of  much  of  the  phosphorus, 
which  is  found  chiefly  in  the  hull  or  bran. 

1  mention  only  two  or  three  articles  of  food  as  specimens.  By 
looking  over  the  tables  furnished,  and  reasoning  upon  the  whole  in 
the  way  I  iiave  done  upon  these  few,  the  reader  can  give  every  article 
something  like  its  proper  value  in  most  circumstances. 

Clillinte.  —  If  health  and  exercise  should  influence  us  in  choosing 
the  kind  and  the  amount  of  food,  climate  must  do  so  quite  as  much. 

In  the  frigid  climate  of  high  latitudes,  it  is  necessary  that  a  great 
deal  of  heat  be  produced  in  the  body,  in  order  to  avoid  perishing  with 
cold.  There  is  no  mystery  now,  as  there  once  was,  about  the  produc- 
tion of  this  heat.  It  comes  from  the  burning  of  carbon  and  other  sub- 
stances in  the  body,  where  they  unite  with  oxygen,  and  make  just  as 
real  a  fire  as  that  which  warms  our  houses.  Oils,  sugar,  starch,  gums, 
etc.,  are  largely  composed  of  carbon,  and  readily  unite  with  oxygen 
in  the  body.  This  is  the  reason  why  they  are  reckoned  as  fuel,  and 
are  called  supjmrters  of  combustion.  And /or  this  reason,  they  require  to 
be  largely  consumed  in  very  cold  climates.  The  instincts  of  men  seem 
to  lead  to  the  same  conclusion,  for  the  dwellers  in  all  high  latitudes, 
consume  great  quantities  of  oils  and  fats.  The  amount  of  train  oil, 
tallow,  the  fat  of  seals  and  other  animals,  devoured  by  the  Laplanders, 
Kamtschatkians,  and  other  northern  people,  is  truly  wonderful. 

In  hot  countries,  the  fundamental  rule  for  preserving  the  health,  is 
to  keep  the  body  cool.  Without  observing  this  rule,  the  strongest  will 
often  fall  victims  to  the  climate  in  low  latitudes.  But  to  keep  cool, 
of  course  all  the  heat-producing  articles  of  food  should  be  avoided. 
Particularly  all  alcoholic  drinks,  which  are  powerful  supporters  cf 
combustion,  should  be  rejected.  Rice,  and  the  various  fruits  form  the 
most  suitable  articles  of  diet. 

The  great  sacrifice  of  life  which  we  have  witnessed  the  last  few 
years  among  the  emigrants  to  California,  has  been  the  result  chiefly 
of  using  ardent  spirits  and  heat-producing  food  while  crossing  the 
Isthmus,  which,  to  a  northern  constitution,  is  much  like  a  vast  oven, 
heated  to  a  temperature  suitable  for  baking  bread.  There  are  few 
persons,  with  tolerable  health  and  strength,  but  would  safely  endure 
the  ordeal  of  the  Isthmian  passage,  if  they  would  live  light  for  a  few 
days  before  starting ;  and  during  the  passage,  take  only  an  abstemious 
vegetable  and  fruit  diet. 

Buyard  Taylor's  Opinion.  —  The  distinguished  traveller.  Bayard 
Taylor,  reports  that  while  spending  a  few  days  in  a  heated  part  of 


72 


HYGIENE. 


P-*« 


Africa,  he  lived,  as  the  iiilnibitants  did,  pretty  much  entirely  upon  the 
fleah  of  well-fatted  sheep ;  and  that  he  enjoyed,  meantime,  excellent 
health  and  strength.  From  this  he  concludes  that  animal  food  is  as 
suitable  in  hot  climates  as  in  cold. 

It  is  a  pity  a  mar.  of  such  excellent  parts  as  Mr.  Taylor,  should 
allow  himself  to  rear  so  tall  a  structure  upon  so  narrow  a  foundation. 
That  he  could  live  on  flesh  in  so  hot  a  region,  and  not  be  made  sick, 
only  proves  that  he  has  a  fine  constitution,  and  that  his  health  is  not 
easily  disturbed ;  and  when  he  attempts  from  his  limited  experience 
of  a  few  days,  to  reason  against  the  established  facts  of  science,  and 
against  the  well-attested  laws  of  life,  he  does  it  evidently  without 
reflecting  that  he  is  in  a  field  of  thought  which  he  has  never  had  oc- 
casion to  cultivate. 

The  great  Jewish  Lawgiver  doubtless  had  a  reason  for  prohibiting 
pork  to  the  Jews.  Whatever  that  reason  was,  the  prohibition  had  a 
wise  bearing  upon  the  health  of  the  people.  Palestine  has  a  hot 
climate,  in  which  pork-fat  is  an  improper  diet 

More  Flit  in  Winter.  —  It  follows  from  what  has  been  said,  that  a 
more  fatty  as  well  as  stimulating  diet  is  needed  in  winter  than  in 
summer.  But  the  change  should  be  made  gradually.  When  cold 
weather  approaches,  the  food  should  become  more  nutritious  and 
warming  by  little  and  little.  The  exercise  should  likewise  be  in- 
creased. 

Even  the  lower  animals  act  upon  this  plan.  In  the  fall,  squirrels 
cat  nuts,  which  are  full  of  oil,  and  grow  fat  upon  them. 

The  instincts  of  men  move  in  the  same  direction.  It  is  in  the  fall 
that  the  hog,  the  ox,  and  the  poultry  are  killed ;  and  in  the  winter 
that  they  are  largely  feasted  upon  and  enjoyed.  Upon  such  food, 
combined  with  various  sorts  of  starch,  man  fattens ;  and  a  good  sup- 
ply of  fat,  deposited  in  the  cells,  is  equal,  in  keeping  out  cold,  to  a 
layer  of  cotton  batting,  —  to  say  nothing  of  the  fire  kept  up  within 
the  body  by  the  burning  of  such  fuel.  As  hot  weather  comes  on,  we 
gradually  lay  aside  these  fattening  articles  (or  ought  to),  and  return  to 
the  watery  yegetables  and  fruits,  such  as  squash,  string  beans,  straw- 
berries, currants,  etc. 

Few  of  u»,  I  apprehend,  would  suffer  from  heat  in  summer,  if  we 
could  persuade  ourselves  to  abandon  stimulating  and  fire-producing 
food,  and  confine  ourselves  pretty  much  to  a  cooling  and  succulent 
diet  Diarrhoeas  in  summer  are  not  induced  by  eating  wholesome 
vegetables,  but  by  combining  them  with  large  quantities  of  animal 
ibod. 

The  State  of  the  Mind.  —  This  should  by  no  means  be  overlooked 
in  choosing  the  kind  and  the  amount  of  food.  If  we  have  lost 
friends,  or  heard  desponding  news,  or  experienced  calamities  of  any 
kind,  we  must  during  the  first  hours  of  the  shock,  or  even  during  the 
first  days,  if  the  affliction  be  heavy,  partake  very  sparingly  of  food. 
The  stomach  is  in  no  condition  to  receive  it.  The  brain  lies  prostrate 
under  the  stroke,  and  the  stomach,  in  sympathy  with  it,  asks  for  a  day 
of  sorrow  and  fasting.     Disturb  it  not 


upon  the 
excellent 
ood  is  as 

)r,  should 
luidation. 
jade  sick, 
1th  iri  not 
xperience 
ence,  and 
'  without 
jr  had  oc- 

rohibiting 
ion  had  a 
las  a  hot 


lid,  that  a 
;r  than  in 
^hen  cold 
tious  and 
ise  be  in- 

l,  squirrels 

in  the  fall 
he  winter 
iuch  food, 
good  sup- 
cold,  to  a 
up  within 
les  on,  we 
return  to 
ns,  straw- 
Tier,  if  we 
jroducing 
succulent 
rholesome 
of  animal 

verlooked 
lave  lost 
es  of  any 
uring  the 
y  of  food, 
prostrate 
for  a  day 


HYGIENE. 


73 


Ilent-prodncinp  Food  Incompatible  with  Exciteiiieiit.  —  It  is  folly 
to  take  heat-producing  aliment  when  laboring  for  days  under  high 
excitements.  During  political  campaigns,  when  the  blood  of  poli- 
ticians is  at  the  boiling  point,  the  diet  should  be  unstimulating, — 
containing  very  little  animal  flesh,  and  not  much  combustive  food. 
Many  a  man  has  died  of  apoplexy,  or  of  heart  disease,  by  putting  on 
the  steam  when  his  blood  was  up.  Whenever  we  have  a  day  ot  un- 
common excitement  to  pass  through,  we  should  always  begin  and 
end  it  with  an  unusual  degree  of  abstinence  as  to  the  amount  of 
food  taken,  and  with  special  care  that  the  articles  be  of  the  lighlesl 
(Juiid. 

An^er  Denmnds  Abstinence.  —  Anger  is  a  passion  which  especially 
unfits  the  stomach  for  doing  much  work.  If  it  occur  often,  or  be 
protracted,  but  little  food  should  be  taken.  Those  who  indulge  it, 
have  a  doubh;  cause  for  abstinence.  Both  their  folly  and  their  stom- 
achs call  for  a  fast. 

Food  Adapted  to  DilTerent  Periods  of  Life. —  Food  must  vary  in 
dlHerent  periods  of  life.  The  infant  needs  a  fattening  diet ;  and  this 
liiis  been  su|)plied  in  the  milk  of  the  mother,  which  contains  more 
butter  (the  fattening  portion)  than  the  milk  of  any  other  animal.  But 
IIS  the  infant  has  much  less  exercise  than  the  young  of  animals,  its  flesh 
is  not  wasted,  and  it  does  not  require  so  much  azotized  food,  that  is, 
the  reader  will  remember,  food  with  nitrogen  in  it.  Accordingly,  it 
will  be  seen  by  looking  at  the  table  on  page  67,  that  human  milk  has 
uHidi  less  of  this  element  than  that  of  the  cow.  As  the  child  grows 
vtp,  and  begins  to  take  active  exercise,  indoors  and  out,  it  wants  more 
solid  food,  and  teeth  make  their  appearance  to  masticate  or  chew  it. 

In  Youtll  and  Manliood,  the  great  amount  of  exercise  usually  taken, 
calls  for  larger  supplies  of  azotized  aliment,  —  beef,  mutton,  pork, 
fowl,  fish,  wheat  flour,  corn-meal,  rye-meal,  potatoes,  turnips,  peas, 
beans,  etc.  This  is  the  working  part  of  life,  when  the  tissues  are 
rapidly  wasted  by  action,  and  the  flesh-forming  aliments  are  wanted 
to  keep  them  good. 

In  Old  Age,  the  exercise  is  diminished,  the  blood  circulates  moie 
slowly,  and  the  body  grows  cold.  Now  is  the  time  to  resort  to  notu 
azotized  food,  —  oils,  fats,  the  various  kinds  of  starch,  sugar,  and  the 
like.  These  will  furnish  fuel  to  warm  the  sluggish  blood,  and  will 
invest  the  body  with  fat,  which  will  serve  the  purpose  both  of  a  cush- 
ion and  a  garment.  Wine,  beer,  porter,  and  distilled  spirits  are  never 
needed  by  young  persons  in  health ;  but  the  aged  are  frequently  bene- 
fited by  them,  if  taken  in  small  quantities.  They  are  chiefly  com- 
posed of  oxygen,  hydrogen  and  carbon,  and  are  properly  ranked  with 
the  supporters  of  combustion.  They  are  likewise  stimulant,  and  add 
to  the  comfort  of  the  old  by  quickening  their  circulation.  Like  tea 
and  coffee,  they  diminish  the  waste  of  the  body,  and  thereby  lessen 
the  demand  for  food. 

The  smallest  amount  of  aliment  upon  which  a  healthy  adult  person 
ever  lived  for  any  length  of  time,  was  twelve  ounces  a  day.     Upon 


^ 


74 


HYGIENE. 


this  small  daily  allowanco,  Lewis  Cornaro,  a  noble  Vpnetinn,  sub- 
sisted in  perfeet  health,  during  tiie  protnicted  period  of  fifty-eight 
years.  This  he  was  able  to  do  only  by  adding  daily  to  his  food 
about  twelve  ounees  of  light  wines.  I  shall  have  oecasion  to  refer  to 
this  case  again. 

Cost  of  Food. 

One  other  consideration  must  ever  influence  the  great  majority  of 
men  in  selecting  their  footl.  I  mean  its  cost.  It  is  a  matter  of  great 
importance  to  the  poor,  to  know  what  kinds  of  food  llu-y  can  subsist 
upon  with  least  expense.  For  the  last  few  years  provisions  have  been 
so  high,  that  persons  in  poor  circumstances  greatly  need  advice  in 
this  matter.  Let  me  endeavor  to  furnish  some  information  which 
shall  be  of  service  to  the  reader. 

Milk  is  supplied  by  nature  to  be  our  first  food,  and  is  a  good  type 
of  all  alimentary  substances.     It  contains  fio.  64. 

curd,  which  has  nitrogen,  and  is  equivalent 
to  albumen  and  librine,  and  represents  the 
blood-forme rn.  It  has  butter  and  sugar. 
These  represent  the  hcnt-formcrs.  It  lias 
salts,  which  contain  potash,  so<la,  phospho- 
rus, etc.  Figure  04  is  a  microscopic  view  I 
of  good  milk  ;  Figure  Go,  of  poor  milk ;  and 
Figure  66,  of  milk  adulterated  with  calf's 
brains. 

Food  will  be  valuable  in  proportion  as 
it  combines,  in  due  proportion,  the  articles 
contained  in  the  four  groups,  represented  by  albumen,  fat,  sugar,  and 
sails. 


Fio.  65. 


Fio.  66. 


Allmininoiis  Group.  —  Albumen,  fibrine,  casein,  gluten,  and  lugu- 
min,  all  enter  into  the  substance  of  animal  and  vegetable  bodies,  and 
are  all  composi;d  of  the  same  elements,  namely,  48  parts  carbon ;  36 
of  liydrog(>ii ;  14  of  oxygen ;  and  6  of  nitrogen.  In  containing  nitro- 
gen they  ail  diiler  from  the  other  three  groups.  Albumen  being  a 
good  type  of  them,  they  are  called  albuminous  compounds.     Albu- 


IIYOIKNK. 


75 


mil,  pun- 
ifty-L'i^ht 
hirt  I'ikmI 
J  refer  to 


fijority  of 
•  of  great 
111  yubsist 
liivc  been 
advice  in 
on  which 

good  type 


swg-or,  and 


and  lugu- 
bodiea,  and 
carbon ;  36 
ining  nitro- 
len  being  a 
nds.     Albu- 


lueii  forms  a  hirgo  portion  of  the  seruni,  in  colorless  part  of  the  blood. 
It  is  the  leading  principle  in  alimentation.  It  is  worked  U|)  into  the 
tissues  of  our  bodies.  It  forms  our  muscles,  our  membranes,  a  por- 
tion of  our  neives,  etc.  It  ia  the  bricks  of  which  the  house  we  live 
ill  is  made.  All  the  articles,  therefore,  which  are  chemically  consti- 
tuted like  it,  may  well  be  termed  albuiiiinoiis. 

These  bodies,  consisting  of  the  four  organic  elements  named  above, 
have  been  called  (/ualcrnnri/  compounds.  Heside  these;  elements,  they 
l.iive  a  minute  portion  of  sulphur  and  phosphorus.  It  has  been  as- 
sumed that  these  compounds  contain  a  common  principle  called />ro- 
/riiw ;  and  hence  they  have  been  called  profeinareous  compounds.  It 
is  doubtful  whether  such  a  principle  can  be  obtained. 

Albumen  is  a  very  unstable  compound,  —  tending  strongly  to  de- 
loinpositioi).  This  is  owing  to  the  complexity  of  its  composition, 
and  to  its  union  with  the  fickle  element,  nitrogen,  which  forms  chemi- 
cal compacts  reluctantly,  and  breaks  them  without  remorse.  Sub- 
stances which  coagulate  or  fix  albumen  in  an  insoluble  compound, 
or  preserve  the  tissues  of  the  body,  which  are  made  from  it,  from 
decomposition  or  putrefaction,  are  called  antiseptics. 

Futty  Cilnni|t.  —  The  next  group,  re|)res«Mitcd  by  fat,  performs  very 
important  oilices  in  the  system,  —  the  most  important  of  which,  is  a 
union  with  albumen  in  the  formation  of  cells.  All  animal  and  vege- 
table life  begins  with  the  cell,  —  the  tiny  cup,  with  which  nature  dips 
all  the  streams  of  life  out  of  the  great  fountain  of  inorganic  matter. 
No  cell  is  formed  without  a  minute  particle  of  oil.  The  portion  not 
used  in  forming  cells,  is  either  burned  as  fuel,  to  kee|)  us  warm,  by 
uniting  with  oxygen,  or  it  is  stored  away  in  the  cellular  tissues,  adding 
to  the  bulk  of  the  person.  If,  then,  the  very  beginnings  of  life  are 
dependent  upon  fat,  it  is  of  great  importance  as  an  article  of  diet.  So 
necessary  is  it  in  the  economy  of  life,  that  when  not  taken  in  the 
food,  it  is  formed  out  of  albumen  in  the  processes  of  assimilation. 


The  Starch  ami  Siijfar  droiip,  composed  of  several  kinds  of  sugar, 
gum,  etc.,  is  never  used  in  forming  the  tissues,  but  they  perform  im- 
portant offices  in  the  changes  going  on  within  the  human  organism. 
Thus,  sugar  of  milk  is  decomposed,  and  forms  lactic  acid,  so  called 
from  being  found  in  sour  milk.  This  acid  plays  a  very  important 
part  in  the  process  of  nutrition. 

Pure  starch  is  a  snow-white  powder,  having  a  glistening  aspect.  It 
is  composed  of  grains  from  jj^  to  jo^a^  of  an  inch  in  diameter  in  the 
different  grains ;  being  largest  in  the  potato,  and  smallest  in  wheat. 
When  examined  with  the  microscope,  they  appear  as  in  Figure  63. 

The  Salts  Oroiqi  are  sufficiently  spoken  of  in  another  place. 

A  wise  philosopher  in  ancient  time  said,  "  I  do  not  live  to  eat  and 
drink  ;  I  eat  and  drink  to  live."  If  we  intend  to  eat  to  live,  we  must 
combine,  in  our  food,  the  foar  groups  above  explained  ;  and  if  we 
would  live  at  as  small  expense  as  possible,  we  must  take  those  articles 
which  are  low  in  price,  and  rich  in  nutritive  matter.  The  following 
table  will  help  the  reader  make  his  selections : 


N 


76 


HYGIENE. 


\k 


Table  of  the  relative  value  of  article*  of  food  arranrird  accordinrj  to 
nutrient  matter  in  each  of  the  four  groups  ofelementu  concerned 


their  proi)ortion$  of 
in  vital  changes. 


In  100  pounds  of 


GUAINS. 

Wheat 

liarley 

Oats 

Rje 

Indian  Com 

liuckwheat 

Rite 

Pod  Plants. 

Beans 

Peas 

Roots. 

Potato 

Turnip 

Carrot 

Beet  (mangold  wurtzel). 

Long  red 

Short  red 

Sugar  beet 

Parsnip 

Lkaf. 

Cabbage 


Mbal. 

Wheat  flour 


Rye  meal 


Barley  meal 
Oat  meal.  . . 
Wheat  bran 


CO 


a  -g 

-I 


15 
15 
16 
12 
14 
15 
13 

14 
14 

75 
88 
8i 
85 
85 
85 
85 
80 


10.33 


14.60 

14 
14 
13.1 


15 

15 

20 

10  to  20 

6 
25 

8 

8  to  11 
9 

4 
3 

3 

2 
3.03 
3.31 

2 

li 


4.63 


55 


10  to  19 

12  to  15 

14  to  1!) 

10  to  15 

12 

8 

7 

24  to  28 
24 

2.0 

1.5 

1.5 

2 

0.48 

0.26 

2.5 

30  to  35 


9.70 


8.97 

14 
18 
19.3 


^4 


IN 


2  to  4 

2  tod 
5  to  7 

3  to  4 
5  to  9 

0.4 
0.7 

2  to  3 
2.1 

0.3 
0.3 
0.4 


0.35 


3 

2 

6 

4.7 


65 
60 

GO 
60 
70 
60 


40 
60 

18 

9 

10 

11 

10.36 
12.46 
13 
16 


68  Starch 
5.85  Sugar 
4.12  Gum 
66.54  Steh 
2.56  Sugar 
9.40  Gum 

68 

62 
.6 


^1 


2 
3 
4 
2 

li 
4 

04 

3 
3 

JtolJ 
h  to  4-5 
1^  to  2 


i 


to  1 
.lb 


2 
2 
7.3 


The  following  tables  have  an  admirably  practical  ■  bearing  upon 
economy  in  food : 


100  Iba. 


Barley, 

Beans, 

Beets, 

Buckwheat, .  .  .  . 

Carrot.s, 

Corn, 

Oats, 

Peas, 

Potatoes, 

Turnips  (field), . 
Do.  (Swedish), . 
Wheat  Flour,  . 
Wheat  Bran,  .  . 

Cheese,* 

Cheese,f 


Muscle-forming 

Elementc, 

in  lb8. 


•  Whole  milk. 


t  Skim-millc. 


14 
26 

2 

8 

li 
12 
17 
24 

2 

n 

11 
18 
28 
45 


Fat-forming 

Elements, 

in  lbs. 


64 
42 
12 
54 
10 
77 
66 
52 
19 

9 
12 
79 

6 
27 

6 


RelHtive  Propor- 
tion of  eacn, 
in  11)8; 

1  to  44 
1  to  l5 
1  to  6 


to6J 
to6i 
to  64 
to4 
to  2,i 
to  94 
to6 
1  to  54 
1  to  7 
1  to  J 
1  to  1 
Itoi 


Husky,  or 

Woody  fibre, 

in  lbs. 


15 
10 

(?) 
25 
S 
6 
20 
8 
4 


£5 


rtion$  of 

tges. 


Itoli 

i  to  4-5 

lito2 

i  tol 

.75 
i 


ng  upon 


sky,  or 
ly  fibre, 
libs. 


55 


Artialw. 


IIYGIKNK. 


<    IHt 


77 


ISiirlcy, 

Ucaiis, 

Voru, 

Oars 

IVas 

I'otlltOfS, 

'I'liniips 

Flour  (fiiu') ]     12  0  >  jmt  bbl. 

Flour  (iiiil)oltc(l) I     11   00 


50 
10 
(j8 
00 
f)0 
iO 


Miifdi'  |ii'oiliicliiK 

t'luit  orMiiM'h'iii'ndua 

M.4 

lll|{    I'.lcllU'lllH. 

IT  bu. 

Urn. 

18c. 

per  lb. 

l(i.<i 

»« 

l.V. 

0.7 

It 

1<>|( 

,     ** 

6.2 

It 

l;U'. 

14.3 

It 

14i'. 

1.6 

II 

94f. 

1.2 

11 

41c. 

•r  bbl. 

38.0 

it 

54c. 

u 

24.8 

<t 

44o. 

u 

Tlifsc  tables  will  Wfll  repay  study,  for  their  practical  xiso  will  save 
many  dollars  to  the  poor.  Let  it  be  remembered  that  producing 
muscle  is  the  Hume  thing  as  producing  strength,  or  labor  power. 
Bearing  this  in  tuind,  the  following  table  will  be  very  interesting: 

One  pound  of  labor-power  from  Potatoes  eo.sts  94e.  per  lb. 
II  41         II  li  II      y\^^^,  l.'l„„r,       5.(,..      " 


ii 
<i 
<i 
it 
u 


"      Uuuliolteil  (lo.44e.      " 


Turnips, 

41c. 

Itarlev, 

180. 

Corn, 

17c. 

Deans, 

15c. 

Peas, 

14c. 

Oats, 

13c. 

Meats  are  omitted  in  the  table.  So  far  as  their  nutritive  qualities 
are  concerned,  it  is  of  little  consccpience  which  are  taken.  Some  are 
more  digestible  than  of  hers.;  and  this  consideration  should  influence 
those  with  weak  stomachs  iu  selecting.  Every  person,  of  course, 
knows  their  relative  cheapness. 

Among  the  vegetables  given  iu  the  table,  there  ia  a  wider  range  for 
choice.     Let  us  consider  them  in  course. 

Wheat. —  In  this,  the  four  groups  are  represented  in  excellent  pro- 
portion. When  not  deprived  of  the  bran,  it  is  perhaps  the  very  best 
supporter  of  animal  life.  So  high  have  been  the  regards  of  men  for 
it,  and  so  generously  have  they  awarded  to  it  their  acknowledgments, 
that  its  product,  bread,  has  been  everywhere  called  "the  staff  of  life." 
it  is  unfortunately  held  at  a  high  price.  My  hope  is  that  the  immense 
])rairies  at  the  W  e.st,  adapted  to  its  culture,  will  yet  furuish  it  in  such 
profusion  as  to  bring  it  within  the  means  of  all. 

Barley. —  This  haa  the  four  groups  represented  in  nearly  the  same 
proportions  as  wheat.  It  is,  therefore,  nearly  as  valuable  an  alimen- 
tary grain.  Unfortunately  it  is  not  so  toothsome  as  wheat,  and  can 
never  be  so  popular  an  article  of  diet.  The  Scotch,  however,  feed 
upon  it  with  apparent  relish,  and  doubtless  think  it  strange  that  for- 
eign palates  are  not  better  pleased  with  it. 

Outs.  —  This  jg.am,  strange  to  say,  has  more  albuminous,  or  nutri- 
tive matter,  more  fat,  more  starch,  and  more  salts  than  wheat.  In 
uniting  a  large  quantity  of  the  four  alimentary  groups,  it  surpasses 
every  other  vegetable  substance.     In  albumen,  it  is  not  quite  as  rich 


* 


78 


HYGIENE. 


an  peua  and  brariH,  niid  in  starch  it  fnllH  a  triflt;  below  fine  wheat 
(lour ;  but  in  fiit  it  is  «'X(t'c(ic(l  only  by  liidian  corn.  This  f»ri»in  i.-» 
likewise  consumed  liirg<'iy  by  tlu;  Scot*-!),  —  a  peopU;  whose  cliiinis  to 
BJinnvd  eotninon  sense  lire  well  supported  by,  as  their  hardy  con.^ti- 
tutions  vindicate,  the  choic< 


ice.  This  ^rn\\\  tnight  well  be  ixTinitted  to 
take  the  place  of  rice.  It  afTords  several  times  as  much  mitriment, 
while  it  cost.s  only  about  one-iit'lh  as  much.  There  is  good  reason 
why  the  horse  should  thriv('  upon  oats.  Most  stal)le-keepers  think 
their  horses  will  do  iriore  work  upon  corn-meal,  but  this  nnist  be  a 
mistake.  In  using  oats  for  horse-feeding,  a  large  portion  of  the  nu- 
trimont  is  lost  by  not  ffrindinff  them. 

Rye.  —  This  is  also  a  grain  of  considerable  nutritive  value.  It  is 
much  cheaper  than  wheat ;  and  rye  meal  has  long  been  a  standard 
article  of  diet  in  New  England,  —  particularly  in  connection  with 
Indian  meal,  as  "  brown  bread."  It  is  useful  for  relieving  costiveness, 
in  the  form  of  "  hasty-pudding,"  with  molasses. 

Indian  Com.  —  This  staple  article  of  American  produce  needs  no 

Praise  from  me.  It  ia  comparatively  cheap,  nutritive,  and  wholeaome. 
t  abounds  in  fat  and  starch,  and  has  a  fair  amount  of  albumen, 
though  not,  as  much  as  the  oat,  the  barley,  or  the  wheat.  In  salts,  it 
is  rather  deficient.  Indian  corn  is  strictly  an  American  plant,  and  is 
perhaps  the  most  popular  grain  in  the  country.  It  has  emphatically 
a  national  reputation,  and  is  perhaps  worked  up  into  more  savory 
dishes  than  any  other.  At  the  South  it  is  an  institution.  It  is  then; 
made  into  hoe  cake,  corn  cake,  batter  cakes,  batter  bread,  muffins,  corn 
pone,  etc.  At  the  North,  we  have  jonny  cake,  Indian  and  pumpkin 
cake,  baked  Indian  pudding,  boiled  Indian  pudding,  beside  the  well- 
known  rye  and  Indian  bread,  and  other  preparations.  Give  an  in- 
genious Southern  or  Northern  housewife  a  few  simple  adjuncts,  such 
as  lard,  milk,  sugar,  eggs,  cream  of  tartar,  and  soda,  and  she  will 
make  a  pretty  respectable  larder  from  this  single  grain.  If  molasses 
be  substituted  for  sugar,  and  a  little  stewed  pumpkin  be  thrown  in 
by  way  of  garniture,  we  may  have  several  preparations  which  are 
very  nourishing  as  well  as  cheap. 

Buckwheat.  —  Poor  in  nutritive  matter,  fat,  starch,  and  sugar,  but 
tolerably  well  supplied  with  salts.  It  will  do  very  well  for  batter 
cakes  in  winter.  When  brought  smoking  upon  the  table,  and  served 
with  sugar  or  molasses  and  butter,  these  cakes  are  a  luxury,  in  which 
the  rich  may  indulge  if  they  choose  ;  but  for  the  poor,  the  amount  of 
nourishment  they  afford  is  too  small  for  their  cost. 

Rice.  —  Much  like  buckwheat,  except  that  it  has  more  fat,  sugar, 
and  starch,  and  less  salts.  As  an  article  of  diet,  it  has  had  too  high 
a  reputation.  Those  who  would  live  on  small  means  cannot  afford  it. 
Boiled  in  plain  water,  it  is  excellent  for  a  relaxed  state  of  the  bowe'^; ; 
and  this  is  about  all  the  commendation  to  which  it  is  entitled. 

Beans.  —  The  richest  in  nutritive  matter  of  all  vegetable  substan- 
ces, except  cabbage  and  oats.     They  have  more  albumen  than  wheat. 


IIYOIENK. 


79 


wheat 
;»rain  is 
[iiiiiiw  to 
r  const  i- 

litti'd  to 
triiiKMit, 
I  ri'usoii 
rs  tliiiik 
irtt  be  a 
the  im- 


p.      It   lA 

standard 
loii  witli 
itivcnt'S!*, 

rjpeds  no 
loleaomc. 
albumen, 
1  sahs,  it 
lit,  and  is 
)hatically 
re  savory 
it  is  thert^ 
pFnis,  cori\ 
pumpkin 
the  WL'll- 
/e  an  in- 
jcts,  sucli 
she  will 
molasses 
hrown  in 
vhich  arc 


ngar,  but 
or  batter 

1(1    SlMVfd 

in  wliift) 
mount  ol' 


at,  sugar, 
too  high 
aftbrd  it. 
bow<'l^ ; 
Id. 

substan- 
an  wheat. 


or  eorn,  or  barley,  or  oats;  but  in  fat  and  starcli,  they  are  lower  in 
the  scale.  Add  to  them  salt  pork,  and  the  highest  of  all  nutrient 
compounds  is  obtained.  During  not  hss  than  four  generations,  |)ork 
iin<l  beans,  as  the  principal  diet,  nourished  an  iron-sided  race  of  men 
in  Ni.'W  Kngland.  Bean-porridge  was  like  honey  u|M)n  the  tongue  of 
the  fiiunders  of  New  England  institutions.  They  ate  it  morning, 
noon,  and  night ;  and  thanked  God  for  it  every  time.  And  well  they 
might  thank  Ilim;  for,  with  Indian  corn,  it  furnished  Ihem  with  a 
diet  better  adapted  to  their  condition  than  any  other. 

Pens. —  Not  quite  as  rich  ns  beans  In  albumen,  but  more  rich  in 
Htareh;  of  about  the  same  value  on  the  whole.  The  Carnulian  French 
in  liower  Canada,  feed  on  peas  to  about,  the  same  extent  that  the 
New  Englanders  did  on  b.'ans.  Pea-soup,  as  prepared  by  the  best 
ccx)k8  among  them,  is  a  dish  of  great  nutritive  excellence;  and,  in 
my  judgment,  more  palatable  than  bean-soup. 

Tlie  Potato.  —  Three-quarters  of  this  root  is  water,  and  it  is  poor 
in  all  the  elements  of  nutrition.  It  is  a  palatable  article,  and  most 
persons  arc  much  attached  to  it.  As  biilk  is  of  some  consequence  in 
food,  the  potato  is  not  without  value ;  but  should  the  disease  with 
which  it  has  been  tormented  for  several  years,  finally  exterminate  it, 
the  loss  to  the  world  would  not  be  so  great  as  many  suppose.  Men 
do  not  often  live  entirely  upon  [wtatoes, — not  even  in  Ireland.  Milk, 
butter-milk,  and  especially  cabbage,  are  united  with  them. 

Turnips,  Carrots,  Beets,  Parsuips.  —  These  are  much  alike,  —  being 
all  poor  in  nutritive  qualities.  They  serve  to  please  the  palate  by 
furnishing  a  variety  ;  but  in  our  city  markets,  they  are  expensive,  and 
do  not  furnish  an  economical  diet. 

Cabbage. —  It  is  interesting  to  observe  how  the  instincts  of  men 
have  in  all  ages  led  them  to  select  those  articles  of  diet  which  their 
circumstances  have  demanded.  The  poverty  of  the  Irish  has  led 
them  to  subsist  largely  upon  the  potato, —  a  root  which  the  soil  of 
their  country  yields  profusely.  But  as  this  root  has  but  little  nutritive 
matter,  necessity  required  that  it  should  be  united  with  some  other 
vegetable.  The  natural  instinct  selected  the  cabbage;  and  when 
chemical  science  came,  at  length,  to  pass  judgment  upon  the  correct- 
ness of  this  instinct,  it  turns  out  that  the  cabbage  is  the  richest  in 
albumen  of  any  known  vegetable.  The  cabbage,  then,  is  the  natural 
complement  of  the  potato ;  and  the  Irish  had  the  sagacity,  without 
ecience,  to  bring  the  two  together.  It  is  said  the  Irish  have  a  dish 
named  "  kohl-cannon,"  consisting  of  boiled  and  mashed  potatoes  and 
cabbage,  seasoned  with  pork  fat,  pepper,  and  salt,  and  that  it  is  a 
truly  savory  dish.  It  certainly  is  a  nourishing,  and  a  cheap  one.  The 
ambassador  who  was  sent  to  tamper  with  the  patriotism  of  a  Roman 
who  had  dined  on  beans,  was  asked  if  he  was  silly  enough  to  think 
gold  and  silver  could  bribe  a  man,  who  was  satisfied  with  so  plain  a 
fare,  and  desired  no  other.  We  come  to  the  conclusion,  then,  that 
bean  porridg(>,  pea  soup,  suet  pudding,  sweetened  with  molasses,  oat 
meal,  and  barley  bread,  w^ith  "  kohl-cannon  "  for  those  who  can  digest 


m 


-■"-f,-i 


80 


HYGIENE. 


it,  will  furnish,  for  hard-working  men,  the  most  substantial  diet,  at  the 
smallest  posr^ible  expense.  To  render  these  dishes  savory,  and  to 
make  the  table  on  which  they  are  spread  an  inviting  board,  the  deft 
housewife  must  employ  her  best  skill  in  serving  them.  With  the 
thousand  "  fixings,"  with  which  a  New  England  matron  knows  how  to 
garnish  them  (or  would  know  how  if  they  came  within  her  culinary 
operations),  they  are  well  fitted  to  leave  savory  impressions  upon 
tongues  which  would  praise  them  to  the  end  of  life.  I  s|ieak  of  thcso 
articles  as  furnishing  a  cheap  diet  for  working  men.  The  indolent, 
the  sedentary,  and  the  effeminate  from  various  causes,  could  not 
digest  them. 

The  Amount  of  Food  Taken. 

We  have  already  explamed  that  this  should  be  governed,  in  part, 
by  the  amount  of  exercise  taken,  by  the  condition  of  the  health,  by 
the  state  of  the  mind,  by  the  climate,  by  the  season,  etc.  It  remains 
to  add  a  few  words,  in  a  general  way,  respecting  the  absolute  amount 
required  by  an  adult  man. 

It  is  plain  enough  that  most  men  eat  too  much.  We  come  v»^ry 
near,  in  this  country,  being  a  nation  of  gormands.  A  principal  reason 
of  our  over-eating  is,  that  we  eat  so  fast.  When  the  food  is  well  and 
slowly  masticated  and  swallowed,  the  gastric  juice  has  time  to  mix 
with  it ;  and  at  the  proper  moiiiont,  the  appetite  ceases.  But  wht/i 
our  food  is  bolted  rapidly,  nature,  finding  her  laws  disregarded,  and 
all  her  purposes  frustrated,  stands  back,  and  lets  us  learn  to  stop,  too 
late,  alas  I  from  a  sense  of  fulness  in  a  stretched  and  abused  stomach. 

It  has  already  been  stated,  that  Lewis  Cornaro  lived  fifty-eight 
years,  namely,  Irom  the  age  of  forty-two  to  one  hundred,  on  twelve 
ounces  of  solid  food  a  day,  with  about  the  same  amount  of  light 
wines.  At  me  age  of  eighty-four,  he  wrote  a  book,  in  which  he 
praises  "  divine  temperance  "  in  terms  which  are  sometimes  eloquent, 
and  often  enthusiastic.  Indeed  it  is  very  rare  that  a  man  at  that  age 
retains  such  clearness  of  intellect,  and  especially  such  freshness  of 
feeling  as  he  evinces  in  his  book.  Probably  but  few  could  live  on  the 
amount  of  food  which  he  found  sufficient.  Yet  it  is  said  the  distin- 
guish =?d  John  Wesley  lived  on  sixteen  ounces  a  day,  which,  as  he  took 
no  wine,  and  had  to  derive  the  combustive  materials  for  warming  tlic 
body  from  the  food,  was  quite  as  scanty  a  fare  as  that  of  Cornaro. 
Considering  that  he  led  a  most  extraordinarily  active  life,  both  of  body 
and  mind,  being  half  his  waking  hours  in  the  saddle,  and  preaching 
almost  daily,  this  is  probably  the  most  remarkable  case  of  fcbstenii- 
ousness  on  record.  Jonathan  Edwards  did  not,  I  think,  exceed  the 
eame  amount  of  food,  but  he  was  not  so  active  a  man. 

Putting  aside  such  excpptionul  case."  as  these,  \,e  may  say  in  round 
numbers,  that  a  laboring  man  requires,  i^)  keep  him  in  health,  about 
two  to  two  and  a  half  pounds  of  solid  food  per  day.  For  mini?tor^;, 
lawyers,  doctors,  authors,  and  merchants,  one  pound  and  a  half  is 
an., '  •  sufficient.  The  amount  should  b.;  increased  a  little  by  a  ■se- 
lection froi     some  of  the  fuel-formers,  if  no  fermented  or  alcoholic' 


4;.  .......ti-. 


■-ski 


t,  at  i\w 
and  to 
the  (If It 
Vith  the 
s  how  to 
culinary 
ns  upon 
:  of  these 
indolent, 
ould  not 


HYGIENE. 


81 


I,  in  part, 
health,  by 
t  remains 
;e  amount 

!ome  very 

pal reaHon 

j  well  and 

ne  to  mix 

But  when 

arded,  and 

3  stop,  too 

i  stomach. 

fifty-eight 

on  twelve 

it  of  ligb^ 

which  he 

eloquent, 

,t  that  age 

3shness  ot 

ll've  on  the 

tlic  dirttin- 

art  he  took 

.fining  tlu' 

If  Cornaro. 

^tli  of  body 

preaching 

|>f  'cbritemi- 

exceed  the 

ly  in  round 
ath,  about 
minigter?:, 
a  half  is 
lie  by  a 
Ir  alcohohv' 


drinks  be  taken,  and  slightly  dinii.iished  if  they  arc  used.  The  reason 
is,  that  these  drinks  furnish  fuel  to  be  burned  in  breathing,  which  has 
to  be  drawn  from  the  food,  when  they  are  not  employed.  This  fur- 
nishes no  motive  for  vsing-  ardent  spirits  ;  for  there  is  fuel  enough  to 
be  had  in  the  oils,  starches,  and  sugars. 

Dyspeptics.  —  It  is  said  that  dyspeptics  eat  more  than  persons  in 
health ;  and,  in  many  cases,  the  remark  may  be  true.  The  appetite 
of  a  person  suffering  from  this  disease  is  almost  always  morbid,  and 
the  information  It  gives  respecting  the  real  wants  of  the  system,  can 
«el(loin  be  trusted.  If  we  a.iow  a  diseased  stomach  to  dictate  to  us 
w  lien,  and  what,  and  how  much  we  shall  eat  and  drink,  our  misery 
lor  life  is  a  foregone  question.  A  sick  stomach  is  like  a  spoiled  child-, 
it  cries  for  what  it  should  not  have  If  the  dyspeptic  will  live,  and 
enjoy  any  amount  of  peace  and  corntct,  he  must  follow  this  simple 
rule :  I'o  eat  no  more  than  can  be  diffesled,  even  though  the  amount  be 
only  an  ounce  a  day. 

Animal  and  Vegetable  Food. 

It  has  generally  been  supposed  that  it  was  intended  man  should 
subsist  on  a  mixed  diet,  consisting  of  both  animal  and  vegetable  sub- 
stances. "Within  the  last  twenty-five  years,  however,  a  school  of 
physiologists  have  appeared  in  this  country,  who  affirm  that  a  vege- 
table diet  is  alone  consistent  with  the  laws  of  health.  They  declare 
that  animal  food  is  not  adapted  to  man's  organization,  —  that  it  un- 
d;  ly  stimulates  the  blood,  predisposes  to  fevers,  consumptions,  diar- 
rhoeas, choleras,  apoplexy,  and  niimerous  other  diseases,  and  of  course 
shortens  life.  That  such  a  school  should  have  come  into  existence  in 
this  country,  where  animal  food  is  more  largely  consumed  than  in 
any  other  part  of  the  world,  in  proportion  to  the  number  of  people, 
is  not  surprising.  We  do,  undoubtedly,  eat  too  much  ilesh.  So 
enormous  is  the  consumption,  that  notwithstanding  the  vast  herds  of 
cattle  raised  in  all  our  agricultural  states,  the  supply  is  not  equal  to 
the  demand  ;  and  beef,  for  two  years,  has  been  selling  in  Boston  mar- 
ket at  twenty  cents  per  pound,  —  at  least  twice  its  f".ll  value  as  a 
blood-former. 

Facts  show  that  man  may  live  upon  flesh  alone,  upon  vegetables 
aioiie,  or  upon  flesh  and  vegetables  combined.  Is  it  best  he  should 
s".'jsist  upon  vegetables  only,  or  upon  a  mixed  diet  ?  A  mere  affirm- 
ation  upon  these  points  is  of  little  consequence.  To  "ite  facts  avails 
nothing.  Men  have  a  way  of  making  their  On  »  affirmations,  and  of 
looking  at  facts  with  eyes  which  sometimes  see  clearly  enough  on 
ijoth  sides  of  them,  but  totally  ignore  their  existence. 

Man's  Structure  Settles  the  ((uestion.  —  To  settle  this  matter,  we 
must  appeal  to  man's  organization.  His  structure  will  tell  us  some- 
thing we  need  not  mistake.  All  the  works  of  God  show  design. 
Everything  ne  has  made  has  a  use,  and  is  so  contrived  as  to  be 
adapted  to  that  use.  Lions,  tigers,  and  oth  animals  for  example, 
which  feed  on  flesh  alone,  have  a^  short  second  stomach,  —  it  being 


82 


HYGIENE. 


only  about  three  times  the  length  of  the  animal's  body.  Animals 
■which  eat  no  ficoh,  have  a  long  second  stomach,  —  that  of  the  shep]) 
being  from  thirty  to  thirty-five  times  the  length  of  its  body.  A  very 
remarkable  difierence  of  anatomical  structure  ! 

This  is  the  meaning  of  the  differen(;e  ;  Vegetable  food  has  a  great 
deal  of  waste  matter  in  it.  Woody  fibre  makes  quite  an  item  in  l.s 
composition.  This  waste  portion  must  all  be  carefully  separated  from 
the  nutritive  part,  and  this  must  all  be  done  in  the  second  stomach 
It  takes  time  to  do  it.  It  must  not  be  done  in  a  hurry.  The  nutritive 
materials  are  destined  to  build  a  living  structure,  whose  duration,  like 
that  of  all  other  fabrics,  will  depend  on  the  care  with  which  the  mate- 
rials are  selected  and  put  together.  The  second  stomach  of  the  sheep 
is  long,  that  there  may  be  ample  time  for  the  mixed  mass  of  chyme 
when  it  passes  out  of  the  first  stomach,  to  be  changed  to  chyle,  and 
then  to  be  carefully  separated  into  the  two  parts,  the  useful  and  the 
useless.  Animal  food  is  in  its  composition  just  like  our  own  flesh, — 
there  is  little  waste  matter,  and  not  much  time  is  required  for  its  sep- 
aration ;  hence,  the  second  stomach  of  flesh-eating  animals  is  short. 
Nearly  the  whole  aliment:  ry  mass  is  quickly  taken  up  by  the  lacteals, 
and  there  is  no  occasion  for  its  travelling  through  a  long  second 
stomach. 

Man^s  second  stomach  is  in  length  midway  between  that  of  the 
flesh-eating  and  the  vegetable-eating  animals.  If  there  be  design  in 
the  works  of  the  Creator,  and  if  that  design  in  the  structure  of  the 
flesh  and  vegetable-consuming  animals  has  now  been  correctly  inter- 
preted, it  is  plain  that  man  is  best  nourished  when  he  eats  both  kinds 
of  food.  The  structure  of  his  teeth,  and  the  motions  of  hia  jaws 
(see  p.  30),  confirms  the  same  conclusion. 

Americans  Eat  too  Much  Meat.  —  Yet,  as  I  have  said,  there  is  no 
doubt  the  Americans  eat  too  much  meat.  Sedentary  persons  require 
but  very  little.  Less  is  wanted  in  summer  than  in  winter,  —  in  warm 
climates  than  in  cold.  People  of  wealth,  whose  circumstances  im- 
pose no  bodily  hardships,  need  less  than  the  poor,  who  are  much 
exposed,  and  work  hard  ;  whereas,  they  consume  more.  Thos«  who 
do  not  labor  with  their  hands,  should  never  taste  meat  more  than 
once  a  day. 

It  is  painfully-amusing  (if  such  a  compound  word  is  admissible) 
to  hear  a  nervous  female,  whose  sole  exercise  consists  in  going  from 
the  parlor  to  the  kitchen  once  or  twice  a  dt.^',  and  in  making  a  brief 
shopping  excursion  once  a  week,  complain  that  she  cannot  maintain 
her-strength  unless  she  eats  freely  twice  a  day  of  meat,  and  takes  her 
free  potations  of  strong  coffee  and  wine. 

A  like  opinion  prevails  generally  among  the  feeble  who  are  not 
obliged  to  labor.  The  child  in  its  nurse's  arms,  must  daily,  it  is 
thought,  suck  a  piece  of  chicken  or  beef  steak  in  order  to  thrive. 
Children  thus  fed,  have  their  blood  constantly  inflamed,  and  stand  a 
poor  chance  when  attacked  by  scarlet  fever.  The  little  master  or 
miss  who  attends  school,  complains  of  headache,  and  grows  pale, 
ieeble,  and  nervous.     The  books  are  bkined  and  thrown  aside  for 


iiimal* 

shepp 

A  vt>ry 

a  great 
I  ill  i.s 
;d  from 
:omach 
lutritive 
ion,  like 
le  inate- 
le  sheep 
f  chyme 
lyle/aiul 
and  the 
Hesli,— 
r  its  sep- 
is  short. 
J  lactealrf, 
g  aecoiid 


lat  of  the 
design  in 
are  of  the 
[ctly  inter- 
)oth  kinds 
hia  jaws 


lere  is  no 

require 

,  in  warm 

Ranees  im- 

much 

:hos»  who 

lore  than 


Idmissible) 

loing  from 

[ng  a  brief 

maintain 

takes  het 

[no  are  not 

laily,  it  is 
[  to  thrive. 
Ind  stand  a 
master  or 
Jrows  pai*^? 
|i  aside  fof 


HYGIENE. 


83 


what  the  dishes  have  done.  The  doctor  is  called  in,  and  assured  that 
the  dear  child  can  eat  nothing  but  a  little  fat  broth,  a  custard,  or 
cake ;  and  if  he  prescribe  a  diet  of  plain  bread  and  milk,  he  is  be- 
lieved to  be  heartless,  and  his  prescription  is  not  followed. 

Tlie  Miijorify  of  MiiiikiiKl  Eat  no  Flesh.  —  All  such  misguided  per- 
sons should  be  apprized  that  the  great  majority  of  mankind  cat  no  flesh, 
because  they  cannot  afford  it.  And  they  do  not  appear  to  suffer  from 
its  loss.  Millions  of  Irish  do  not  taste  of  flesh  or  fish  from  one  moiiTli's 
end  to  another.  Potatoes,  oat  meal,  and  cabbage  constitute  their  chief 
diet.  Rice,  poor  as  it  is  in  nourishment,  sustains,  when  combined  with 
vegetable  oil,  millions  of  people  in  Asia.  The  Lazaroni  of  Naples, 
with  active  and  finely  moulded  forms,  live  on  bread  and  potatoes. 
These  facts  do  not  afK)rd  ground  for  altogether  rejecting  animal  food, 
any  more  than  Bayard  Taylor's  statement  respecting  whole  tribes  in 
Africa  who  live  upon  flesh,  furnishes  a  reason  for  excluding  vegetable 
aliment.  Man  may  live  and  enjoy  health  upon  either,  but  hia  organ- 
ization implies  the  use  of  both. 

Proportions  of  Animal  and  Vegetable  Food. 

Upox  this  subject,  it  is  imnossible  to  fix  any  absolute  rules.  This 
is  a  point  which  must  be  det  mined  by  the  temperament,  the  state 
of  the  health,  the  constitution,  etc.  Persons  of  a  scrofulous  habit 
should  eat  freely  of  animal  food.  But  an  inflamed  stomach  should 
never  be  tormented  with  flesh.  Meat  is  stimulating,  and  will  be  al- 
most sure  to  do  mischief  when  there  is  heat  and  tenderness  at  the  pit 
of  the  stomach.  There  are  cases  of  inflammation  of  this  organ,  in 
which  it  may  be  necessary  to  live  on  bread  and  milk,  with  articles  of 
the  starch  group,  for  months,  and  even  for  years. 

On  the  other  hand,  when  the  system  has  run  low  from  some  ex- 
hausting disease,  which  excites  no  feverv  h  action,  it  may  be  necessary 
at  times,  to  take  a  diet  almost  exclusively  animal. 

It  is  absurd  to  talk  of  the  same  diet  as  adapted  to  all  persons,  even 
.'hen  in  health.  As  well  might  we  expect  one  shoe  to  fit  every  foot, 
or  one  coat  every  back,  or  one  color  every  eye,  or  one  doctrine  every 
mind.  ...         -  -  .-. 

Temperance  the  Main  Tiling. —  After  all,  the  great  thing  to  be 
aimed  at  is  temperance.  It  is  not  so  necessary  to  reject  one  article 
and  use  another,  as  to  partake  of  all  with  moderation.  "  I  do  not 
live  to  eat  and  drink ;  I  eat  and  drink  to  live,"  said  a  wise  philoso- 
pher of  the  olden  time.  One  would  think  the  moderns  had  reversed 
this  rule.  A  modern  table  has  the  appearance  of  being  spread  for  the 
purpose  of  inducing  men  to  eat  all  their  stomachs  will  hold.  A  man 
who  can  dine  daily,  for  half  a  dozen  years,  at  one  of  our  first  class 
hoteh,  and  then  find  himself  free  of  dyspepsia,  and  all  other  diseases, 
must  have  a  fine  constitution,  as  well  as  most  admirable  control  over 
his  appetite.  Mr.  Addison  said,  "  When  I  behold  a  full  table  set  out 
in  all  its  magnificence,  I  fancy  I  see  gout,  cholic,  fevers,  and  lethargies 


M 


•.4" 


9W<M«B|Bm*> 


84 


HYGIKNE. 


lying  ill  ambuscade  among  the  dishes;"  to  which  he    'hh,  with  much 
truth,  in  another  place,  "  Abstinence  starves  a  growing  distemper." 

Good  Results  of  Teniperiinre. —  A  temperate  diet  has  always  been 
attended  with  excellent  results,  and  always  will  be.  There  are  times 
of  great  anxiety,  when  abstinence  should  be  pushed  to  the  extreme 
verge  of  endurance.  During  the  siege  of  Gibraltar,  Lord  Heath- 
field,  its  gallant  defender,  lived  eight  days  on  four  ounces  of  rice  per 
day.  Dr.  Franklin,  when  a  journeyuian  printer,  lived  two  weeks  on 
bread  and  water,  at  the  rate  of  ten  pounds  of  bread  a  week,  and  was 
stout  and  hearty.  Dr.  Jackson,  an  eminent  physician  in  the  British 
army,  says,  "  I  have  wandered  a  good  deal  about  the  world,  and  never 
followed  any  prescribed  rule  in  anything;  my  health  has  been  tried 
in  all  ways ;  and  by  the  aids  of  temperance  and  hard  work,  I  have 
worn  out  two  armies,  in  two  wars,  and  probably  could  wear  out  an- 
other before  my  period  of  old  age  arrives." 

Lord  Bacon  was  right  in  the  opinion  that  intemperance  of  some 
kind  or  other  destroys  the  bulk  of  mankind,  and  that  life  may  be  sus- 
tained by  a  very  scanty  portion  of  nourishment.  Cornaro,  whom  I 
have  before  mentioned  as  having  lived  fifty-eight  years  on  twelve 
ounces  of  solid  food  a  day,  wrote  as  follows  respecting  himself  in  his 
eighty-fifth  year :  "  I  now  enjoy  a  vigorous  state  of  body  and  of  mind. 
I  mount  my  horse  from  the  level  ground  ;  I  climb  steep  ascents  with 
ease ;  and  have  wrote  a  comedy  full  of  innocent  mirth  and  raillery. 
When  I  return  home,  either  from  private  business  or  from  the  senate, 
I  have  eleven  grand-children,  with  whose  education,  amusement  and 
songs,  I  am  greatly  delighted  y.  and  I  frequently  sing  with  them,  for 
my  voice  is  clearer  and  stronger  now,  than  ever  it  was  in  my  youth. 
In  short,  I  am  in  all  respects  happy,  and  quite  a  stranger  to  the  dole- 
ful, morose,  dying  life  of  lame,  deaf,  and  blind  old  age,  worn  out  with 
intemperance."  Howard,  tht?  philanthropist,  fasted  one  day  in  the 
week  ;  and  Napoleon,  when  he  felt  his  system  unstrung,  suspended  his 
rneals,  and  took  exercise  on  horseback. 

Nothing  can  be  plainer  than  the  duty  of  fasting,  when  the  stomach, 
having  been  overworked,  is  disinclined  to  receive  food.  Brutes  in- 
variably follow  this  suggestion  of  nature ;  they  never  eat  when  sick, 
—  probably  because  they  have  no  silly  nurses  to  coax  them  to  swal- 
low stimulating  aliments.  The  habit  of  putting  high-seasoned  food 
Into  the  stomach  when  it  is  inflamed  and  feverish,  is  about  as  wise 
as  directing  streams  of  blue,  violet,  or  red  light  into  the  eye  when  it  is 
led  and  swollen  with  inflammation. 


Tea  and  Coffee. 

It  h  proper  before  closing  this  chapter  upon  diet,  that  something 
should  be  said  respecting  the  beverages  of  tea  and  coffee. 

Some  twenty  years  ago,  more  or  less,  a  meeting  was  held  by  the 
leading  physicians  of  a  city  in  the  old  world,  in  which  the  merits  of 
tea  and  coffee  were  discussed.  In  this  discussion  each  man  first 
utated   his  experience  in  the   use  of  these    articles,  and   then  con- 


rith  much 
iTipev.'' 

rays  been 
are  times 
3  extreme 
fd  Heath- 
)f  rice  jx>r 
weeks  on 
:,  and  was 
he  British 
and  never 
been  tried 
3rk,  I  have 
ar  out  an- 

36  of  some 
lay  be  sus- 
ro,  whom  I 

on  twelve 
iself  in  his 
id  of  mind, 
scents  with 
nd  raillery. 

the  senate, 
lement  and 
h  them,  for 

my  youth. 

o  the  dole- 
rn  out  with 

day  in  the 

spended  his 

He  stomach, 
Brutes  in- 
when  sick, 
m  to  swal- 
isoned  food 
»ut  as  wise 
e  when  it  is 


;  something 

held  by  the 
le  merits  of 
ii  man  first 
then  con- 


HYGIENE. 


85 


gtructed  his  argument  according  to  that  experience.  The  amount  of 
what  the  reader  could  learn  from  the  discussion  was,  that  Dr.  A.  had 
used  tea  all  his  life,  and  been  benefited  by  it,  while  coffee  had  uni- 
formly injured  him ;  and  that  he  thought  tea  should  be  used,  while 
cotVoe  should  be  rejected  ;  —  that  Dr.  B.  had  taken  coffee  at  breakfast, 
and  found  it  an  excellent  support  to  the  stomach  and  nervous  system, 
while  tea  had  disturbed  his  digestion  and  his  mind ;  and  that  the  former 
was  a  beverage  of  excellent  qualities,  while  the  latter  was  detestable; 
— that  Dr.  C.  had  always  drank  both  tea  and  coffee,  and  recommended 
them  to  everybody; — and  that  Dr.  D.  had  himself  never  been  able 
to  indulge  either  tea  or  coffee,  and  would  have  them  both  expelled 
from  every  household. 

The  discussion  was  not  creditable  to  the  learned  and  really  able 
men  who  participated  in  it.  The  arguments  were  all  based  upon  the 
miserably  narrow  basis  of  single  individual  experiences.  They  were 
no  more  valid  than  that  of  the  man  who  should  hold  up  a  shoe,  de- 
claring it  fitted  his  foot  the  best  of  any  he  ever  had,  and  recommend- 
ing all  men  to  have  their  shoes  made  upon  the  same  last. 

The  truth  is,  there  is  but  one  thing  which  can  be  affirmed  universally 
of  the  effect  of  tea  and  coffee.  They  both,  w^hen  taken,  tend  to  prevent 
waste  in  the  body,  and,  consequently,  less  food  is  required  when  they 
are  used.  This  may  be  affirmed  of  them  in  their  applicability  to  all 
persons,  but  nothing  further.  The  truth  is,  some  can  drink  tea  but 
not  coflfee,  and  some  coffee  but  not  tea  ;  some  can  use  both,  and  some 
neither.  Every  man's  susceptibility  to  the  eff'ects  of  these  beverages 
is  his  own,  as  much  as  his  susceptibility  to  the  effects  of  light,  or  heat, 
or  atmospheric  changes ;  and  these  eff'ects,  each  person  must  learn 
from  experience.  Coffee  often  produces,  and  generally  aggravates,  a 
bilious  habit,  —  an  effect  which  cannot,  I  believe,  be  traced  to  the  use 
of  tea.  I  have  no  doubt  but  that  many  cases  of  confirmed  dyspepsia 
are  traceable  to  ihe  use  of  coffee  alone. 

Water. 

There  is  one  universal  beverage ;  it  is  water.  All  men  are  fond 
of  it.  In  sickness  and  in  health,  in  joy  and  sorrow,  in  summer  and 
winter,  in  cold  climates  and  in  hot,  man  loves  and  drinks  water.  The 
■stomach,  abused  and  made  sick  by  stimulating  food  and  drinks,  and 
lepeiling  everything  else,  still  gratefully  opens  itself  to  water.  Wher- 
ever man  exists,  therefore,  or  wherever  he  should  exist,  water  is  found, 
either  in  the  form  of  springs,  or  running  brooks,  or  rivers,  or  ponds, 
or  lakes ;  and  even  where  it  is  not  found  in  some  of  these  forms,  it  is 
periodically  dropped  down  from  the  clouds.  As  there  is  no  element 
in  nature  more  necessary  for  man's  existence  than  water,  so  there  is 
none  more  universally  diffused. 

Pure  Water  Essential  to  Health. — But  water  varies  very  materially, 
both  in  its  physical  qualities,  and  in  its  adaptation  to  its  purposes. 
Pure  water  is  as  essential  to  health  as  pure  air.  When  either  of  these 
fluids  is  rendered  impure  by  mixture  w^ith  foreign  matters,  disease 
will  be  a  frequent  result.  The  ancients  must  have  been  inffuencod 
by  this  fact,  or  they  would  not  have  incurred  such  heavy  expenses  in 


u 


86 


HYGIENE. 


procuring  pure  water  from  great,  distances.  The  strong  atjueduftn 
tlnoiiglj  wliicl),  for  many  miles,  largi'  streams  of  water  are  at  this  day 
poiin-d  inlo  fallen  Rome,  attest  the  Ireeness  of  the  expenditures  she 
made  for  tiiis  purpose  in  tlio  day  of  her  renown.  We  may  pity  th'; 
ancient  Romans  for  being  governed  in  their  military  operations  by  the 
oninions  of  augurs  and  soothsayers,  and  certainly  these  things  were 
silly  enough;  but  in  other  things,  at  first  view  equally  superstitious, 
they  showed  practical  wisdom.  Vetruvius  reports  that  \n  selecting  the 
sites  of  their  cities,  they  inspected  the  livers  and  spleens  of  animals  to 
jearn  the  salubrity  of  the  waters  and  the  alimentary  pro<liif.tions  of  the 


region. 


The  size  and  condition  of  these  organs  do  in  fact  indicate 


the  nature  of  the  pasturage  and  the  qualities  of  the  water  with  which 
animals  are  supplied.  No  people  can  enjoy  good  health,  when  sub- 
jected to  the  double  influence  of  b  id  w.iter  and  impure  air. 

Division  of  Water. — The  simplest  division  of  water  is  into  two  kinds, 
soft  and  hard.  Rain,  river,  pond,  and  snow  wa  er  is  soft :  well  and 
spring  water  is  generally  hard.  Soft  water  contains  but  little  impu- 
rities, and  when  used  for  washing,  forms  a  good  lather  with  soap. 
Hard  water  contains  at  least  one  of  the  salts  of  lime,  often  more; 
mixed  with  soap,  it  curdles  and  turns  white.  The  reason  of  this  is, 
that  the  oily  acids  of  the  soap  unite  with  the  lime,  and  form  a  com- 
pound which  the  water  will  not  dissolve.  Such  water  is  not  suitable 
for  domestic  purposes. 

Clieillicill  ]l'iltlil'e  of  Water.  —  Water  contains,  reckoning  the  ele- 
ments of  which  it  is  composed  in  volumes,  one  volume  of  hydrogen, 
and  half  a  volume  of  oxygen.  These  two  gases,  the  unlearned 
reader  will  please  to  remember,  are  highly  subtle  bodies,  not  visible  to 
the  eye  ;  and  yet,  when  chemically  united,  they  form  a  liquid  which 
covers  two-thirds  the  entire  surface  of  the  globe,  —  lloating  upon  its 
bosom  the  navies  and  merchant  ships  of  all  nations,  and,  by  its  un- 
measured depths,  and  vast  breadths,  and  sublime  movements,  fills  the 
thoughtful  mind  >vith  conceptions  of  creative  Power,  which,  words 
never  attempt  to  express.  Should  the  two  gases  which  compose 
this  vast  body  of  water  cease  to  love  each  other,  and  fall  asunder, 
the  first  lighted  taper  would  set  the  world  on  fire,  and  not  a  living 
being  upon  its  surface  could  escape  destruction. 

Iiupurities  in  Water.  —  It  is  not  surprising  that  a  fluid  with  as  great 
a  solvent  power  as  water,  should  often  dissolve  and  hold  in  solu- 
tion a  great  many  impurities.  In  passing  along  through  the  earth, 
before  it  comes  up  in  springs  and  wells,  it  is  filtered  through  various 
mineral  earths,  and  becomes  contaminated  accordingly.  Jn  running 
through  beds  of  limestone,  it  takes  up  a  little  carbonate  of  lime. 
Salt  beds  impart  to  it  common  salt  (muriate  of  soda),  while  sulphur 
and  other  ores  tinge  it  with  salts  of  various  kinds. 

Water  from  the  wells  of  Boston,  formerly  used  by  the  inhabitants, 
was  largely  impregnated  with  common  salt,  and  other  mineral  substan- 
ces. So  marked  was  the  saline  taste,  from  this  cause,  that  the  New- 
Yorkers  and  Philadel|)hians  used  to  say  the  Bostonians,  when  visi^ting 
their  cities,  had  to  salt  their  water. 


"~^ 


qncdnots 
,  lliis  diiy 
lures  slit' 

i  pity  ♦'>'- 

•ns  by  tlu! 
ngs  wiiv 
erstitious, 
ecting  the 
.ninials  to 
ons  of  the 
t  indicate 
ith  which 
jvhen  sub- 

hvo  kinds, 
,  well  and 
ttle  impu- 
.vitli  soap, 
ten  Hiore; 
of  this  is, 
inn  a  com- 
oi  suitable 

ig  the  ele- 
hydrogen, 
unlearned 
jt  visible  to 
juid  which 
|g  upon  its 
L  by  its  un- 
its, fills  the 
ich,  words 
|h  compose 
11  asunder, 
lot  a  living 


ith  as  great 
lid  in  solu- 
tbe  earth, 
Igh  various 
Vin  miming 
te  of  linie. 
lile  sulphur 

Inhabitants, 
ral  substan- 
[t  the  New- 
lien  visiting 


CochitUiUc  Wiltcr.  —  These  wells,  which  so  long  yielded  up  bniek- 
isli  water  to  offend  liie  ])aliites  of  strangers,  are  now  ai)andoned,  and 
Boston  is  blessed  by  a  copious  stream  of  pure  soft  wat(;r,  drawn 
through  a  fine  aqueduct  from  Cwhituate  LaK(>,  twenty  miles  distant. 
This  water  is  distributed  to  about  every  house  and  siiop  in  the  city. 

'J'he  result  is,  that  the  healtii  of  tlie  citizens  has  been  materially 
improved.  Fevers,  particularly  those  of  the  typhoid  type,  have  dimin- 
ished, both  in  prevah;nce  and  fatality.  The  decaying  vegetable  and 
animal  matter,  so  much  of  which  gets  into  the  common  sewers,  and 
which,  in  former  year^,  sent  up  poisonous  gases  to  attack  the  life  of 
the  citizens,  are  now  washed  away  by  the  soft  water,  which  is  daily 
and  hourly  dropping  through  the  sinks  of  all  the  dwellings  of  the 
city.  ^ 

Nehiiylkill  and  Crotoil  Waters.  —  The  Schuylkill  water,  introduced 
into  Philadelphia,  and  the  Croton,  brought  from  quite  a  distance  to 
New  York,  are  both  good  waters ;  though  neither,  as  chemical  analy- 
sis has  shown,  is  quite  as  pure  as  the  Cochituate,  of  Boston. 

Lead  Pipes.  —  In  each  of  these  three  cities,  water  is  conveyed 
through  the  dwellings  in  leaden  pipes,  —  a  practice  fraught  with  a 
<hinger  to  which  the  inhabitants  should  not  expose  themselves.  That 
lead  does  often  become  oxidized  and  impart  its  poisonous  properties 
to  water  when  long  in  contact  with  it,  is  a  well-known  fact.  Let  a 
number  of  persons  drink  every  morning  from  the  first  water  drawn 
from  the  pipes,  and  a  portion  of  them  will  be  attacked  with  some 
form  of  lead  disease.  The  pipes  should  be  emptied  every  morning, 
before  using  the  water  for  domestic  purposes  ;  and  then,  it  is  true, 
there  is  little  danger.  But  where  the  work  in  the  kitchen  is  done  by 
hired  persons,  who  have  no  appreciation  of  the  danger,  how  is  it  to 
be  known  whether  this  act  of  safety  is  always  carefully  performed  ? 
Water  pipes  should  certainly  be  made  of  some  other  material. 

Physical  and  Other  Properties  of  Water.  —  Good  water  is  without 
smell,  is  perfectly  clear,  and  in  the  mouth,  has  a  soft  and  lively  feel. 
When  poured  from  one  vessel  to  another,  it  should  give  out  air- 
bubbles.  Boiled  and  distilled  waters  have  a  vapid,  flat  taste.  This 
is  owing  to  their  containing  no  carbonic  acid  gas  or  atmospheric  air, 
—  these  being  driven  ofl'  in  the  act  of  boiling  and  distilling.  A  hun- 
dred cubic  inches  of  good  river  water  contains  about  2^  of  carbonic 
acid,  and  1^  of  common  air. 

Carbonic  acid  is  what  gives  to  mineral,  or  soda  water,  its  bris^, 
and  even  pungent  taste.  Without  a  portion  of  this  acid  and  atmos- 
pheric air,  water  is  perfectly  insipid,  and  not  fit  to  be  used  as  a  bev- 
erage. Hence,  if  it  be  boiled  or  distilled  to  clear  it  of  earthy  matters, 
we  must  expose  a  large  surface  of  it  to  the  air,  and  shake  it,  that  it 
may  re-absorb  from  the  atmospheric,  what  it  has  lost,  and  thus  recover 
its  taste. 

Rain  Water  is  tlie  Result  of  Distillation  on  a  large  scale,  and  would 
be  insipid,  like  other  distilled  water,  only  that,  after  being  distilled  off 


88 


HYGIENE. 


from  the  waters  upon  the  surface  of  the  earth,  it  recovers,  while  as- 
cending as  vapor,  tlio  carlxinic  acid  and  atmospheric  air. 

Fishes  breathe  air  as  well  as  land  animals,  and  hence,  lakes  wpoii 
the  tops  of  high  mountains,  where  but  little  oxygen  can  be  absorbed 
into  the  water  from  the  air,  are  not  iidiabited  by  the  finny  tribes. 

The  Saltliess  of  the  Oceait  is  simply  the  accumulation  of  the  salinf 
substances  washed  out  of  the  bowels  of  the  earth. 

The  wat<;r  which  for  thousinds  of  years  has  been  distilling  off  as 
vapor,  from  the  surface  of  the  ocean,  is  nearly  pure.  Being  carried 
by  the  winds  to  the  continents,  it  falls  as  rain,  sinks  into  the  earth,  is 
filtered  through  mineral  substances,  comes  to  the  surfaces  in  springs, 
is  colleeU'd  into  rivers,  and,  with  all  its  freight  of  mineral  salts,  is 
borne  back  to  the  ocean.  Everything  that  water  can  dissolve,  anil 
carry  down  from  the  continents,  finds  a  great  depository  in  the  oeean  ; 
and  as  this  has  no  outlet,  the  accumulation  must  go  on  without  limit. 
Rivers  which  flow  iino  the  ocean,  contain  from  ten  to  fifty  grains  of 
salts  to  the  gallon,  —  composed  chiefly  of  common  salt,  sulphate  and 
carbonate  of  lime,  magnesia,  soda,  potash  and  iron  ;  and  these  are 
the  constitmuits  of  sea-water.  The  time  must  come,  in  the  history 
of  our  globe,  when  these  salts  will  render  the  water  of  the  ocean  so 
dense  that  a  man  can  no  more  sink  in  it  than  a  cork  can  sink  in  fresh 
water. 

Cleansing:  of  Impure  Water.  —  Impure  waters  should  be  cleansed 
before  being  used  for  domestic  purposes.  Distillation  is  the  most 
perfect  method  of  purification.  Filtration  through  sand  is  a  good 
method.  It  removes  all  suspended  vegetable  or  animal  matter,  and 
all  living  animals.  Boiling  likewise  kills  all  animals,  and  throws  to 
the  bottom  carbonate  of  lime.  It  is  this  which  constitutes  the  crust 
which  lines  tea-kettles  in  all  regions  where  limestone  exists. 

Settlers  in  a  new  country,  should  make  it  a  prime  object  to  find 
good  water.  This  is  of  great  moment.  Their  own  health,  and  the 
health  of  tlieir  posterity  is  dependent  upon  it.  Any  soil,  good  or  bad, 
is  not  worth  half  price,  if  it  yield  impure  water. 

Reasons  for  Prizing;  Water.  —  Finally,  we  ought  all  to  prize  water 
very  highly,  for  it  composes  nearly  eight-tenths  of  our  entire  bodies,  in- 
cluding our  flesh,  blood,  and  other  fluids.  Nay,  we  owe  to  it  the  very 
softness,  delicacy,  and  smoothness  of  our  persons.  Our  muscles,  nerves, 
blood-vessels,  glands,  cartilages,  etc.,  all  play  smoothly  upon  each  other 
in  consequence  of  water.  Take  all  the  water  out  of  us,  and  we  should 
be  dry  sticks  indeed.  All  our  comeliness  would  be  gone.  Nobody 
would  or  could  love  us.  We  should  be  walking  reeds,  shaken  and 
sported  with  by  every  wind.  Let  us  never  forget  how  much  we  are 
indebted  to  water. 

Exercise. 

Animal  life  is  conditioned  upon  exercise.  Without  it  health  can- 
not exist,  or  life  itself  be  continued  for  any  great  length  of  time. 


e  water 
dies,  ill- 
the  very 

nerves, 
2h  other 

should 
iNobody 

tea  and 

we  are 


llth  caii- 
le. 


HYGIENE. 


89 


Proper  exercise  communicates  motion  to  every  part  susceptible  of 
it.  It  expands  the  breast,  contracts  and  relaxes  the  inuselcs,  quickens 
the  motion  of  the  blood,  moves  afresh  all  the  other  fluids,  and  stirs  to 
the  centre  the  whole  frame.  More  easy  and  perfect  digestion,  the 
nutrition  of  every  part,  and  the  proper  performance  of  all  the  secre- 
tioiis  and  excretions,  are  the  results  of  such  exercise. 

A  distinguished  physician  said  :  "  I  know  not  which  is  most  neces- 
sary to  the  support  of  the  human  frame,  food  or  motion."  Some  of  the 
finest  talents  in  the  world  are  probably  lost  for  the  want  of  exercise ; 
for  without  it  the  mind  loses  its  ke<!n  perception,  and  its  bounding 
energy ;  its  power  of  application  and  its  general  scope.  If  nu'u  of 
great  talents  would  give  attention  to  exercise,  the  world  would  reap 
a  larger  harvest  from  their  written  thoughts. 

The  arrangements  of  modern  society  have  very  much  abridged  Ww 
facilities  for  taking  exercise  ;  but  if  Trenck  in  his  damp  prison,  with 
fetters  of  seventy  pounds  weight  upon  him,  could  preserve  his  health 
by  leaping  about  like  a  lion,  most  persons  could  do  aa  much  with  the 
fetters  of  modern  society  upon  their  limbs. 

Must  be  Re^lur.  —  Exercise,  to  be  of  much  service,  must  be  regu- 
lar, —  not  taken  by  fits  and  starts,  —  a  good  deal  to-day  and  none  to- 
morrow ;  but  in  reasonable  measure  every  day.  Occasional  eflbrta, 
with  intervening  inactivity,  only  does  mischief. 

Must  be  Pleasurable. —  It  should  be  connected,  too,  if  possible,  with 
8ome  pleasing  occupation  or  pursuit.  The  movement  of  the  limbs 
should  carry  us  towards  some  place  or  end  in  which  the  mind  feels 
an  interest ;  exercise  will  then  do  us  most  good.  Hence,  botanical 
pursuits,  the  cultivation  of  a  garden,  and  the  like,  are  often  preferable 
to  a  solitary  and  aimless  walk. 

Must  not  be  Excessive.  —  Exercise  should  never  be  carried  so  far  as 
to  produce  great  fatigue.  Extremes  are  injurious  ;  and  too  much  ex- 
erci.se,  especially  by  a  sick  or  feeble  person,  may  be  as  injurious  as  too 
little. 

No  clothing  should  be  thrown  off  after  exercise,  nor  should  one  cool 
off  by  sitting  in  a  draft  of  air.  Very  serious  consequences  often  fel- 
low this  practice. 

Xot  to  be  Taken  After  Meals.  —  It  is  not  best  to  take  exercise  im- 
mediately after  meals.  The  reasons  for  this  caution  have  been  ex- 
plained. It  is  true  many  laboring  men  go  at  once  to  their  work  after 
earing,  without  apparent  injury.  Yet  they  are  strong,  and  can  endure 
Vhat  those  who  use  their  brains  chieHy  could  not.  And  even  they  do 
:K)t  labor  as  easily  and  cheerfully  immediately  after  dinner. 

Active  and  Passive.  —  Exercise  is  properly  divided  into  active  and 
passive.  Walking,  running,  leaping,  dancing,  gardening,  various  sports, 
etc.,  are  active.  While  sailing,  swinging,  and  riding  in  carriages,  are 
passive.  Riding  on  horse-back  is  of  a  mixed  nature,  —  being  both 
active  and  passive. 

A  few  remarks  upon  these  several  kinds  of  exercise,  will  have  a 
practical  value  to  some  of  the  readers  of  these  pages. 


■■ 


90 


IIYGIKXR. 


Willkill^'  is  oiu!  of  tlic  most  gentlo,  easy,  and  gcnrnilly  one  of  tin' 
most  useful  of  the  active  exercises.  It  is  within  the  reach  of  all  who 
have  the  use  of  their  liuibs,  and  is  indulged  at  th(!  expense  only  of  a 
little  shoe  leather.  To  make  it  agreeal)le,  the  face  is  only  to  hi' 
turned  to  some  favorite  locality,  and  the  mind  put  in  eonunuiiioii 
with  the  voices  of  nature. 

To  walk  with  the  Ix'st  advantage,  the  body  .should  be  kept  upright, 
tlie  slioulders  thrown  back,  the  breast  projected  a  little  forward,  so  iis 
to  give  the  lungs  full  play,  and  the  air  an  op|)ortunity  to  descend  to 
the  bottom  of  them.  This  attitude  places  all  the  organs  of  the  body 
in  the  most  natural  position,  and  relieves  them  from  all  restraint. 
Walking  then  becomes  a  source  of  pleasure.  The  artist  who  bend'? 
over  his  pallet,  and  gets  into  a  cramped  position,  is  by  this  kind  of 
walking  relieved,  and  his  body  kept  upright.  Females,  particularly 
of  the  wealthier  class,  are  much  more  apt  to  neglect  this  species  of 
exercise  than  males. 

It  is  not  so  in  England.  There  it  is  no  uncommon  thing  for  ladies 
of  high  rank  to  walk  ten  miles  a  day ;  and  they  do  it  in  shoes  of  sulli- 
cient  thickness  to  protect  their  feet  from  all  dampness,  and  in  clothes 
large  enough  to  give  their  muscles  full  play.  As  a  consequence,  they 
enjoy  excellent  health,  and  in  many  cases,  even  retain  their  freshness 
and  beauty  to  old  age. 

A  master  of  one  of  the  vessels  of  our  navy  who  spent  some  time, 
lately,  in  the  British  Channel,  was  several  times  invited  to  spend  the 
evening  at  Lord  Hardwick's,  where  he  made  the  acquaintance  of  two 
daughters  of  his  lordship,  who,  in  the  drawing  room,  he  thought  the 
most  accomplished  ladies  he  ever  saw.  Yet  those  young  women,  on 
two  occasions,  in  company  with  other  friends,  walked  miles  to  visit 
his  vessel,  once  on  a  rainy  day,  clad  in  thick,  coarse  cloth  cloaks  which 
no  rain  could  penetrate,  and  caring  as  little  for  wet  weather  as  a 
couple  of  ducks. 

Good  for  the  Studious. —  For  the  studious,  walking  is  a  most  capi- 
tal exercise.  It  varies  the  scenes  so  constantly,  and  brings  the  mind 
in  contact  with  so  many  objects,  that  the  monotony  of  in-door  life  is 
admirably  broken.  It  was  a  maxim  of  Plato,  that  "  he  is  truly  a  tup- 
pie,  who,  cultivating  his  mind  alone,  suft'ers  his  body  to  languish." 

GoodJu  Cold  Weather.  —  Walking  is  valuable  in  cold  weather,  be- 
cause it  exposes  one  to  the  cold  atmosphere,  and  hardens  the  person 
against  frosty  weather,  —  a  consideration  of  great  consequence  iu 
countries  which  are  subject  to  extremes  of  cold. 

Ruunui^  and  Leaping;  are  forms  of  exercise  w^hich  should  be  in- 
dulged w^ith  prudence  even  by  the  young  and  healthy.  For  the  feeble 
and  the  aged,  they  are  entirely  inadmissible.  Used  cautiously,  in  a 
system  of  regular  training,  they  may  help  raise  the  bodily  powers  to 
a  high  degree  of  agility  and  endurance.  The  North  American  Indian, 
who  is  bred  to  the  chase,  runs  with  surprising  swiftness,  and  for  en- 
durance is  scarcely  excelled  by  his  faithful  dog.  What  training  does 
for  the  Indian,  it  may  do  for  the  white  man,  who  may  chance  to  in- 
herit as  goo<l  a  constitution. 


-r- 


lie  of  tlif 

all  will) 

t)iilv  1)1"  !l 

ilv  to  bf 

numnioii 

t  uprif,'lit, 

xni,  so  !is 

frtC'ciid  to 

the  body 

restniiiit. 

ho  bciuls 
s  kind  of 
irti(!uliirly 
species  of 

for  ladies 
es  of  sutli- 

in  clothes 
ence, they 
■  freshness 

ome  time, 
I  spend  the 
nee  of  two 
nought  the 
■•omen,  on 
C8  to  visit 
>aks  which 
ather  as  a 

most  capi- 
the  mind 
oor  life  is 

nly  a  crijv 

guish." 

•ather,  be- 

le  person 

quence  in 

uld  be  in- 

the  feeble 
ously,  in  a 

powers  to 

:an  Indian, 

nd  for  en- 

lining  does 

ance  to  in- 


IIYGIKNK. 


91 


TIh'  CiliniH'  of  Bull  requires  very  active  running,  and  for  the  young, 

it  is  an  cxcc'dingly  In-altlifid  amuscnirMt.      It  lills  the  wlioh 

he  currciils  of  life 


runnnig 


In  line 
ike 


with  a  bounding  spirit,  and    sets 
swollei.  brookH  after  heavy  rains. 

(•yilllDlsticH. —  The  more  active  species  of  exercise  havi^  generally 
been  included  under  the  term  gyiiuiuslics.  Among  the  (Jrceks  and 
Romans,  feats  of  strength  and  endurance  were  supposed  to  confer 
honor.  For  this  reason,  and  because  war  was  a  laborious  calling,  re- 
quiring bodily  endurance  and  strength,  their  youth  were  trained  in 
the  most  active  exercises.  Gymnastic  games  M'cre  with  them  at  once 
the  school  of  health,  and  the  military  academy. 

In  England,  during  the  middle  ages,  acts  of  parliament  and  royal 
proclamations  were  employed  to  regulate  and  foster  those  manly 
sports  and  exercises,  which  fitted  the  people  for  the  activity  required 
on  the  field  of  battle. 

Those  preparations  for  brutal  wars  would  be  unsuited  to  the  pres- 
ent state  of  the  world ;  but  the  capacity  for  endurance  which  these 
trainings  produced,  cotUd  be  most  usefully  enq)loyed  in  the  laborious 
and  scientific  researches  which  modern  advancrement  requires.  Very 
few  of  our  scientific  men  have  sufficient  hardness  of  frame  to  sus- 
tain them  in  their  laborious  studies. 

The  heart  diseases  which  prevail  so  extensively  are  the  result,  many 
of  them,  of  violent  exercise,  taken,  perhaps,  from  necessity,  and  prov- 
ing injurious  because  not  a  matter  of  every-day  practice.  Violent 
exercise,  more  than  any  other  kind,  must  be  regular  in  order  to  be 
borne, 

Needed  by  Yonnjc  Women. —  Gymnastic  exercises,  and  calisthenics, 
are  particularly  needed  by  our  young  women,  to  give  them  something 
of  the  robustness  of  our  mothers,  two  generations  back.  For  the 
want  of  them,  they  are  dwindling  away,  and  becoming  almost  worth- 
lesr  for  all  the  purposes  for  which  they  were  made. 

In  view  of  this  want,  I  carmot  but  express  my  gratification  here, 
that  a  high  school  for  young  ladies  is  now  ojM'n  in  this  city,  under  the 
care  of  the  Rev.  George  Gannett  and  his  lady,  in  which  a  large  and  suit- 
able room  is  set  apart  for  the  daily  practice  of  calisthenic  and  gym- 
nastic exercises,  suited  to  the  age  and  strength  of  each  pupil,  under 
the  instruction  of  an  exrx'rienced  teacher  of  their  own  sex.  I  cannot 
but  look  upon  this  school,  offering,  as  it  does,  the  highest  advantages 
for  a  complete  education  in  scieace  and  morals  also,  as  the  beginning 
of  better  things. 

Modems  Physically  Inferior  to  the  Ancients.    Renson  for  It  —  It  is 

evident  that  the  moderns  are  inferior  in  bodily  strength  to  the  ancient 
Greeks  and  Romans.  Before  the  introduction  of  Christianity,  men 
knew  very  little  about  the  future,  and  therefore  strove  to  make  the., 
most  of  the  present.  Hence,  they  took  measures  to  ensure  health  and 
long  life.  It  is  true  that  a  due  regard  to  the  welfare  of  the  future, 
need  not,  and  should  not,  prevent  a  care  for  the  present ;  but  from 
various  causes,  to  be  referred  to  on  a  subsequent  page,  such  has  been 
the  practice,  to  the  manifest  physical  injury  of  the  race.  ■ . 


92 


HYUIENE. 


Dtmcillir,  when  hedged  iilumt  with  proper  restrietioiiH  and  liniitii- 
tioiiH,  hiis  great  lulvmituges  iis  ii  physical  trainer  cf  the  young.  Then- 
are  very  few  forniM  of  exereine  which  give  mo  free  a  phiy  to  all  thi- 
niuricles,  and  at  the  wanic  time  ho  agreeably  interest  the  mind.  Begini 
in  early  life,  and  pursued  systematic^ally,  daneing  imparts  a  grace  and 
ea8e  of  iriotion  which  nothing  else  can  give.  For  this  rea;<on  uloiie, 
it  should  be  cultivated  as  an  art. 

Everyman  and  woman  is  often  placed  in  circumstances  in  life  /hern 
the  possession  of  an  easy  carriage  of  body,  and  an  uneinbarrassed 
maiuier,  would  hv  prized  above;  gold.     One's  personal  inltuence  in  the 


world  is  g^'-atly  increased  by  an  easy,  graceful  manner.     We  all  know 
how  a  poliie  manner  wins,  while  a  rough  and  uncouth  one  repels  us. 

Warniii}(  Apinst  ExcefW.  —  While  dancing  has  many  things  to  re- 
commend it,  there  are  also  several  considerations  which  should  warn 
us  against  using  it  to  excess,  particularly  in  the  ball  saloons  of  fash- 
ionable life.  So  many  muscles  are  called  into  play,  the  breathini> 
is  so  much  quickened,  and  the  air  breathed  is  often  so  impure,  that 
the  circulation  of  the  blood  is  hastened  almost  to  fever  excitement 
And  when  to  this  we  add  the  use  of  wines  and  cordials,  alternated 
with  ices  and  iced  drinks,  and  the  exposure,  on  returning  home  from 
balls,  to  the  chill  night  air,  under  the  miserable  protection  of  insnlli- 
cient  clothing,  we  have  draw-backs  enough  to  abridge,  if  not  to  anni- 
hilate the  benefits  derived  from  this  otherwise  healthful  and  elegant 
exercise. 

But  then  it  will  be  said,  and  truly  enough,  that  these  arc  the  abu.ses, 
not  the  uses  of  dancing.  To  these  abuses,  no  parent  should  permit 
the  health  of  a  child  to  be  exposed.  In  the  parlor  at  home,  in  con- 
nection with  a  few  young  friends  gathered  in  to  spend  an  evening; 
or,  in  a  well-ventilated  hall,  under  the  instruction  of  a  master  of 
known  character  and  retineinent,  dancing  is  of  high  utility,  and  mucii 
may  be  said  in  its  favor.  An  amusement  for  which  there  is  so  gen- 
eral a  fondness,  one  may  say,  passion,  must  be  fitted  to  meet  some 
want  of  the  animal  economy,  and  perhaps  of  man's  higher  nature. 

Grace  of  motion  gratifies  our  sense  of  the  beautiful,  and  in  its 
nature  is  allied  to  poetry.  Turning  away  from  the  abuses  of  dancing, 
let  the  reader  thankfully  use  it  as  one  of  the  very  best  physical,  social, 
and  ajsthetical  educators  of  youth. 

But  if  dancing  is  salutary,  it  is  only  when  every  limb  and  muscle' 
is  allowed  to  participate  naturally  and  without  restraint  in  the  geneial 
motion.  When  performed  in  a  dress  so  tight  as  to  restrain  all  free- 
dom, not  only  is  every  grace  destroyed,  but  injury  of  a  serious  char- 
acter may  be  the  result.       ^  '  • 

The  CiiltiTiitioit  of  a  Garden  is  also  a  species  of  exercise  highly 
conducive  to  health.  To  the  poor  it  should  have  a  double  attraction. 
It  is  not  only  ;i  healthful  exercise,  but  it  yields,  in  its  season,  many 
wholesome  vegetables,  the  price  of  which,  when  they  have  to  be  pur- 
chased, frequently  puts  them  beyond  the  reach  of  the  poor.  It  i^ 
pleasant  to  know  that  in  the  towns  of  Massachusetts,  where  shoes 
are  largely  muiiufactured,  most  of  the  workmen  own  small  pieces  of 


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23  WEST  MAIN  SrSEET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


:»-  I 


CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


jt 


Canadian  Institute  for  Historical  IVIicroreproductions  /  Institut  Canadian  de  microreproductions  historiques 


HYGIENE. 


93 


ground  which  they  cultivate  as  gardens,  —  deriving  health  both  from 
the  labor,  and  from  the  vegetables  raised.  This  is  one  of  the  kinds 
of  exercise  which  are  more  beneficial  from  having  an  end  in  view 
The  man  who  works  in  his  garden  derives  pleasure  from  the  im- 
provement he  is  making  upon  his  ground,  and  from  the  prospect  of 
advantage  to  himself  and  family. 

Other  Actire  Exercises.  —  To  the  exercises  already  spoken  of  may 
be  added  those  which  are  mostly  taken  indoors,  —  the  dumb-bejls, 
jumping  the  rope,  the  battle-door,  etc.  They  may  be  resorted  to 
when  the  weather  is  stormy,  or  when  any  other  cause  may  prevent 
one  from  going  into  the  open  air.  Nevertheless,  as  promoters  of 
health,  they  are  inferior  to  those  exercises  which  take  one  out  under 
the  open  sky.  They  are  too  mechanical  in  their  nature,  and  have  too 
little  aim,  to  be  allowed  to  take  the  place  of  the  preceding. 

Passive  Exercises. 

Sailing.  —  This,  to  many  persons,  is  among  the  most  pleasurable 
and  exciting  of  the  passive  exercises.  But  the  excitement  arising 
from  the  motions  of  a  boat,  sometimes,  in  ca^:e  of  timid  persons, 
degenerates  into  fear^  which  is  injurious.  Yot_  .^  gentlemen  who 
manage  the  boat  upon  sailing  excursions,  should  never  put  on  too 
much  sail  in  a  brisk  wind,  and  torment  the  ladies  by  exciting  their 
fears,  as  their  own  amusement  may  be  in  this  way  purchased  at  the 
cost  of  others'  health,  —  a  result  far  enough  from  their  thoughts  or 
intentions,  but  not  the  less  real. 

Swinging. — The  sick  may  sometimes  indulge  in  this  exercise,  when 
capable  of  enduring  no  other.  To  swing  gently  has  a  soothing  effect, 
and  often  allays  nervous  irritability  in  a  wa^  7/hich  nothing  else  can. 
It  is  like  the  lullaby  motion  of  the  cradle.     It  calms  and  soothes. 

Nervous  children  and  grown  persons  in  feeble  health,  are  some- 
times, by  roguish  boys,  swung  too  high,  and  very  much  excited  and 
alarmed.  This  is  wrong.  It  may  do  great  injury.  Very  few  boys 
would  do  it  if  they  knew  the  evil  consequences.  Boys  and  girls  are 
generally  kind  bearted ;  and  though  they  may  like  to  hector  others, 
they  will  seldom  knowingly  injure  them  for  their  own  amusement 

Garriage-Riding. —  The  advantages  to  be  derived  fron  is  species 
of  exercise  are  probably  rated  too  high.  For  feeble  perso^.j,  just  re- 
covering from  illness,  who  cannot  endure  walking  or  riding  on  horse- 
back it  is  valuable,  particulaHy  if  taken  in  an  open  carriage.  But  for 
those  wholiave  more  strength,  it  is  less  desirable  than  many  other  ex- 
ercises. True,  it  is  generally  an  agreeable  mode  of  locomotion,  and 
for  this  reason,  it  is  generally  more  serviceable  than  the  small  amount 
of  exercise  afforded  by  it  would  lead  one  to  suppose. 

Carriages  are  luxuries,  and  like  all  other  luxuries,  they  are  apt  to 
bring  on  debility,  and  perhaps  shorten  life.  A  man  is  apt  to  order 
his  carriage  to  the  door  at  the  time  when  increasing  wealth  enables 
him  to  retire  from  the  active  pursuits  of  life, — the  very  moment  when 


•■■^ 


¥ 


4 


rv 


he  is  most  in  need  of  some  exertion  to  take  the  place  of  rhat  to  which 
he  has  been  accustomed.  Yet  so  it  is,  luxury  cornea  to  enfeeble,  at 
the  time  when  we  need  something  to  harden  us. 

Could  rich  men  be  persuaded  to  let  their  luxuries  consist,  in  part, 
in  doing  good,  and  like  Howard,  find  pleasure  in  travelling  on  foot  to 
visit  those  who  are  sick  and  in  prison,  they  would  be  surprised  to  see 
how  their  happiness  would  be  increased. 

Close  carriages  are  generally  used  by  the  wealthy.  They  at  best 
contain  but  little  air,  which  is  breathed  over  and  over,  and  becomes 
unfit  for  respiration.  The  windows  of  such  carriages  should  always 
be  open,  except  in  rainy  weather,  when  tlie  latticed  windows  only 
should  be  used. 

Riding  iu  Sleij^lis  furnishes  an  agreeable  excitement,  and  may  be 
indulged  to  some  extent  with  advantage.  Yet  it  can  be  had  only  in 
cold  weather,  and  persons  who  partake  of  its  pleasun^s,  should  be 
careful  to  wear  clothing  enough  to  protect  themselves  against  the 
frost.  This  is  the  more  necessary,  aa  very  little  motion  is  communi- 
cated to  their  bodies  by  the  sleigh. 

Horse-Back  Riding;.  —  This  form  of  exercise  may  fairly  rank  next 
to  walking;  in  some  states  of  the  «ystem,  it  is  preferable.  It  justly 
holds  a  high  rank  as  an  exercise  for  consumptive  persons.  Many  a 
man,  and  woman  too,  has  been  benefited  by  it  when  suffering  from 
lung  disease.  For  those  who  have  hernia^  or  falling  of  the  bowel,  it 
is  not  proper,  as  the  most  serious  consequeacea  may  result  from  its 
use. 

Tlie  Horse  should  be  Owued.  —  A  feeble  man  who  rides  on  horse- 
back should,  if  possible,  own  hia  horse ;  for,  becoming  attached  to  him, 
as  he  generally  does,  he  will  be  able  to  ride  farther  than  upon  an  ani- 
mal in  which  he  feels  less  interest.  A  horse  is  a  noble  creature,  and  a 
man  who  loves  him,  will  sometimes  acquire  a  passion,  almost:,  for 
being  upon  his  back,  and  witnessing  hia  splendid  performances. 

Pleasurable  Exercises  Most  Beneficial. —  Finally,  those  exercises  arc 
most  beneficial,  and  can  be  longest  endured,  in  which  we  feel  the 
greatest  interest.  Place*  before  even  a  feeble  man  some  desirable  ob- 
ject, and  he  will  endure  a  great  deal  to  reach  it ;  or  engage  the  mind 
of  a  very  tired  person  in  something  which  greatly  interests  it,  and 
considerably  more  exertion  will  be  easily  borne.  This  is  well  illus- 
trated by  the  story  told  by  Miss  Edgeworth  of  a  certain  father,  who 
had  taken  a  long  walk  with  his  little  eon,  and  found  the  boy  appar< 
ently  unable  to  walk  further,  some  time  before  reaching  home.  "  Here," 
saici  the  shrewd-minded  father,  ♦'  ride  on  my  gold-headed  cane."  Im- 
mediately the  little  fellow  was  astride  the  cane,  which  carried  him  as 
safely  home  aa  the  freshest  horse. 

Mental  Co-operation  ia  of  the  highest  importance  in  all  exercise. 
Men  who  are  paid  by  the  job,  work  with  far  more  spirit  than  those 
who  are  paid  by  the  day.  One  would  dig  in  the  earth  with  very  little 
Hpirit,  if  he  had  no  motive  for  doing  it ;  but  if  he  expected  with  every 


r-;-*),, 


0  which 
ieble,  at 

in  part, 

1  foot  to 
:d  to  see 

'  at  beat 
becomes 
1  always 
)ws  only 

may  be 
I  only  in 
hould  be 
linst  the 
ommuni- 


ank  next 
It  justly 
Many  a 

ring  from 
bowel,  it 

i  from  its 

on  horse- 
ed  to  him, 
)n  an  ani- 
ure,  and  a 
Imost,  for 
cea. 

jrcisea  arc 
;  feel  the 
irable  ob- 
the  mind 
its  it,  and 
well  illus- 
ither,  who 
K>y  appar- 
"Here," 
line."  Im- 
ed  hina  as 


1  exercise. 

han  those 

very  little 

with  every 


HYGIENE, 


QH 


ghovelful  of  earth  to  bring  up  gold-dust,  he  would  not  only  work  with 
a  will,  but  would  endure  a  great  deal  more  labor.  From  these  consid- 
erations we  may  infer  that  those  farmers  and  manufacturers,  who  pay 
their  men  the  highest  wages,  make  the  most  money  on  their  work. 

Tlie  best  time  for  takinji:  exercise  is  that  in  which  it  docs  us  most 
good.  For  most  persons,  the  morning  hours  may  be  cons'''^red  most 
mvorable.  But  there  are  many  who  cannot  take  exercise  in  the  early 
inorning,  without  suffering  from  it  through  the  whole  day.  Some  are 
able  to  walk  miles  in  the  afternoon,  who  would  be  made  sick  by  sim- 
ilar exertions  immediately  after  rising. 

Persons  often  injure  friends  who  have  this  peculiarity  of  constitu- 
tion,  by  urging  them  out  in  the  morning.  They  do  it  from  good 
motives,  but  are,  nevertheless,  blamewortiiy  for  attempting  to  advise 
ill  matters  which  they  do  not  understand. 


Rest  and  Sleep. 

Our  bodies  are  like  clocks  ;  they  run  down  and  are  wound  up  once 
evcvy  twenty-four  hours.  Were  they  obliged  to  work  on  uninter- 
ru|)tedly,  they  would  wear  out  in  a  few  days.  It  is  a  merciful  pro- 
vision that  periods  of  repose  are  allotted  to  us.  Everything  has  it' 
proper  place.  Rest  is  not  less  a  luxury  after  exercise,  than  exercise 
\;i  after  rest.  They  both  confer  bappiaess  at  the  same  time  that  they 
promote  our  w«!ll-being. 

Sleeping;  Rooms,  —  The  largest  part  of  our  rest  is  taken  in  sleep. 
Of  course  the  kind  of  room  in  which  we  sleep  is  worthy  of  considera- 
tion. Hufeland  says :  "  It  must  not  be  forgotten  that  we  spend  a 
considerable  portion  of  our  lives  in  the  bed-chamber,  and  consequently 
that  its  healthiness  or  unhealthiness,  cannot  fail  to  have  a  very  im- 
portant influence  upon  our  physical  well-being."  It  should  at  least 
be  large.  That  is  of  prime  importance,  because,  during  the  several 
hours  that  we  are  in  bed,  we  need  to  breathe  a  great  deal  of  air,  and 
our  health  is  injured  when  we  are  obliged  to  breathe  it  several  times 
over.  We  should  at  least  pay  as  much  attention  to  the  size,  situa- 
tion, temperature,  and  cleaniiness  of  the  room  we  occupy  during  the 
hours  of  repose,  as  to  the  parlors,  or  drawing-room,  or  any  other 
apartment.  And  yet  how  different  from  this  is  the  general  practice 
of  families.  The  smallest  room  in  the  house  is  commonly  set  apart 
for  the  bed  and  its  nightly  occupants. 

The  sleeping-room  should  have  a  good  location,  so  as  to  be  dry 
It  should  be  kept  clean,  and  neither  be  too  hot  nor  too  cold.  A"  u 
more  important  still,  it  should  be  >vell.  ventilated. 

One  bed,  occupied  by  two  persons,  is  as  much  as  should  ever  be 
allowed  in  a  single  room ;  though,  of  course,  two  beds  in  a  large 
room,  are  no  more  than  one  in  a  small  one.     Both  are  objectionable. 

Fire  in  Sleeping;  Rooms.  —  As  to  having  fire  in  a  sleeping  room, 
that  is  a  matter  to  be  determined  by  the  health  of  the  occupant. 
Persona  who  have  poor  circulation,  and  are  feeble,  had  better  have  a 


mm 


•a 


I 


little  fire  in  the  bed-chamber,  in  cold  weather.     For  those  in  good 
health,  a  cold  room  is  preferable. 

Open  Windows  in  Sleeping  Rooms.  —  In  the  hot  weather  of  sum- 
mer, it  is  better  to  keep  the  windows  open  to  some  extent,  through 
the  night,  but  not  on  opposite  sides  of  the  room  so  as  to  make  a  draft 
across  the  bed. 

There  is  a  difference  of  opinion  as  to  the  safety  of  this  practice; 
but  the  experience  of  those  who  have  used  it  prudently  and  persevepj 
iiigly,  has  generally  sanctioned  its  employment.  It  is  pre.snmed  that 
night-air  is  made  to  be  breathed;  and  if  we  breathe  it  habitujilly,  there 
irt  no  good  reason  why  it  should  be  considered  hurtful.  At  all  events, 
we  have  got  to  do  one  of  three  things,  —  either  breathe  it,  or  be  poi- 
soned by  air  which  is  breathed  several  times  over,  or  use  very  large 
sleeping  rooms,  and  thus  lay  in  a  stock  to  last  over  night. 

An  Open  Fireplace  in  a  bed  chamber  will  do  much  towards  its  puri- 
fication. It  carries  oft'  foul  air.  But  many  persons  board  up  this 
outlet  as  if  bad  air  were  a  friend,  with  whom  they  could  not  think  of 
parting.  At  the  same  time,  they  will  carefully  close  all  windows  and 
doors,  as  if  fresh  air  were  an  enemy  not  to  be  let  in. 

Beds.  —  It  is  a  pleasant  thought  <that  while  so  many  things  which 
injure  health  are  coming  into  fashion,  some  which  have  a  like  effect 
are  going  out.  Among  the  injurious  things  which  are  silently  with- 
drawing, are  fecther  beds. 

In  earlier  times,  a  bed  made  of  eider-down  was  thought  to  be  a 
great  luxury,  to  be  carefully  preserved,  and  handed  down  from  mother 
to  daughter.  Beds  made  of  htns'  feathers,  and  other  coarser  kii  ds, 
were  thought  to  be  only  fit  for  children.  With  due  deference  to  these 
earlier  judgments,  it  must  be  said  that  feather  beds,  whether  downy 
or  coarse,  are  not  even  fit  for  children.  They  are  composed  of  ani- 
mal matter,  and  by  a  slow  process  of  decay,  are  always,  when  stirred, 
sending  up  an  exhalation  which  it  is  not  healthful  to  breathe. 

By  their  softness,  too,  they  increase  the  general  tendency  to  effemi- 
r.acy.  In  warm  weather,  they  are  too  heating.  To  sink  down  into 
them,  and  lie  nearly  buried  all  night,  is  to  insure  a  feeling  of  lassitude 
and  debility  in  the  morning.  Only  the  strongest  persons  can  endure 
it  without  being  made  conscious  of  the  evil  effects. 

Beds  mnst  not  be  too  Hard.  —  On  the  other  hand,  it  is  almost 
equally  unwise  to  choose  a  bed  of  absolutely  unyielding  hardness. 
When  very  tired,  we  may  rest  even  upon  a  board;  but  sleep  will 
gv.  "rally  be  more  sound  as  well  as  refreshing,  if  the  bed  be  some- 
what J  "elding.  The  hair  mattress  is  the  very  best  bed  yet  use3.  It 
is  healthful  and  easy.  No  person  once  accustomed  to  it,  will  ever 
return  to  feathers.  In  summer,  it  is  a  luxury ;  in  winter,  it  is  suffi- 
ciently warm,  though  a  little  more  covering  is  needed  than  with 
feathers. 

Beddinn;. —  In  hot  weather,  I'nen  sheets  are  preferable  to  cotton, 
and  of  course  will  be  used  by  those  who  have  ample  means.     But 


^r^^'M^ 


HYGIENE. 


97 


in 


good 


of  sum- 
,  through 
:e  a  draft 

practice," 
pcrrieveH" 
ined  that 
dly,  there 
ill  events, 
ar  be  poi- 
r^ery  large 

8  its  puri- 
d  up  this 
t  think  of 
dowB  and 


igs  which 
like  effect 
ntly  with- 
it  to  be  a 
m  mother 
ser  kii  ds, 
:e  to  these 
er  downy 
ed  of  ani- 
en  stirred, 
e. 

to  effemi- 

lown  into 

lassitude 

in  endure 


is  almost 
hardnesi 

sleep  will 
be  some- 
used.  It 
will  ever 
t  is  suffi- 
lan  with 


to  cotton, 
ans.     But 


rotten  ones  are  good  enough,  and  in  winter  are  decidedly  the  more 
desirable  of  the  two.  Cotton  is  best,  too,  for  those  who  suffer  wiih 
rheumatic  affections.  For  external  covering,  comfortables  are  objec- 
tionable, because  they  do  not  let  the  insensible  perspiration  pass  off 
as  freely  as  it  should.  They  are  light,  however,  and  so  are  rose 
blankets,  which  have  the  adclitional  good  quality  of  being  povous. 
We  should  sleep  under  as  few  clothes  as  possible,  consistenlly  with 
comfort.  ■  •-        ' 

Mjflit  Dress. —  The  flannel,  cotton,  linen,  or  silk,    vorn  Mxt  the 
nkiii  through  the  day,  should  always  be  replaced,  on  retiring,  by  a 
tiiiitable  night-dress.     This  should  be  of  the  same  material  wiln  thr.t 
which  is  taken  off.     If  we  wear  flannel  through  the  day,  we  .\eed  j 
quite  as  much  at  night 

Do  not  Cover  the  Face.  —  The  practice  of  ploeping  wi(h  t/ie  face 
entirely  covered  with  the  bed  clothes,  is  very  injurious.  It  (rompeb 
one  to  breathe  the  air  over  several  times. 

latiiral  Position  for  Sleep. —  The  most  natural  position  in  which 
to  sleep  is  upon  the  right  side.  This  attbrds  the  easiest  play  to  the 
internal  organs.  It  is  best,  however,  to  learn  to  sleep  in  (Jiff<'rent 
positions,  and  to  change  occasionally  from  side  to  side,  Ujon  the 
back  is  not  so  easy  a  position.  To  lie  in  this  way  obstructs  the  cir- 
culation of  the  blood,  by  the  pressure  of  the  stomach,  bowels,  etc., 
upon  the  large  blood  vessels  which  pass  down  and  up  in  front  of  the 
back  bone.  It  is  very  tiresome  and  injurious  to  lie  with  the  hands 
above  the  head. 

Amount  of  Sleep.  —  The  average  amount  of  sleep  required  by  pcr- 
t<ons  in  health,  is  from  seven  to  eight  hours.  Occasionally  we  find 
l^rsons  who  get  along  very  well  with  six,  or  even  five  hours  ;  while 
t^ome,  even  in  health,  require  nine.  There  is  no  absolute  standard  for 
all  persons,  in  the  amount  of  sleep,  any  more  than  in  that  of  food.  It 
depends  on  the  temperament,  the  constitution,  the  amount  of  exercise, 
and  the  exhausting  nature  of  the  mental  application. 

The  object  of  sleep  is  to  repair  the  energies  ;  the  extent  to  which 
they  are  wasted,  and  the  recuperative  power  possessed,  will  measure 
the  amount  required.  ' 

Late  Suppers.  —  These  are  a  bar  to  all  sound  and  healthful  sleeps 
The  last  meal  should  always  be  taken  at  least  three  hours  before  re- 
tiring, and  should  be  light  During  sleep,  the  stomach  should  have  a 
chance  to  rest.  It  will  work  the  better  on  the  morrow.  Some  per- 
sons boast  that  they  can  sleep  perfectly  well  after  a  heavy  supper. 
Perhaps  they  can;  but,  as  Franklin  has  wisely  suggested,  Ihey  may 
by  and  by  "  have  a  fit  of  aooplexy,  and  sleep  till  dooms  day."  This 
will  be  sleeping  too  well ! 

Preparation  for  Sleep.  —  Dr.  Franklin  left  behind  the  record  of  a 
wise  life,  as  well  as  many  excellent  moral  and  philosophical  direc- 
tions. A  good  conscience  was  his  prescription  for  quiet  sleep  and 
pleasant  dreams,  —  a  most  ex.-^.ellent  direction.     Sleep  is  promoted, 

13 


-•i 


98 


HYGIENE. 


too,  by  withdrawing  the  mind,  a  short  time  before  retiring,  from  afi 
hard  study,  and  exciting  themes  of  conversation ;  and  turning  it  to 
calmer  subjects  of  reUcction,  such  as  the  moral  attributes  of  God,-~- 
particularly  his  love  and  paternal  character. 


Objects  of  Clothing. 

The  clothes  we  wear  are  intended,  or  should  be  intended,  to  secure 
three  objects,  —  warmth  in  winter ,  coolness  in  summer ^  and  health  at 
all  times. 

It  has  already  been  shown  that  our  bodies  are  warmed  by  tlieir 
own  internal  fires.  In  the  lungs,  in  the  skin,  and  indeed  in  all  parts 
of  the  body,  oxygen  unites  with  carbon  and  other  combustible  mat- 
ters, producing  heat  in  the  same  way  that  it  is  produced  in  a  grate 
where  anthracite  coal  is  burned ;  and  as  our  temperature  always 
needs  to  be  kept  up  to  about  98*^  of  Farenheit,  it  follows  that  this 
combustion  must  always  be  going  on. 

Now,  the  atmosphere  which  surrounds  us  is  always  receiving  into 
itself  the  heat  which  comes  to  the  surface  of  our  bodies,  and  thus 
robbing  us  of  our  warmth.  In  summer,  the  atmosphere,  full  of  the 
rays  of  a  burning  sun,  may  impart  heat,  instead  of  taking  it  away ; 
while  in  winter,  it  takes  more  than  it  gives,  and  would  cause  us  to 
perish  with  the  cold,  were  it  not  for  the  protection  afforded  by  our 
clothing. 

Clothes,  of  course,  have  no  power  to  manufacture  or  impart  heat. 
They  only  retain,  and  keep  in  contact  with  our  bodies,  that  which  is 
generated  within  us.  If  we  have  on  a  single  garment  which  is  made 
tight  at  the  bottom  and  top,  so  that  no  current  can  pass  up  or  down, 
there  will  be  a  layer  of  air  between  it  and  the  body,  which,  becoming 
immediately  heated,  and  being  retained  there,  helps  keep  us  warm,  or 
rather,  prevents  us  from  being  cold.  With  every  additional  garment 
put  over  this,  there  is  another  layer  of  heated  air,  adding  still  more 
impenetrable  guards  against  either  the  intrusion  of  cold,  or  the  escape 
of  internal  heat. 

Bad  Comluctors  Df  Heat.  —  But,  that  our  clothes  may  thus  retain 
our  warmth,  and  prevent  its  dispersion,  they  must  be  bad  conductors 
t)f  heati  —  that  is,  they  must  not  readily  take  up  the  heat  and  convey 
it  away  from  the  body.  They  must  slowly  absorb  the  caloric  into 
their  own  substance,  and  then  retain  it  tenaciously. 

.  Linen,  which  is  so  universally  popular  in  temperate  climates,  as  an 
article  to  be  worn  next  the  skin,  is  unfortunately  a  good  conduiitor  of 
heat.     It  does  not  afford  a  warm  garment.     It  conducts  heat  rapidly 
FiQ.  ev.  away  from  the  body.    Hence  it  always  feels  cool 

to  the  touch.  It  is  really  no  colder  in  itself  than 
other  kinds  of  cloth,  but  it  is  solely  the  rapidity 
with  which  it  conducts  heat  away  from  the 
body,  that  gives  it  the  feeling  of  coldness.  It 
has  other  qualities  which  compensate,  in  some 
measure,  for  this  defect.     The  fibres  of  which  it  is  composed,  ars 


HYGIENE. 


99 


ts,  as  an 

,j  It  or  of 
.  rapidly 
tels  cool 
Lelf  than 
[rapidity 
torn  the 
liess.  It 
|in  ?orae 
psed,  are 


Fio  68. 


round  aiul  plial)lt>,  which  make  linen  cloth  sinuuth  and  Huft,  and  the 
spiisations  produced  by  it,  upon  the  skin,  altogether  agreeable.  Figure 
H7  represents  u  fibre  of  linen,  as  it  appears  under  a  microscopt!  which 
magnifies  it  155  times. 

Cottuii  is  warmer  than  linen,  because  it  is  a  worse  conductor  of 
heat.  The  perfection  to  which  its  manufacturer  has  been  carried, 
makes  it  almost  a  rival  of  linen  in  softness  and  pliability.  It  doei 
not  absorb  as  much  moisture  as  linen,  and  therefore  better  retains 
its  powers  as  a  non-conductor. 
But  then  the  fibres  of  cotton  are  not  round  and  smooth,  like  those 
of  linen,  but  flat  and  spiral,  with  shsirp  edges. 
Figure  68  rt  presents  two  of  its  fibres,  magnifiec 
155  times.  This  renders  cotton  irritable  to  some 
very  delicate  skins.  This  is  the  reason  why  linen 
is  better  than  cotton  for  binding  up  wounds, 
where  there  is  tenderness  of  the  surface. 

Silk  has  a  round  fibre,  like  linen,  which  is  even  softer  and  smaller. 
It  absorbs  less  moisture  than  cotton,  and  in  its  power  of  cominuni- 
Piiting  warmth,  it  is  superior  to  both  the  preceding.  It  forms  the 
most  desirable  fabric  for  clothing  that  we  have  ;  but  its  cost  makes  it 
inaccessible  to  the  great  body  of  the  people,  except  as  a  holiday 
dress  for  the  ladies.  Its  culture  in  our  own  country,  if  once  exten- 
sively established,  would  be  a  source  of  national  wealth. 

Tlie  Fibre  of  Wool  is  quite  rough,  almost  scaly,  and  highly  irritative 
to  delioate  skins.  Figure  69  shows  fibres  magni- 
fied 310  times.  It  is  not  possible  for  some  per- 
sons to  wear  it  next  the  skin.  But  where  this 
cannot  be  done  it  may  be  worn  outside  the  linen 
or  cotton ;  and  being  a  good  non-conductor,  it  will 
in  this  way  preserve  the  warmth  of  the  body, 
without  either  irritating  the  skin,  or  disturbing 
its  electricity. 

Wool,  in  cold  climates,  is  one  of  the  very  best 

materials  of  which  clothes  can  be  made.    In  New  . 

England,  and,  indeed,  in  all  cold  and  temperate  regions,  it  should  be 
worn  by  delicate  persons,  in  the  form  of  thick  or  thin  garments,  al! 
the  year  round.  It  does  not  readily  absorb  moiKture,  and  is  a  dry, 
warm,  and  wholesome  material  for  clothing. 

Hair.  — Though  not  precisely  in  the  line  of  these  remarks,  Aai»  may 
as  well  be  introduced  here.  Wool  is  in  fact  hair.  Every  part  f  tne 
skin,  with  the  exception  of  that  upon  the  soles  of  the  feet,  and  the 
palms  of  the  hands,  is  intended  to  produce  hairs.  On  most  parts  of 
the  body,  they  are  short  and  fine,  hardly  rising  above  the  surface. 
Upon  the  head  and  the  5<'ce,  they  grow  to  considerable  length. 

Hair,  like  wool,  is  a  bad  conductor  of  heat ;  and,  as  growing  upon 
m^  '"/^d  and  face,  is  doubtless  intended  for  some  useful  purpose. 
That  it  was  designed  as  a  warm  covering,  can  hardly  be  doubted. 
1  he  beard,  when  permitted  to  grow,  is  a  natural  respirator,  guarding 


Fio.  69. 


J 


k 


I? 


100 


IIYOIKNR. 


the  lungs  agiiiiist  cold  niid  dust.  Mr.  CImdwick  niiiced  that  black, 
smiths  wlio  allowed  their  beards  to  grow,  hud  their  inuatachioit  discol- 
ored by  iron  dust,  which  lodged  among  the  hairs,  and  very  justly  in- 
ferred  that  the  dust  must  have  found  its  way  into  the  lungs,  and  done 
mischief,  had  it  not  been  arrested  by  this  natural  respirator. 

That  the  beard,  when  long,  does  ward  otV  a  great  many  colds  and 
throat  ails,  is  too  well  known  to  be  denied,  it  has  reciuired  moral 
courage  on  the  part  of  those  who  have  broken  away  from  the  univer- 
sal practice  of  shaving,  for  which  they  should  be  hon-  fio.  70. 
oied  rather  than  ridiculed.  For  those  who  dr  not  sutler 
from  throat  or  lung  complaints,  especially  if  they  are 
getting  advanced  in  lif'',  it  may  not  be  thought  worth 
while  to  abandon  the  razor.  Yet  the  change  would  not 
lie  regretted.  Figure  70  is  a  human  hair,  magnified  250  times,  show- 
ing its  scaly  surface. 

The  Color  of  our  C'lotliiii<i;  is  a  matter  of  some  moment.  The  dark 
colors  absorb  the  light,  the  sun's  rays,  and  heat,  much  more  than  the 
iightx^r  ones ;  and  as  those  bodies  which  absorb  heat  well,  are  like- 
wise good  radiators,  the  dark  colors  have  the  highest  roAUating  ]>oioer. 
White  rellects  heat,  and  rays  of  light,  and  is  a  bad  absorber  and  bad 
radiator,  In  summer  it  prevents  the  sun's  rays  from  passing  inward 
to  heat  the  body,  and  in  winter,  interrupts  the  heat  of  the  body  in  its 
|)assage  out.  In  summer,  it  makes  the  coolest  garment;  in  winter, 
the  warmest  one.  These  facts  can  be  very  simply  illustrated,  by  lay- 
ing, side  by  side,  upon  the  snow,  when  the  sun  shines,  two  pieces  of 
cloth,  the  one  black,  the  other  white.  Lifting  them  up,  after  a  time, 
the  snow  will  be  found  considerably  me/led  wider  the  black  cloth,  but 
not  under  the  white. 

It  id  now  seen  that  the  object  of  clothing  is  not  to  impart  heat  to 
the  body,  but  to  prevent  its  loss ;  that  it  is  not  to  create  it,  but  to 
furnish  the  occasion  for  increasing  its  degree.  It  appears  further,  that 
clothing  protects  the  body  against  the  evil  eflfects  of  changes  of  tem- 
perature, and  that  white  garments,  by  reflecting,  instead  of  absorbing 
heat,  guard  it  against  the  heat  of  summer. 

Clothinji^  should  be  Porous.  —  All  articles  used  for  garments,  shouli^ 
be  parous,  and  permit  the  free  passage  of  insensible  perspiration.  The 
ijkin  receives  oxygen  through  its  pores,  and  gives  ba(-k  carbonic  acid. 
It  performs  a  sort  of  subordinate  respiration.  India  rubber  ga'  .ents 
worn  next  to  it,  interrupts  this,  and  must  do  mischief.  Shoes  made 
of  tho  material,  soon  cause  the  feet  to  become  damp  and  cold.  The 
dampness  is  occasioned  by  the  insensible  perspiration,  which  cannot 
escape  through  the  rubber.  Such  shoes  worn  in  the  open  air,  should 
be  immediately  taken  ofli'on  entering  the  house. 

Thin  Shoes.  —  The  defective  way  in  which  American  females  pro- 
tect their  feet  from  cold  and  wet,  is  a  sore  evil ;  and  he  who  perstfadea 
them  to  adopt  a  wiser  fashion,  and  cover  their  feet  with  better  guards 
against  colds  and  consumptions,  will  deserve  the  gratitude  of  the 
nation.    We  are  in  many  things  too  fond  of  copying  foreign  fashions: 


HYGIENE. 


101 


blacks 
I  (liscol- 
istly  in- 
id  done 

ild»  and 

1  moral 

univer- 

o.  70. 


s,  show- 


?\\e  dark 
:hun  the 
are  like- 

and  bad 
inward 
dy  in  its 
1  winter, 
1,  by  lay- 
)iece3  of 
;r  a  time, 
cloth,  but 

t  heat  to 
it,  but  to 
■ther,  that 
s  of  tem- 
absorting 

ts,  shoulO 
Lion.  The 
lonic  acid, 
ga'  .ents 
joes  made 
old.  The 
ich  cannot 
iir,  should 

Tiales  pro- 
pprsqadea 
;ter  guards 
jde  of  the 
n  fashions : 
/ 


but  if  our  ladies  would,  in  this  matter,  follow  th«!  excellent  example 
of  English  women,  they  would  live  longer,  and  leave  a  hardier  pos- 
terity behind  them. 

The  shoes  worn  by  our  females,  high  and  low,  rich  and  poor,  are 
not  thick  enough  to  walk  with  safety  upon  a  |)ainted  floor,  hardly 
upon  a  carpet  in  an  luiwarmed  room  ;  and  yet  they  walk  with  them 
upon  cold  brick  side-walks,  upon  damp  and  frozen  ground,  and  even 
in  v'ud. 

T  le  result  is,  that  they  suffer  from  colds,  sore  throats,  pleurisies, 
lung  fcverw,  suppressions,  inflammations  of  the  womb,  and  many  other 
ailments,  which  in  early  life,  rob  them  of  their  freshness  and  beauty, 
of  their  health  and  comfort,  of  their  usefulness  to  their  household  and 
the  world,  and  leave  them  helpless  in  the  arms  of  their  friends,  with 
a  patrimony  of  suffering  for  themselves  whil'j  they  live,  and  a  legacy 
of  disease  to  hand  down  to  their  children.  Would  that  they  were  wise 
in  season !  Some,  to  their  honor  be  it  said,  have  already  adopted  a 
safer  course.     It  is  hoped  the  evil  will  be  gradually  correcte  J. 

Mever  attempt  to  mould  the  Form  by  Dress.  —  Parents  commit  a 
great  error  when  they  attempt  to  mould  the  forms  of  their  children, 
particularly  their  daughters,  by  their  dress.  This  cannot  be  done. 
It  is  tlie  work  of  ntiture,  and  she  wants  no  assistance  in  it.  The 
great  object  of  dress  in  childhood  as  well  as  in  adult  life,  is  to  pro- 
mote health.  With  this,  there  is  not  much  difficulty  in  preserving  the 
Byiumetry  ;  vnthout  it,  deformity  is  almost  a  matter  of  course. 

The  fact  cannot  be  too  often  repeated,  nor  too  seriously  urged  upon 
parents,  that  while  the  foundation  of  all  graceful  and  just  proportion 
of  the  different  parts  of  the  body  must  be  laid  in  infancy,  it  cannot 
be  done  by  tight  bands,  and  ligatures  upon  the  chest,  and  loins,  and 
legs,  and  arms.  Upon  all  these  points,  the  garments  of  children 
should  set  easy,  leaving  the  muscles  at  liberty  to  assume  the  fine 
swell  and  development  which  nothing  short  of  unconstrained  exercise 
can  give.  Could  infants  tell  all  the  horrors  they  suffer  from  the  re- 
straints put  uj)on  them  by  tight  dresses,  it  would  make  many  a  moth- 
er's heart  bleed. 

In  these  brief  remarks,  the  principles  are  given  which  should  guide 
us  in  the  selection  of  our  clothing.  The  mtelligent  reader  will  be 
able  very  easily  to  fill  up  the  outline. 

Bathing  and  Cleanliness. 

Aristotle  calls  cleanliness  one  of  the  half  virtues ;  and  Addison, 
in  the  Spectatt)r,  recommends  it  as  a  mark  of  poliieness,  and  as  analo- 
gous to  purity  of  mind.  Both  in  the  Jewish  and  Mohammedan  law,  it 
is  enforced  as  a  part  of  religious  duty.  Its  requirement  as  a  prerequi- 
site to  christian  communion,  would  be  wiser  than  the  demands  some- 
times made.  A  dirty  Christian  may  perhaps  be  found,  but  not  among 
those  who  mean  to  be  intelligent. 

The  importance  of  keeping  the  skin  clean  is  not  generally  appre- 
ciated.    The  motive  for  cleanliness  is  often  a  lower  and  meaner  one 


I0:i 


HYGIENE. 


.•*»^ 


'■-    • 

r 


\ 


b 


thiiM  should  be  allowed  to  liiivo  place  in  tlir  iiiliid.  Many  perMJim 
wonid  he  mortilicd  to  have  their  hands,  or  face,  or  neck  dirty,  who  do 
not  wash  their  whoh;  IxKly  once  a  year.  That  they  may  appear  well 
in  the  eyes  of  others,  is  the  only  motive  with  such  for  keeping  clean. 

Offices  of  file  Skin. —  If  wo  look  a  little  at  the  offices  of  the  skin, 
w«!  shall  better  understand  the  need  of  keeping  it  clei»n. 

The  skin  is  not  merely  a  covering  to  prott^ct  us  from  the  weather. 
It  is  a  living  structure,  curiously  wrought,  with  a  large  extent  of  sur- 
face, and  having  important  duties  to  perform  in  the  animal  economy. 
Its  slnirlure  is  more  particularly  explained  under  ihe  head  of  "Anat- 
omy" and  "Skin  Diseaaea."  It  has  been  already  said,  that  it  helps 
the  lun;i;s  in  breathing.  It  does  many  other  things  on  which  the 
health  is  dependent 

IViiiiiber  of  Persplnitory  Tubej».  —  The  skin  performs  several  kinds 
of  secretion,  —  that  is,  it  separates  several  things  from  the  blood, — 
one  of  which  is  the  perspiration,  or  sweat.  The  sweat  is  formed  in 
small  glands,  situated  just  under  the  skin,  and  is  brought  to  the  surface 
in  small  dncts,  or  tubes,  like  the  hose  through  which  firemen  throw 
water.  These  little  tubes  are  spiral,  as  seen  in  cut  44,  and  run  uj\ 
through  the  two  skins. 

These  s|)iral  canals  are  very  numerous,  covering  every  part  of  the 
human  frame,  —  there  being  about  SHOO  of  them  upon  every  square 
inch  throughout  the  body ;  and  as  a  man  of  ordinary  size,  has  about 
S-'iOO  square  inches  of  surface,  the  number  of  tubes  in  the  sk>n  of  one 
man  is  seven  mi/lions. 

The  months  of  these  tubes  are  called  the  pores  of  the  skin.  Each 
one  of  these  tubes  is  extended  just  below  the  skin  ;  and  there,  among 
the  cells  where  the  fat  is  deposited,  it,  or  rather  the  two  branches  into 
which  it  is  divided,  are  wound  into  a  eoi',  called  the  sudoriferous,  or 
sweat  gland.  These  ducts  are  each  about  a  quarter  of  an  inch  in 
length,  which  makes  an  aggregate  length  of  tubing  in  the  human  skin 
of  about  twenty-eight  miles. 

Insensible  Perspiration.  —  Through  each  of  these  seven  million  of 
quarter  inch  hose,  there  is  poured  out,  day  and  night,  as  long  as  a 
man  lives,  a  stream  of  sweat  in  the  form  of  vapor.  When  this  is 
thrown  oft'  very  rapidly,  as  happens  when  active  exercise  is  taken,  it 
accumulates  in  drops,  and  is  called  sweat.  Ordinarily  it  does  not 
thus  accumulate  ;  it  is  then  called  insensible  perspiration,  —  not  being 
lecognized  by  the  senses. 

This  transpiration  may  be  proved  very  beautifully  by  inserting  the 
naked  arm  into  a  long  glass  jar,  and  closing  up  the  space  around  it 
at  the  mouth  so  that  no  air  can  get  in.  The  inside  of  the  glass  will 
soon  be  covered  with  a  vapor,  which  will  grow  more  and  more  dense 
until  it  is  converted  into  drops.  Boerhaave  says:  "If  the  piercing 
chill  of  winter  could  be  introduced  into  a  summer  assembly,  the 
insensible  perspiration  being  suddenly  condensed,  would  give  to  each 
person  the  appearance  of  a  heathen  deity,  wrapped  iv  bis  own  sepa- 
rate cloud." 


IlYlJir.XK. 


loa 


Now,  tliiH  continiml  exudation  of  Bweat  thmtlgh  thcMo  millions  of 
tnbfs  irt  for  a  wi«e  and  nci-i'Haiiry  purposo.  It  is  to  take  out  of  \\w 
blood  and  other  fluids  various  salts,  which  would  do  luischirf  if 
allowed  to  reiuaitt  l«)iiger,  and  partieulariy  carbonic  acid,  which  is 
poisonous, — the  same  matters,  in  fact,  which  are  thrown  cut  by  the 
\\u\^ii.  The  skin,  in  truth,  is  a  kind  of  hel|)er  of  the  lungs  ;  and  a 
jjidy,  by  covering  herself  with  garments  which  have  no  pores,  and 
will  neither  admit  air  nor  let  off  insensible  perspiration,  may  be  stran- 
gled almost  as  certainly  as  by  putting  a  cord  around  lu-r  neck,  and 
(losing  hei  windpipe.  Almost  twicti  aa  much  iluid  pauuctt  ulf  through 
the  skin  as  through  the  lungs.  < 

Keep  the  Pores  Open. —  It  is  obvious  from  what  has  now  been  said, 
tJiat  the  pores  of  the  skin  should  be  kept  open  to  preserve  health. 
When  bathing  is  neglected,  and  the  under  garments  are  not  changed 
sufficiently  often,  the  insensible  perspiration  accumulates  and  dries  up 
u|)on  the  skin,  mingling  with  the  oily  matter  secreted  by  the  oil  glands, 
jind  with  the  shreds  of  the  scarf  skin,  and  forming  a  tenacious  gluey 
matter,  which  closes  up  the  pores.  By  this  misfortune,  that  large  quan- 
tity of  worn-out  matter  which  usually  goes  otVwith  the  fluid  through 
the  pores,  is  retained  to  poison  and  embarrass  the  living  current  of 
blood,  or  seek  an  outlet  through  lungs  or  kidneys  which  are  already 
burdened  with  (piite  as  nmch  as  they  are  able  to  do.  How  impor- 
tant, then,  that  these  channels  through  which  the  body  is  purified, 
should  be  k<*pt  open !  that  the  skin  should  be  kept  healthy  and  in 
working  order  I 

The  Biltli,  tlie  fireat  I*urifier.  —  But  this  can  only  be  done  by  daily 
washing.     The  bath  is  the  great  purifier  of  the  human  skin. 

The  antiquity  of  bathing  is  very  great.  The  practice  is  supposed 
to  reach  back  to  the  infancy  of  the  race,  or  certainly  to  a  very  early 
period.  The  inhabitants  '^f  middle  Asia  are  said  to  have  beet  the 
iirst  to  use  the  bath  for  the  specific  purposes  of  purification  and 
health.  Domestic  baths  are  represented  as  having  been  used  by 
Diomed  and  Ulysses.  Andromache  prepared  warm  wat^r  for  Hector 
on  his  return  from  battle.  Penelope  banished  sorrow  by  unguents 
and  baths. 

Tlie  Baths  of  tlie  Nedes,  the  Persians,  and  the  Assyrians  were  much?, 
celebrated.      Alexander,  though  familiar  with  the  voluptuous  baths 
of  Greece  and  Macedon,  was  astonished  at  the  magnificence  of  those 
of  Darius. 

Roman  Batlis.  —  As  luxury  and  refinement  advanced,  the  means  of 
luxurious  bathing  were  multiplied,  until  establishments  were  built  by 
the  Romans,  the  very  remains  of  which  excite  wonder  at  this  day. 
Among  these  are  the  Therma;  of  Agrippa,  of  Nero,  of  Vespasian, 
of  Titus,  etc.  One  of  the  halls  of  the  buil'Hng  constructed  for  baths 
by  Diocletian,  forms  at  this  day  the  church  of  the  Carthusians,  one 
of  the  most  magnificent  temples  in  Rome. 

Nnniber  and  Cliaracter.  —  According  to  Pliny,  uaths  were  intro- 
Uucpd  into  Rome  about  the  time  of  Pompey ;  their  first  erection  Dion 


104 


HYGIENE. 


attributes  to  Mfrcnms.  Agri|)pa  increased  their  number  to  one 
hundred  ani\  seventy  ;  nnd  within  two  hundred  years  they  were  mul- 
tiplied to  about  eight  hundred.  These  establishments  were  so  vast 
that  one  writer  compares-,  them  to  provinces.  They  were  paved  either 
with  crystal,  or  mosaic,  or  plaster,  and  were  adorned  by  sculpture  and 
painting  to  the  very  highest  degree.  They  added  not  merely  to  the 
health  and  luxury  of  the  people,  but  contributed  to  their  culture  in 
the  highest  departments  of  art  and  tasts. 

Names  of  Btltlis.  —  To  the  apartment  of  their  dwelling  in  which 
they  washed  their  bodies  in  warm  or  hot  water,  the  Romans  gave  the 
nunie  of  ba/neuni,  or  bath;  to  the  public  establishments,  that  of  balnea, 
or  baths.  The  apartment  which  held  the  vessels  was  called  vasarium. 
In  this  were  the  three  immense  vessels  which  contained  the  cold,  warm, 
and  hot  watei.  There  were  instruments  of  bone,  ivory,  and  metal, 
for  scraping  the  skin,  with  a  groove  in  the  edge,  through  which  the 
impurities  of  the  skin  might  run  off. 

On  the  north  front  of  the  thermae  was  a  reservoir  of  cold  water 
large  enough  for  swimming,  called  by  Pliny  the  younger,  baplisleium. 
In  the  centre  was  a  spacious  vestibule,  and  on  each  side,  warm,  cold, 
and  vapor  baths,  with  apartments  for  cooling,  dressing,  an«i  refresh- 
ments. There  was  the  frigidaium,  a  vaulted  loom,  a  co  jling  room 
midway  between  the  warmer  and  the  open  air ;  the  tejiidarium,  with 
a  temperature  widway  between  the  above  and  the  hot  bath  ;  and  the 
tolidarium,  or  the  vapor  bath. 

Then  there  was  the  room  where  the  body  was  rubbed  over  with  a 
great  number  of  ointments  and  essences  of  the  most  precious  kinds ; 
and  another  in  which  it  was  sprinkled  over  with  powder  ;  and  also  a 
room  which  held  the  clothes,  in  which  the  bathers  undressed  and 
dressed  at  pleasure. 

All  these  apartments  were  double,  the  two  wings  being  appropri- 
ated to  the  sexes. 

Open  to  all.  —  These  baths,  thus  numerous  and  magnificent,  were 
open  to  all  classes  of  the  people,  and  contributed  largely  to  the  gen- 
eral health  and  physical  endurance  for  which  the  Romans  were  con- 
spicuous. 

The  Biitli  Nejrlecfed  nnder  the  Christian  System. — When  Jesus  of 
Nazareth  came  into  the  world,  he  found  man's  nature  cultivated  in  a 
most  defective  way.  The  moral  element  had  sunk  down  to  the  low- 
est place,  while  the  physical  had  risen  to  the  highest, — just  the  reverse 
of  the  true  order  of  things.  This  Divine  Teacher  came,  not  to  re- 
commend a  neglect  of  the  body,  but  a  new  cure  for  the  imperishable 
part  Mankind  were  for  the  first  time  systematically  taught  to  forgive 
injuries.  Prostrate  liberty,  and  degraded  woman,  became  the  wards 
of  Christianity. 

Unfortunately,  under  the  new  order  of  things,  the  lower  element 
of  man,  which  had  been  exalted  and  worshipped,  was  cast  down  and 
abused.  What  the  Pagan  had  pampered,  the  Christian  persecuted. 
The  body,  which  had  been  bathed,  and  .scrubbed,  and  anointed,  aiKl 


._ J 


HYGIENE. 


105 


'1 


perfumed,  was  thenceforward,  in  conaequence  of  the  improper  i 
pretation  of  certain  texts,  scourged,  and  fasfed,  and  clothed  in 


inter- 
j)retation  of  certain  texts,  scourged,  and  fasfed,  and  clothed  in  rags. 
Thousands  believed,  and  thousands  do  to  this  day,  that  to  torment 
the  body  is  to  please  God.  Under  this  feeling,  the  public  and  private 
baths  were  neglected;  and  to  this  day,  nrt  christian  nation  has  fully 
appreciated  the  necessity  of  cleanliness,  and  of  sanitary  measures  for 
the  maintenance  of  the  public  health.  To  a  considerable  extent,  the 
body  is  still  under  disabilities;  still  the  subject  of  persecution;  and 
where  this  's  not  the  case,  it  is  too  often  regarded  only  as  a  loose  out- 
hide  garment,  to  be  thrown  over  the  traveller  to  the  celestial  city,  and 
is  expected  to  be  well  soiled  with  mud  and  dust.  The  teachings  of 
I  he  Great  Master  will  by  and  by  cease  to  be  perverted,  and  will  be 
applied  to  raise  up  man's  body,  as  they  have  raised  his  mental  and 
moral  nature,  and  will  make  a  well-developed  and  harmonious  being. 
In  the  mean  time,  it  is  the  duty  a. id  the  privilege  of  the  physician 
to  urge  a  return,  not  to  the  magnificence  of  the  ancient  regimen  for 
training  the  body,  but  to  its  real  efficiency  in  a  simpler  form. 

Cold  Bathing.  —  Water  applied  to  the  skia  at  a  temperature  below 
75'  of  Farenheit,  is  called  a  cold  bath.  If  applied  to  a  person  with 
sufficient  constitutional  energy  to  bear  it,  it  is  a  decided  and  very 
powerful  tonic.  By  this  is  meant  that  it  promotes  the  solidity,  com- 
pactness, and  strength  of  the  body. 

The  first  effect  of  the  application  of  cold  water  to  the  skin,  is  the 
sudden  contraction  of  all  its  vessels,  and  the  retreat  of  the  blood 
towards  the  internal  organs.     The  nervous  system,  feeling  the  shock, ^ 
causes  the  heart  to  contract;  with  more  energy,  and  throw  the  blood 
back  with  new  force  to  the  surface. 

This  rushing  of  the  blood  back  to  the  skin,  is  called  a  reaction  ; 
and  when  it  occurs  with  some  energy,  it  is  an  evidence  that  the  sys- 
tem is  in  a  condition  to  be  much  benefited  by  the  cold  bath.  When 
this  does  not  take  place,  but  the  skin  looks  shrunken,  and  covered 
with  "  goose  flesh,"  and  a  chilliness  is  felt  for  a  longer  or  shorter  time 
after  bathing,  then  the  inference  should  be,  either  that  the  water  has 
been  used  too  profusely,  or  that  the  bather  has  too  little  reactionary 
power  for  this  form  of  the  bath.  The  latter  conclusion  must  not  be 
accepted  until  cold  water  has  been  tried  with  all  possible  guards, — 
such  as  beginning  with  tepid  water,  and  gradually  lowering  the  tem- 
perature ;  bathing  for  a  time,  at  least,  in  a  warm  room ;  beginning 
the  practice  in  warm  weather  ;  and  applying  the  water  at  first  with  a 
qx)nge,  out  of  which  most  of  it  has  been  pressed  by  the  hand.  With 
some  or  all  of  these  precautions,  most  persons  may  learn  to  use  thu 
cold  bath.  It  is  always  to  be  followed  by  brisk  rubbing  with  a  coarse 
towel  or  flesh-brush. 

The  Sponge  Btltll. —  A  wet  sponge  is  the  simplest,  as  well  as  the 
best  mode  of  applying  water  to  the  surface  of  the  body.  With 
persons  who  are  feeble,  a  part  only  of  the  body  should  be  exposed 
at  a  time,  —  which  part,  having  been  quickly  sponged  and  wiped 
dry,  should  be  covered,  and  another  part  exposed,  and  trcatetJ  in  a 
like  manner.     In  this  way,  all  parts  of  the  body  may  successively  be 


._  _) 


f 


subjected  to  the  bracing  influence  of  water  and  friction,  with  little 
risk,  even  to  the  mo.st  delicate,  of  an  injurious  shock.  The  only  fur- 
niture required  for  carrying  out  this  sinnple  plan  of  bathing,  is  a 
eponge,  a  basin,  and  a  towel.  There  ia  no  form  of  bathing  so  uni- 
versally applicable  as  this,  or  so  generally  conducive  to  health. 

The  Shower  Bath  re(]uires  a  brief  notice.  The  shock  to  the  nervous 
Bystem  produced  by  it,  is  much  greater  than  that  from  sponging. 
Beside  the  sudden  application  of  coldness,  there  is  a  concussion  o( 
the  skin  by  the  fall  of  the  water.  This  form  of  the  bath  is  excellent 
for  those  wh  are  strong  and  full  of  vitality,  but  is  fraught  with  some 
danger  for  the  feeble  and  delicate.  This,  however,  depends  on  the 
judgment  with  which  it  is  used.  In  the  form  of  a  delicate  shower, 
and  with  tepid  water,  the  frailest  body  might  bear  its  shock. 

The  Warm  Bath.  —  A  temperate  bath  ranges  from  75"  to  So° ;  a 
tepid  bath,  from  85°  to  95° ;  a  warm  bath,  from  95°  to  98° ;  a  hot 
bath,  from  98°  to  105°.  A  warm  bath  is  of  the  same  temperature 
with  the  surface  of  the  body.  Of  course  it  produces  no  shock.  To 
those  who  are  past  the  meridian  of  life,  and  have  dry  skins,  and  begin 
to  be  emaciated,  the  warm  bath,  for  half  an  hour,  twice  a  week,  is 
eminently  serviceable  in  retarding  the  advances  of  age. 

It  is  a  mistake  to  suppose  the  warm  bath  is  enfeebling.  It  has  a 
soothing  and  tranquillizing  effect.  It  renders  the  pulse  a  little  slower, 
and  the  breathing  more  even.  If  th'*  bath  be  above  98°,  it  becomes 
a  hot  one,  and  the  pulse  is  quickened. 

The  temperature  of  the  warm  bath,  as  of  the  cold,  should  be  made 
to  range  up  and  down  according  to  the  vigor  of  frame,  and  the  circu- 
lation of  the  individual.  The  aged  and  the  infirm,  whose  hands  and 
feet  are  habitually  cold,  require  it  to  be  well  up  towards  the  point  of 
blood  heat.  The  pulse  should  not  be  made  to  beat  faster  by  it,  nor 
should  sensations  of  heat  or  fulness  be  induced  about  the  temples 
and  f&ce. 

The  Vapor  Bath.  —  This  diflfers  from  the  warm  bath  in  being  ap- 
plied to  the  interior  as  well  as  to  the  exterior  of  the  body.  The 
warmth  is  inhaled  into  the  air  tubes  at  the  same  time  that  it  envel- 
ops the  external  person.  The  first  sensation  of  the  vapor  bath  is 
oppression,  and  causes  some  difficulty  of  breathing ;  but  this  passes 
oft  as  soon  as  the  perspiration  begins  to  flow.  From  the  steam- 
chamber,  the  bather  should  step  into  a  tepid  bath,  and  after  remain- 
ing a  short  time  in  this,  wipe  himself  thoroughly  with  dry  towels. 

Cold  Affnsiou  immediately  after  either  the  warm  or  the  vapor  bath, 
is  excellent.  In  Russia  it  is  common,  after  the  vapor  bath,  to  pour 
upon  the  head  of  the  bather,  a  bucket  of  warm  water,  then  one  of 
tepid,  and  lastly  one  of  cold ;  and  to  finish  with  giving  him  a  good 
towelling.  It  is  even  said  that  the  natives  leave  the  steam  and  the  hot 
bath,  and  roll  themselves  in  the  snow. 

No  danger  need  be  feared  from  cold  affusion  when  the  skin  is  red 
and  excited  by  the  warm  bath,  provided  the  nervous  frame  is  not  in 
a  depressed  condition.     If  the  body  is  chilled,  and  the  nerves  pros- 


Hiii 


iiiiiiiiiitliiwiifriiiii 


th  little 

tiily  fur- 

ig,  irt  a 

80  uiii- 


nervous 
joiiging, 
ssiori  oi 
xcelleiit 
th  some 
oil  the 
shower. 


85°:  a 


;  a  hot 

iperature 

ock.     To 

ind  begin 

week,  is 

It  has  a 

le  slower, 
t  becomes 

[  be  made 
the  circn- 

lands  and 

16  point  of 
by  it,  nor 

le  temples 

being  ap- 
ody.  The 
it  it  envel- 
or  bath  is 
this  passes 
the  steam- 
er remain- 
towels. 

mpor  bath, 
th,  to  pour 
hen  one  of 
lim  a  good 
ind  the  hot 

skin  is  red 
16  is  not  ill 
erves  pros*- 


HYGIENR. 


107 


trated  by  tlisease  or  fatigiu',  llio  applicution  of  eold  water  io  the  skin 
may  do  great  mischief,  and  should  in  no  case  be  hazarded.  Cold 
water  applied  to  a  hot  skin,  cannot  do  harm  ;  to  a  cold  skin,  it  can  do 
nothing  but  harm.  Hence,  the  cold  bath  may  be  used  with  advan- 
tage on  rising  in  the  morning,  while  th(!  body  is  warm.  Another  good 
time  is  at  ten  or  eleven  o'clock  in  the  forenoon,  when  the  nervous 
power  is  advancing  towards  its  height  for  the  day. 

Resictiuil  Kecessiiry.  —  As  a  means  for  promoting  cleanliness,  the 
im|)ortance  of  the  bath  can  hardly  lie  overstated.  For  the  support 
and  improvement  of  health,  it  is  equally  imporlar  But  for  the  pro- 
motion of  the  latter,  one  prerequisite  is  essential,  —  the  reaction  of 
the  skin. 

Various  means  are  resorted  to,  to  secure  this.  The  Hindoos  secure 
it  by  a  kind  of  shampooing,  thus  described  by  a  writer :  "  One  of  the 
attendants  on  the  bath  extends  you  upon  a  bench,  sprinkles  you  with 
warm  water,  and  pr»»ssos  the  whole  body  in  an  admirable^  manner. 
He  cracks  the  joints  of  the  fingers,  and  of  all  the  extremities.  He 
then  places  you  upon  the  stomach,  pinches  you  over  the  kidneys, 
seizes  you  by  the  shoulders,  and  cracks  the  spine  by  agitating  all  the 
vertebrte,  strikes  some  powerful  blows  over  the  Heshy  and  muscular 
parts,  then  rubs  the  body  with  a  hair-glove  until  he  perspires,  etc." 
"  This  process,"  says  the  writer,  "continues  for  three-quarters  of  an 
hour,  after  '  /hich  a  man  scarcely  knows  himself;  he  feels  like  a  new 
being."  Sir  John  Sinclair  speaks  thus  of  the  luxury  of  the  process : 
"  If  life  be  nothing  but  a  brief  succession  of  our  ideas,  the  rapidity 
with  which  they  now  pass  over  the  mind  would  induce  one  to  believe 
that,  in  the  few  short  minutes  he  has  spent  in  the  bath,  he  has  lived  a 
number  of  years." 

Tlie  Coarse  Towel,  the  horsehair  glove,  and  the  flesh-brush  are  the 
appliances  commonly  used  for  stimulating  the  skin,  and  causing  reac- 
tion. For  tender  skins,  the  towel  is  sufficiently  rough.  With  this 
the  bather  should  rub  himself,  unless  he  is  weak  and  the  exertion  pro- 
duces palpitation.  The  muscular  exertion  necessary  for  this  will  help 
the  reaction. 

Restoration  of  the  Batli  desirable.  —  It  is  greatly  to  be  wished  that 
the  bath  might  be  restored  to  something  like  the  importance  it  held 
among  ancient  nations.  It  is  a  luxury,  a  means  of  health,  and  a 
source  of  purity  both  of  body  and  of  mind;  for  the  morals  of  any 
people  will  rise  where  the  use  of  the  bath  is  regular  and  habitual. 
The  attempt  to  cure  all  diseases  by  what  is  called  the  "water-cure," 
has  a  bit  of  fanaticism  about  it,  which  will  i  iire  itself  in  time.  But 
that  water,  used  judiciously  in  the  form  of  baths,  is  a  potent  moral 
and  physical  renovator  of  the  race,  is  not  to  be  doubted  ;  and  this 
should  commend  it  to  all  sensible  people,  even  though  it  should  some- 
times be  abused  by  excess,  as  all  good  things  are. 

A  people  with  clean  hand.^*,  and  clean  bodies,  and  clean  health,  will 
very  naturally  come  to  like  clean  streets  and  clean  cities,  and  finally, 
clean  consciences.     A  fondness  for  cleanliness  in  one  form,  almost 


p- 


108 


HYGIENE. 


/ 


necessarily  nxns  into  a  like  fondness  for  it  in  other  forms,  until  the 
purifying  desire  pervades  the  whole  nature,  moral  aa  well  as  physical. 

Air  and  Ventilation. 

Watek  and  a'r  arc  fluids.  Water  covers  two-thirds  the  surface  of 
the  globe,  havin.^  a  depth,  in  some  places,  of  ^.,e  miles  or  more.  Air 
covers  not  merely  the  rf  ;Tiaining  third  of  Ine  earth,  but  the  water  i:s 
well.  It  embraces  the  entire  globe,  pressing  alike  upon  land  ami 
water,  and  having  a  depth  of  about  forly-fwe  miles.  This  is  a  sea  of 
8U  1  magnitude,  that  the  Atlantic  or  Pacific  shrinks  to  a  very  small 
lake  in  the  comparison. 

Man  has  his  residence,  and  walks  about  at  the  boltom  of  this 
ocean.  He  has  no  means  of  navigating  it,  and,  therefore,  never  rises 
to  its  surface ;  but,  with  his  natural  eyes,  and  with  telescopes,  he  dis- 
covers objects  which  lie  millions  and  billions  of  miles  beyond  it,  and 
even  acquires  much  exact  and  useful  information  respecting  them. 

This  vast  ocean  of  air  we  call  an  atmosphere,  from  two  Grp(>k 
words  signifying  vapor,  and  a  sphere,  —  it  being  an  immense  fluid- 
sphere,  or  globe. 

Pressure  of  the  Atmosphere.  —  This  atmosphere  presses  upon  man 
and  upon  every  object  on  the  surface  of  the  earth,  with  a  force  equal 
to  fifteen  pounds  to  every  square  inch  ;  and  as  a  mmi  c  average  size 
has  a  surface  of  about  2500  square  inches,  the  air  ii  which  he  lives, 
presses  upon  him  with  a  weight  of  eighteen  ton.  This  would  of 
course  crush  every  bone  in  his  body,  but  for  the  l  Is  within  hiin 
which  establish  an  equilibrium,  and  leave  him  unopprcssed. 

Tlie  Philosophy  of  Breathing  cannot  be  fully  explained  in  the  brief 
space  allotted  to  this  subject ;  it  is  enough  to  say,  that,  upon  the  at- 
tempt being  made  to  draw  in  the  breath,  the  muscles  of  the  breast 
draw  up  the  ribs,  the  diaphragm  or  midrirt"  at  the  same  time  contract- 
ing,—  the  whole  movement  being  such  as  to  create  a  vacuum  in  tlii' 
lungs.  The  air,  pressing  upon  every  part  of  the  surface,  as  mentioned 
above,  instantly  rushes  in  and  fills  the  vacuum.  The  lungs  being 
filled,  the  contraction  of  the  muscles  of  the  belly  causes  the  dia- 
phragm, which  has  sunk  down  towards  a  plane,  to  rise  up  into  the 
form  of  an  umbrella,  and  squeeze  the  air  out  of  the  lungs. 

This  is  about  all  that  need  to  be  said  of  the  method  of  getting  the 
air  into  and  out  of  tlie  lungs.  The  whole  process  is  under  the  con- 
trol of  that  part  of  the  nervous  system  called  the  medulla  oblongaUi, 
or  top  of  the  spinal  cord. 

Objects  of  Breathiug;.  —  There  are  at  least  three  objects  to  be  ac- 
complished by  breathing;  the  renewal  of  the  blood  and  the  taking  of 
impurities  out  of  it ;  the  warmitig  of  the  body ;  and  the  finishing  up 
of  the  process  of  digestion,  and  the  change  of  chyle  into  nutritive 
blood. 

There  is  no  good  reason  for  attempting  here  to  explain  the  last  of 
these  objects.  To  give  any  idea  of  the  first  two,  it  is  necessary  to 
furnish  a  very  brief  explanation  of  the  circulation  of  the  blood. 


y 


itil  th»> 
lysical. 


of  this 

r  risi's 

he  dis- 

it,  and 

hem. 

Grp(<k 

fluid- 


HYGIENE. 


109 


Fio  71. 


The  heart  is  double.  There  are  in  fact  two  hearts,  a  right  and  a 
left,  joined  together.  The  right  heart  receives  the  blood  from  the 
veins,  and  forces  it  up  into  the  lungs,  whence  it  is  brought  back  to 
the  left  heart,  and  by  this  is  driven  through  the  arteries  into  every 
part  of  the  body.  \Vhen  received  into  the  lungs,  the  blood  is  of  a 
dark  purple  color,  and  is  loaded  with  carbonic  acid  and  some  other 
impurities.  It  has  also  been  deprived,  during  its  circulation  through 
the  body,  of  most  of  its  oxygen.  The  small,  delicate  vessels  which 
convey  this  dark  and  impure  blood  through  the  lungs,  pass  directly 
over  the  £.ir  cells ;  and  at  this  moment  the  carbonic  acid  and  water 
pass  through  the  blood  vessels  and  air  cells,  and  are  borne  from  the 

body  on  the  outgoing  breath ;  while  the  oxy- 
gen enters  the  blood  through  the  walls  of  the 
same  vessels  ;  and  this  exchange,  which  takes 
place  with  every  bn^ath,  alters  the  blood  from 
a  dark  purple  to  a  scarlet  red.  Figure  71 
shows  at  1,  a  bronchial  tube  divided  into  three 
branches ;  2,  2,  2,  are  air-cells  ;  3,  branches  of 
the  pulmonary  artery  winding  around  the  air- 
cells  with  the  dark  blood  to  be  reddened. 
That  carbonic  acid  and  water  are  borne  out  of  the  lungs  with  every 
breath,  may  be  easily  proved.  If  we  breathe  into  lime-water,  it  will 
become  white.  This  is  owing  to  the  carbonic  acid  in  the  breath 
uniting  with  the  lime,  and  producing  carbonate  of  lime.  Then,  if  we 
breathe  upon  a  piece  of  glass,  it  becomes  wet,  showing  that  there  is 
watery  vapor  in  the  breath.  That  the  blood  receives  oxygen  from 
the  air  we  breathe  is  proved  by  the  fact  that  the  ingoing  breath  has 
one-fourth  more  oxygen  in  it  than  the  outgoing. 

The  lungs,  then,  take  out  of  all  the  air  we  breathe,  one-fourth  of 
its  oxygen.  If  we  breathe  it  over  a  second,  a  third,  and  a  fourth  time, 
it  not  only  has  less  oxygen  each  time,  and  is  less  useful  for  the  pur- 
poses of  respiration,  but  it  becomes  positively  more  hurtful  by  reason 
of  the  poisonous  carbonic  acid  which,  at  every  outgoing  breath,  it 
carries  with  it  from  the  lungs. 

Effect  of  Sleeping  in  a  Small  Room.  —  Now,  consider  the  effect  of 
sleeping  in  a  small  room,  seven  feet  by  nine,  not  furnished  with  the 
means  of  ventilation.  A  pair  of  lungs,  of  ordinary  size,  take  in,  at 
each  breath,  about  a  pint  of  air.  Out  of  this  air  one-fourth  of  its  oxy- 
gen is  extracted  ;  and  when  it  is  returned  from  the  lungs,  there  comes 
along  with  it  about  eight  or  nine  per  cent,  of  carbonic  acid.  As  it  is 
not  safe  to  breathe  air  containing  more  than  three  or  four  per  cent, 
of  this  gasj  the  pint  which  the  lungs  take  in  and  throw  out  at  each 
breath,  is  not  only  spoiled,  but  it  spoils  something  more  than  another 
pint  with  which  it  mingles;  and  as  the  breath  is  drawn  in  and  thrown 
out  about  eighteen  times  per  minute,  not  less  than  four  cubic  feet  of 
air  is  spoiled  in  that  tinu  by  one  pair  of  lungs.  This  is  two  hundred 
and  forty  feet  an  hour;  and  in  eight  hours,  the  usual  time  spent  in 
the  sleeping  room,  it  amounts  to  one  thousand  nine  hundred  and 
twenty  cubic  feet.     During  the  hours       sleep,  therefore,  one  pair  of 


no 


HYGIENE. 


lungs  8o  spoil  one  thousand  nine  hundred  and  twenty  cubic  feet  of 
air  that  it  is  positively  dangerous  to  breathe  it. 

In  a  room  seven  feet  by  ten,  and  eight  feet  high,  there  are  five  hun- 
dred and  sixty  cubic  feet  of  air,  a  little  more  than  one-quarter  the 
amount  spoiled  by  one  pair  of  lungs  during  sleeping  hours.  In  a 
room  of  this  size,  there  is  not  air  enough  to  last  one  person  three 
hours  ;  and  yet  two  persons  often  remain  in  such  rooms  eight  or  nins 
hours. 

Why  then  do  they  not  perish  ?  Simply  because  no  room  is  entirely 
air  tight.  Fortunately,  all  our  rooms  are  so  made  that  some  foul  air 
will  get  out,  and  a  little  that  is  pure  will  find  its  way  in.  Were  it  twt 
so,  no  man  tv/io  closed  the  door  behind  him,  for  the  night,  in  a  small  bed- 
room, would  ever  see  a  return  of  day. 

Suppose  fifty  children  are  confined  in  an  unventilated  school-room, 
twenty  feet  by  thirty,  and  ten  feet  high.  These  children  will  spoil 
about  one  hundred  and  fifty  feet  of  air  in  one  minute,  or  nine  thou- 
sand feet  per  hour,  or  lioenty-seven  thousand  feet  in  three  hours,  —  a 
usual  half  day's  session.  But  the  room  holds  only  six  thousand  cubic 
feel  of  air,  —  the  whole  of  lohich  these  children  would  spoil  in  forty 
minutes. 

These  simple  facts  show  the  absolute  necessity  of  ventilation.  Yet 
how  poorly  it  is  provided  for  in  our  sleeping  rooms,  our  sitting  rooms, 
our  school  houses,  our  churches,  our  court  houses,  our  halls  of  legis- 
lation, and  even  in  our  anatoii  ical  and  medical-lecture  rooms! 

In  sick-rooms,  veiitilutioii  should  receive  special  attention. — Every 
disease  is  aggravated  by  the  breathing  of  bad  air.  Yet  it  is  common 
to  close  all  the  doors  and  windows  of  rooms  where  sick  persons  are 
confined,  lest  the  patients  should  take  cold.  This  is  a  bad  practice. 
The  sick  should  have  a  plenty  of  fresh  air.  Their  comfort  is  pro- 
moted by  it,  and  their  recovery  hastened. 

It  is  strange  that  human  beings  should  be  afraid  of  pure  air.  It  is 
their  friend  and  not  their  enemy.    Impure  air  only  should  be  shunned. 

Tlie  supply  of  good  air  ample.  —  There  is  no  necessity  for  breath- 
ing air  which  has  lost  a  part  of  its  oxygen,  and  acquired  a  portion  of 
carbonic  acid.  The  supply  of  good  air  is  ample.  An  ocean  of  it 
forty-five  miles  deep,  covering  the  whole  globe,  seems  a  pretty  plain 
intimation  that  it  is  not  to  be  sparingly  used.  When  men  retire 
within  their  dwellings,  and  attempt  to  shut  out  this  great  sea  of  air, 
they  show  about  as  much  wisdom  as  would  be  exhibited  by  fishes 
which  should  build  water-tight  huts  around  themselves  at  the  bottom 
of  the  ocean,  and  swim  about  continually  in  the  unchanged  water 
within.  Fishes  can  only  live  in  glass  globes  when  the  wat«r  is 
changed  every  day ;  and  if  the  water  be  changed  half  a  dozen  times 
a  day,  they  cannot  be  as  healthy  as  when  swimming  in  the  great 
ocean. 

Cultivating  Trees. —  In  most  of  our  cities  there  is  almost  a  criminal 
neglect  of  the  cultivation  of  trees ;  yet  they  add  greatly  to  the  health, 
and  prolong  the  lives  of  the  citizens. 

The  leaves  of  a  tree  are  the  lungs  with  which  it  breathes  ;  but  in- 


Btcad  of  extracting  oxygen  from  the  air,  and  giving  back  carbonic 
acid,  like  man,  it  taked  only  the  poisonouB  carbonic  acid,  and  givca 
back  oxygen. 

Were  there  no  animals  on  the  globe,  the  vegetables  would  consume 
all  the  carbonic  acid,  and  die  for  want  of  breathing  material ;  on  the 
other  hand,  wt.e  there  no  trees  or  other  vegetables,  the  animals  would 
in  time  so  far  exhaust  the  oxygen  as  to  perish  f  >r  lack  of  it.  The  two 
together  keep  the  air  healthv  for  each. 

The  relatioi.  of  plants  Pud  animal:.,  in  ah  that  relates  to  their  pecu- 
liar actions  and  efiects,  is  a  complete  antugonibm.  Their  movements 
are  in  contrary  directions,  and  by  hostile  forces.  Their  opposing  ac- 
tions may  be  illustrated  thus : 


The  vkoktaiu.k  pRonucKS  the  non- 
nitrogenized  substances,  sugar,  Btarch,  and 
gum. 

TiiK  VEOETAiiLK  DKCOMP08E8  Car- 
bonic acid,  water,  aii'l  ammoniacal  salts. 

TllK  VKGKl'AIILK   l)I.SKNOAGK3  OXygen. 

TiiK  VKOKTAIU.K   AHsouiis  heat  and 
electricity. 
The  veoetahlk  is  a  dk-oxidizbr. 
tlie  veoktabi.-;  is  9tationaby. 


The  animai,  consumes  the  non-ni- 
trogcnizcd  substances,  sugar,  starch,  and 
gum. 

The  animai,  rRODucES  carbonic  acid, 
water,  and  ammoniacal  salts. 

TiiK  ANIMAI.  AiisORiis  oxygcn. 

The  ANIMAL  I'RODUCES  HEAT  aud  el- 
ectricity. 

The   ANIMAI.    TS   AN   OXIDIZER. 
The   ANIMAL   IS    LOCOMOTIVE. 


We  learn  from  llie  facts  of  Geology  that  the  time  was  in  the  his- 
tory of  our  globe,  when  lunged  animals  could  not  breathe  its  atmos- 
phere ;  it  was  too  much  loaded  with  carbonic  acid.  The  trees  then 
1,'rcw  with  a  rapidity  almost  inconceivable,  decomposing  the  poison- 
ous gas,  taking  to  themselves  the  carbon  and  setting  the  oxygen  free, 
and  lifting  up  their  brawny  arms  to  heaven  in  acts  of  thankfulness 
for  the  great  feast. 

At  length  the  noxious  gas  was  exhausted;  and  then,  pale  and  sickly, 
they  feebly  held  up  their  hands  for  help ;  and  God  sent  numberless 
tribes  of  warm-blooded  animals,  full  of  life  and  energy,  that  sported 
in  the  exhilarating  air,  and  destroyed  vast  forests,  thereby  reproducing 
carbonic  acid. 

These  simple  facts  should  teach  man  the  sanitary  importance  of 
trees  and  bushes ;  and  wherever  he  has  a  rod,  I  had  almost  said  a  foot 
of  ground  to  spare,  a  tree  should  be  planted  and  carefully  nursed. 
This  is  particularly  necessary  in  large  cities.  Every  narrow  street 
even  in  Boston,  should  be  lined  with  trees.  For  their  absence,  thou- 
sands of  men,  women,  and  children  have  died  sooner  than  they  other- 
wise would.  We  want  them  stretching  up  their  arms  to  all  our  win- 
dows to  give  us  oxygen,  and  to  take  to  themselves  the  carbonic  acid 
we  exhale. 

Tij^lit  Dresses.  —  The  health  may  be  injured  by  not  breathing  air 
enough,  as  well  as  by  inhaling  that  which  is  impure.  It  is  therefore 
improper  to  compress  the  lungs  by  wearing  tight  dresses.  If  the  ribs 
are  held  down  by  the  dress,  but  little  air  can  get  into  the  lung.s,  and 
only  a  small  amount  of  carbonic  acid  can  be  carried  out.  In  this 
event,  the  health  is  injured  in  two  ways ;  the  blood  is  not  vitalized  by 
oxygen  received,  and  it  is  poisoned  by  carbonic  acid  retained. 


.  Hg 


112 


HYGIENE. 


Tight  lacing  has  in  a  measure  gone  out  of  fa.Mhion  ;  yet  too  murh 
of  it  for  the  best  development  of  female  health  is  vet  retHi"*"'  As  a 
knowledge  of  physiology  and  the  laws  of  life,  and  a  betier  judgment 
of  the  true  symmetry  of  the  female  form  prevail,  this  barbarous  cus- 
tx)m  will  pass  out  of  use,  and  the  substantial  health,  and  real  beauty 
of -the  American  woman  will  together  rise  to  a  higher  standard. 

Fill  the  \ungk  well.  —  Persons  who  take  but  little  exercise  are  apt 
to  accjuire  the  liiil)it  of  drawing  the  air  very  little  into  the  lower  part 
of  the  lungs.  This  should  be  counteracted  by  taking  long  and  full 
inspirations  for  a  short  time,  every  day,  while  in  the  open  air.  This 
practice  would  get  the  lungs  in  the  habit  of  opening  to  the  air  (luitc 
clown  to  their  base,  and  would  iriake  the  breathing  much  more;  natural 
us  well  as  etfectual  at  all  times.  In  the  case  of  young  persons,  it 
\»'ould  enlarge  the  capacity  of  the  chest,  and  add  to  the  bri(?f  years 
ot  life.  Parents  should  see  to  it  that  their  children  spend  from  ten  to 
twenty-five  minutes  every  morning  inflating  their  lungs  with  pure  air. 

Travelling. 

It  is  true  that  many  persons  who  dwell  in  one  apot,  and  hardly 
move  from  it  all  their  lives,  live  to  old  age.  Yet  change  of  location 
lor  a  short  time,  or  permanently,  does  promote  health,  and  protract 
life.  The  mind  tires  of  contemplating  one  .set  of  objects  for  a  great 
length  of  time;  and  in  the  absence  of  all  stimulation,  it  sinks  into 
apathy,  and  imparts  no  enert'jy  to  the  body.  The  physical  frame, 
partaking  of  the  ennui  of  the  mind,  droops.  This  is  doubly  true  when 
one  is  suttering  from  illness. 

Travelling  is  eminently  fitted  to  draw  the  thoughts  of  the  nervous 
and  feeble  from  themselves,  and  to  turn  them  with  interest  to  outward 
objects.  This  is  of  great  importance.  It  is  better  than  stimulants 
and  tonics. 

The  nervous  system  has  great  power  over  the  health  ;  and  the 
pleasurable  sensations,  excited  by  visiting  new  places  and  scenes,  and 
conveyed  to  the  mind  through  the  nerves,  often  awaken  in  the  consti- 
tution, energies  which  are  essential  to  recovery. 

Travelling  places  a  man  in  entirely  new  circumstances.  It  sur- 
rounds him  with  novelties,  every  one  of  which  makes  a  demand  upon 
his  attention.  It  breaks  up  his  old  trains  of  thought,  which  have  been 
monotonous  so  long  that  they  have  grown  oppressive.  It  causes  the 
world  to  touch  him  at  a  thousand  new  points,  and  surprises  him  every 
day,  perhaps  every  hour,  with  a  view  of  the  false  relations  he  has 
sustained  to  it.  It  opens  to  him  new  depths  in  his  own  nature,  and 
causes  him  to  wonder  that  they  never  attracted  his  attention  before. 
It  opens  to  him  one  door  after  another,  leading  him  into  new  apart- 
ments of  knowledge  ;  and  as  the  world  grows,  he  finds  himself  grow- 
ing with  it,  until  his  whole  nature  dilates  and  beats  with  new  life. 

Nenus  of  Travelliiiii;  Increased.  —  The  last  twenty-five  years  have 
greatly  increased  tha  facilities  for  travelling.  Many  of  the  sick  may 
now  seek  health  in  distant  lands,  who,  had  their  circumstances  been 


ma^ 


IIYllIENK. 


113 


similar  twenty  years  ago,  would  have  been  compelled  to  pine  at 
home.  The  cara  give  an  easy  journey  to  thousanuii  who  could  not 
have  borne  a  ride  in  the  old  stage  coach. 

One  thinic  more  wanted. —  But  one  thing  is  wanted  to  bring  the 
means  of  travelling,  for  the  sick,  very  nearly  to  perfection  ;  it  is  a 
method  of  propelling  carriages  upon  cotnrnon  roads,  by  some  cheap 
power,  which  can  never  be  exhausted,  and  which  shall  be  easily  man- 
aged by  the  traveller  or  his  (onipiuiioii.  This  is  a  prominent  want  of 
the  present  hour;  a  giant  discovery,  which,  at  a  single  stride,  would 
ciirry  the  world  forward  a  hundred  years,  and  which,  we  may  hope,  is 
ill  the  Womb  of  the  near  future.  The  power,  it  is  believed,  'vill  be 
flcctro-moffnetism.  The  mode  of  applying  it,  when  discovered,  will 
be  simple,  yet  wonderful ;  and  the  results  to  the  sick,  benelicent  be- 
yond expression.  The  human  mind  cannot  conceive  the  advantages 
which  invalids  would  derive  from  such  a  mode  of  conveyance.  Jour- 
neys might  be  long  or  short;  might  be  made  with  any  rate  of  speed 
which  the  strength  permitted.  The  morning  or  afternoon  stages 
might  be  discontinued  when  fatigue  demanded,  and  resumed  at  pleas- 
ure. Over  uninviting  regions  the  traveller  might  glide  swiftly,  and 
linger  where  nature  spreads  her  feasts  for  the  mind. 

Tlie  best  Seasons  for  TrnveUing  are  spring  and  autumn.  V/inter 
is  too  cold.  A  pleasurable  excursion  may  sometimes  be  made  in 
summer  ;  but  in  general  the  season  is  too  hot  for  comfort.  In  chang- 
ing climate,  food,  water,  etc.,  in  the  sultry  season,  therj  is  danger  of 
contracting  very  troublesome  bowel  complaints. 

Means  of  Travellinjf  for  the  Poor.  —  There  is  one  painful  thought 
connected  with  travelling  as  a  means  of  health.  It  cannot  be  en- 
joyed by  the  poor.  When  sick  they  generally  have  the  careful 
attention  of  humane  physicians ;  they  receive  from  kind  neighbors 
little  delicacies  of  food  and  drink ;  they  are  watched  with  by  night, 
and  visited  by  day ;  but  though  suffering  from  the  hard  routine  of  a 
laborious  life,  and  needing  diversion  and  recreation  more  than  all 
else,  they  cannot  travel.  They  have  not  the  means,  and  nobody 
thinks  of  supplying  them  for  such  a  purpose. 

This  is  a  channel  into  which  charity  ought  to  pour  some  of  its 
benevolent  streams.  In  large  cities  there  is  a  diss  of  poor  females, 
who  sit  in  their  small  rooms  and  ply  the  needle  diligently  through 
the  whole  year,  and  who  run  down  every  summer  very  near  to  con- 
finement in  bed.  Two  or  three  weeks,  in  the  hot  season,  spent  in 
travelling  in  the  mountains  and  elsewhere,  would  bring  back  the  color 
to  the  pale  cheeks  of  such  persons,  and  save  them  many  years  both 
from  the  grave  and  from  the  almshouse.  No  millionnaire  could  make 
a  better  use  of  his  property  than  to  set  it  apart,  at  his  death,  for  the 
specific  purpose  of  enabling  the  poor  to  travel.  And  if  this  sugges- 
tion should  induce  one  rich  man  to  consecrate  his  wealth  to  the  God- 
like work  of  bestowing  health,  happiness,  and  intelligence  upon  the 
poor,  the  great  labor  of  preparing  this  book  will  not  have  been  en- 
dured in  vain. 

15 


114 


IiyGIENE, 


Amusements. 


f'l- 


»'  / 


% 


That  which  engages  the  mind,  and  at  the  same  time  imprenses  it 
with  pleasurable  senuations,  in  a  pulHciently  accurate  definition  of 
amusement  Whatever  occupies  the  thoughts  and  senses  in  an 
agreeable  way,  ond  employs  them  with  some  degree  of  intensity, 
comes  under  the  same  head. 

This  brjad  and  general  defmition  allows  us  to  regard  our  diiily 
employments  as  ainuserncnts  when  they  engage  our  deep  attention. 
an(   at  the  same  time  give  us  pleasure. 

The  term  amusements,  however,  in  the  more  popular  sense,  is  re- 
stricted to  those  sports,  games,  plays,  exhibitions,  entertaiiunents,  cto,, 
which  involve  a  suspension  of  our  daily  labors,  and  are  properly  called 
diversions. 

When  nature  is  tired  and  worn  with  those  severe  and  exhausting 
toils  by  which  we  earn  our  bread,  amusements  turn  us  aside,  divert 
us,  engage  other  |)Owers,  and  allow  our  tired  faculties  to  rest.  They 
are,  therefore,  of  very  great  im|)ortance.  Even  tiie  most  trifling 
amusements  may  have  the  highest  value.  Their  very  nature  and  ob- 
ject imply  that  they  will  be  valuable  just  in  proportion  as  they  divert 
and  rest  us.  And  just  in  proportion  as  they  do  these  things,  they 
give  us  health. 

One  other  thing  amusements  do  for  us,  which  must  not  be  forgot- 
ten ;  they  preserve  in  us,  in  middle  life,  and  CTcn  in  old  age,  the  warm 
simplicity  of  childhood.  They  keep  us  young  in  our  dispositions  and 
feelings.  They  keep  us  in  harmony  with  nature,  and  consequently 
artless  and  truthful.  They  prevent  the  formalities  of  conventionai 
life  from  stiffening  us  into  cold  and  repulsive  iiypocrites. 

Selection  of  Anmsements.  —  Of  course  the  same  amusements  are 
not  adapted  to  all  persons.  The  farmer  who  has  worked  his  muscles 
all  day,  would  not  be  benefittd  by  a  game  of  ball  in  the  evening; 
yet  there  are  few  games  more  suitable  for  the  student  who  has  bent 
for  many  hours  over  his  books.  Care  should  always  be  taken,  there- 
fore, that  amusements  or  sports  do  not  bear  upon  those  limbs  or  fac- 
ulties which  are  wearied  by  work. 

Amusements  Improve  various  faculties.  —  To  one  who  has  a  taste 
for  art ;  who  is  fond  of  works  of  genius  and  poetry,  theatrical  enter- 
tainments  wi.'l  always  be  agreeable,  and  a  source  of  gratification  and 
health.  I  know  these  exhibitions  are  objected  to  by  many  as  immoral 
and  hurtful,  but  more,  I  think,  from  habit  and  fashion,  than  upon  any 
solid  grounds  of  reason  or  religion.  They  certainly  appeal  to  a  high 
order  of  faculties  in  the  human  mind ;  and  to  those  who  are  fitted  to 
receive  them,  teach  lessons  of  great  moment  Even  the  lower  exhi- 
bitions of  comedy,  though  not  particularly  improving  to  the  mind,  are 
yet,  from  their  power  to  provoke  lauffhter,  among  the  most  powerful 
up-builders  of  health. 

The  Gomes  of  Whist,  Euclire,  etc.,  engage  the  minds  of  the  players 
in  a  sort  of  mental  contest,  which  is  exciting,  agreeable,  and  health- 


IIYOIENK 


115 


rOB8C8   it 

litioii  of 
s  in  an 
ntcnsity, 

)nr  daily 
itteiition, 


ents,  etc^ 
rly  csilled 

xhausting 
de,  divert 
it.  They 
it  trifling 
e  and  ob- 
liey  divert 
ings,  they 

be  forgot- 
the  warm 
itions  and 
isequently 
nventional 


sments  are 
lis  muscles 
i  evening; 
J  has  bent 
iken,  thore- 
ibs  or  fac- 

has  a  taste 
rical  enter- 
cation  and 
as  immoral 
II  upon  any 
il  to  a  high 
ire  fitted  to 
lower  exhi- 
e  mind,  are 
st  powerful 

the  players 
and  health- 


imparting.  These  gamoH  make  urt  skilful  in  calculating  chances,  and 
judging  how  tncu  ought  to  act  under  certain  contingencies.  They 
make  us  sharp  to  detect  and  turn  aside  the  unseen  forces,  which  tend 
to  oppose  ana  destroy  our  Bucceaa  in  life. 

1  hardly  need  say  that  m' iiey  or  other  property  should  never  be 
staked  upon  a  game  of  cards,  or  upon  any  other  game,  (iatiibling  is 
one  of  the  mea  -st  as  well  as  most  destructive  things  in  which  men 
can  engage.  It  raises  the  healthful  excitement  of  tnese  innocent 
amusements,  —  innocent  when  properly  pursued,  —  into  raging  pas- 
sions, which,  when  defeat  comes,  as  come  it  will,  sink  into  remorse 
and  bitterness  as  terrible  as  the  mind  can  conceive.  I  warn  yoimg 
men  as  they  woidd  escape  the  pangs  'ji  a  hell  on  earth,  and  the  loss 
«)f  character,  happiness,  and  probably  health  for  life,  to  avoid  any 
such  abuse  of  cards. 

Chess,  Chequers,  etc.,  appeal  likewise  to  the  fondness  of  competl- 
tion,  which  is  common  to  all  men.  lint  they  cultivate  in  ua  a  little 
more  of  the  mathematical  element.  As  they  require  very  close  appli- 
cation of  the  mind,  they  are  not  suitable  for  persons  of  sedentary  em- 
ployments, or  whose  daily  avocations  re(|uire  a  constant  use  of  the 
mind.  Such  persons  should  choose  lighter  and  more  active  amuse- 
ments. 

Lidfhter  Aliiusemeiits. —  Beside  these  higher  amusements,  there  are 
a  great  number  of  lighter  and  more  childish  ones,  which  should  not 
be  overlooked. 

Some  of  these  are  merely  physical,  involving  a  trial  of  strength, 
fleetness,  action,  etc.,  as  the  games  of  ball,  cricket,  etc.  Others  are 
domestic  in  their  nature,  involving  mirth,  and  various  other  of  the 
lighter  excitements,  as  blind-man^j  buH",  puss  in  the  corner,  hole  in  the 
wall,  fox  and  geese,  hunt  the  slipper,  hurly-burly,  roll  the  platter,  etc. 

In  fashionable  American  households,  these  simple  domestic  plays 
have  in  a  great  measure,  gone  out  of  use,  —  being  deemed  vulgar,  and 
below  the  dignity  of  ladies  and  gentlemen.  I  am  sorry  to  say  this ; 
for  the  vulgarity,  in  my  judgment,  is  in  those  who  reject  them,  and 
not  in  the  plays. 

The  officer  of  our  navy,  whose  visit  to  the  mansion  of  Lord  Hard- 
wick  1  have  spoken  of  on  page  90,  reports  that  on  the  evening  of  one 
of  his  visits,  the  play  of  blind-man's  buft'  was  engaged  in  by  the 
whole  party;  and  that  his  Lordship  in  attempting  to  make  a  short 
turn  during  the  play,  fell  upon  his  back,  when  one  of  his  daughters, 
who  was  blinded,  caught  him  by  the  heels,  and  being  assisted  by 
others,  drew  him  steni-foremost  half  the  length  of  the  hall,  amid  the 
shouts  of  the  whole  party.  This  would  have  been  deemed  very  vul- 
gar by  fashionable  people  in  this  country.  But  to  me,  who  am  no 
believer  in  any  nobility  which  Lord  Hardwick  can  receive  from  kings 
or  queens,  this  simple  narrative  raised  him  at  once  to  a  peerage  in 
nature's  realm.  Without  doubt,  he  is  one  of  nature's  noblemen.  A 
man  in  his  station,  and  with  his  wealth  and  temptations  to  snobbery, 
who  can  preserve  such  simplicity  of  character,  must  have  a  warm  as 
well  as  a  noble  heart  in  his  breast 


ii 


116 


IIYGJENR 


Viilae  of  D()nii>Mtic  AiiiUHeiiicntx. —  I  remark  hern,  that  in  all  our 
ainuHt-riuMitrt,  wu  should  an  far  im  poitttible,  seek  those  of  a  domeolic 
character.  They  are  more  Hiiiiple  and  cliildhke  in  t'leir  nature,  and 
prettervc  in  uh,  even  to  old  age,  the  freshncHS  of  feelinff,  and  truthful 
Hiniplieity,  which  ttpreud  eo  beautiful  a  greenncsa  over  the  autumn  of 
life. 

Simple  domestic  amuHcmentrt,  too,  are  always  gotten  up  on  a  cheap 
Hciile;  they  do  not  encourage  costly  extravagance,  and  can  be  indulged 
in  by  the  poor  as  well  as  the  rich. 

Hut  more,  and  better  than  all,  they  keep  you  ig  men  and  old  men, 
lid  young  women  and  old  women,  nt  honu*,  by  making  the  domestic 
..(•le  the  centre  of  attraction.  They  draw  ifie  seekers  of  pleasure 
iKiund  the  hearth-stone,  instead  of  outward  into  the  world.  They 
incline  young  and  old  to  look  to  \\\e  family  circle  as  the  centre  of  the 
tiutst  pure,  because  the  most  simple  and  natural,  enjoyments.  They 
teach  us  to  look  to  home  as  the  centre  of  life,  and  to  all  outside  as 
only  its  appendages. 

It  has  i)cen  said  that  homes  are  found  only  in  England;  that  in 
other  c»)untries,  life  wanders,  houseless  and  shelterless,  abroad,  seek- 
ing happiness,  it  knows  not  where,  while  in  England  it  nesJes  warmly 
in  the  bosom  of  home.  To  whatever  extent  this  is  true,  —  and  I  be- 
lieve there  is  triilii  in  it,  —  it  is  owing  to  the  simple  household  amuse- 
ments of  England 

All  Aiiiericail  Want.  —  One  of  the  great  wants  of  this  country  is  a 
more  liberal  provision  for  amusements.  We  attach  here  too  much 
value  to  wealth  ;  and  we  |)ursiie  it  with  an  intensity  altogether  in- 
com|)atible  with  health.  We  cannot  take  time  for  recreation  because 
we  are  in  so  great  a  hurry  to  be  rich. 

if  we  would  save  ourselves  from  a  total  wreck  of  health,  we  must 
take  broader  and  better  views  of  life.  We  nmst  value  it  for  its  solid 
comforts,  rather  than  for  its  glitter  and  show. 

We  need  quite  an  increase  in  the  number  of  our  holidays,  —  days 
on  which  the  people  can  give  themselves  up  to  sportive  recreation.^. 
Some  progress  has  been  made  in  this  direction  of  late.  Washing- 
ton's birth  day  has  very  nearly  fixed  itself  among  us  as  a  holiday ; 
the  claim  of  Lafayette's  to  a  similar  observance  is  beginning  to  be 
acknowledged.  Quite  a  number  move,  scattered  through  the  year, 
are  much  wanted.  They  would  save  hundreds  of  our  population 
annually  from  insanity. 

Contrary  to  the  general  belief,  .nsanity  is  very  prevalent  among 
seamen  and  farmers.  The  former  lead  a  life  of  dreary  solitude  upon 
the  ocean  ;  the  latter,  one,  if  not  of  equal,  certainly  of  very  objection- 
able solitude  upon  the  land.  The  sailor  who  does  business  upon  the 
great  sea,  should  provide  himself  with  great  numbers  of  games  to 
amuse  him  in  his  wanderings.  The  farmers  of  our  land  shoulc'  culti- 
vate more  of  the  sociabilities  of  life.  Let  them  meet  together  in  the 
fiie'surnnier  evenings,  like  the  peasants  of  France,  and  dance  gayly 
upon  the  green  lawns  before  their  cottages.  They  will  till  their  lands 
more  cheerfully  for  it ;  enjoy  better  spirits  and  health ;  and  live  to 
greater  age. 


IIYCIENR. 


117 


CompletriiCNH  «f  Mfo. —  Amusnru'nts  nr<'  nccfUHnry  in  order  to  gfvo 
Q  cotni)l«'tnn'>«M  to  life.  'I'lic  fiicultics  of  tho  hiiinuii  mind  iirc  nutii<*N 
ohh.  It  irt  only  when  they  lire  all  cxfrciHi-d.  in  llnir  dnc  proportion, 
thiit  there  iw  ii  ImrrnonionH  heinity  in  onr  lives.  'I'lie  cnslonis  of  mK\- 
oty  twist  ufl  all  ont  of  »lmpe, —  jM-rvertin^  us  nienfiilly,  inondly,  and 
phynieully,  and  robbing  ns  of  every  rinnily  and  lieiiltlifnl  (pudity. 
(Setting  out  of  the  tn\A  of  fuailiionublo  life,  wo  inuat  eonu  back  'o  the 
eiuiplc  paths  of  nature. 

I  would  stronqly  imprcsH  upon  parentn,  teachers,  and  giiardiunn 
the  importance  of  btudying  well  the  vnriouH  temperumcnts,  phytfieul 
and  mental  peculiarities  of  their  children,  in  order  to  judge  wisely  of 
the  kind  and  amount  of  recreation  required  by  them. 

Instance:  a  pale,  delicate  eh  1  of  ten  to  twelve  or  fourteen  years, 
with  clear  complexion,  flaxen  .'ir,  blue  eyes,  slender  frame,  and  a 
nervous,  Bcnsitivc  orgini/ation,  wiia  strong  mental  cast,  requires  much 
more  recreation  and  out-of-door  exercise  than  a  full-blooded,  robust 
chiiu  of  that  age ;  a  fact  not  at  present  duly  considered,  as  a  gcne/al 
thi'ig. 


>   I 


\ 


(ft."'' 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS, 


Man  ha5  thinkings  warminp^^  tunmshing;  and  moving  powers.  Foi 
the  performance  of  each  of  these  great  functiona,  he  has  organa  of 
the  beat  possible  construction. 

For  Tliinking',  he  has  a  brain.  If  us  be  large  il^  proportion  to  his 
other  organs^  it  gives  a  character,  a  cast,  a  peculiarity  to  his  whole 
organization.  Everything  about  him  is  subordinate  to  his  brain. 
We  recognize  him,  at  once,  as  a  thinking  and  a  feeling  being.  He 
has  an  intellectual  look.  There  is  a  delicacy,  a  refinement,  a  sensi- 
tiveness, a  studious  habit,  an  air  of  thoughtfulness  about  him,  which 
determine  his  traits,  his  tone,  his  temper,  his  whole  character.  Hence 
it  ia  proper  to  say  he  has  a  cephalic  or  thin/cing  temperament. 

The  Liui8;s  and  Heart,  devoted  to  renewing  and  circulating  the 
blood,  are  placed  in  the  chest  or  thorax.  If  these  be  large  in  man  in 
proportion  to  other  organs,  he  is  characterized  by  great  activity  of  cir- 
culation, by  a  large  supply  of  red  blood,  and  by  the  general  indica- 
tions of  a  full,  warm,  and  bounding  life.  This  activity  gives  him  his 
ton*;  and  temper,  and  shows  that  his  is  the  tho'/acic  ov  calorific  temper' 
ament. 

In  the  Great  Cavity  of  the  Abdomen  ia  done  the  work  of  re'^eiving, 
digesting,  and  disposing  of  the  materials  which  nourish  the  body. 
If  the  organs  which  do  this  wotiv  be  lari'e  in  proportion  to  others,  the 
body  is  fed  to  repletion,  and  the  whole  organization  speaks  of  the 
table.  The  habit,  the  look,  the  temper,  are  all  sluggish.  This  ia  the 
abdominal  or  alimentary  temperament. 

Tlie  Bones  and  Muscles  are  instruments  by  which  the  movemeMs 
of  the  body  are  performed.  If  these  be  the  largest,  in  proportion,  of 
any  in  the  body,  then  the  locomotive  powers  are  in  higher  perfection 
than  any  others.  There  is  largeness  of  person,  energy  of  movement, 
and  greatness  of  endurance.  The  whole  cast  of  the  person  partakes 
of  the  strength  and  coarseness  of  bone  and  muscle.  This  is  the  wws* 
cular  or  locomotive  temperament. 

This  gives  us  four  temperaments,  as  follows : 

I.  The  Cephalic  Temperament,  denoted  by  large  brain,  activity  of 
mind,  and  general  delicacy  o.'^  organization. 


riMMii 


TEMl'KKAMKNTS,  COXSTITUTIOV,  AND   SYMPTOMS. 


119 


II.  The  Tlioracic  Temperament,  indicated  by  a  large  chest,  force 
of  circulation,  redness  of  skin,  great  activity,  warmth  of  temper,  and 
fulness  of  life. 

III.  The  Abdominal  Temperainerii,  denoted  by  a  large  develop- 
ment of  the  stomach,  liver,  bowels,  and  lymphatics ;  by  a  fulness  of 
belly,  fondness  of  high  living,  and  a  disposition  to  float  sluggishly 
upon  the  current  of  the  world,  rather  than  to  struggle  against  it. 

IV.  Tlie  muscular  Temperament,  indicated  by  largeness  of  frame 
and  limbs,  coarseness  of  structure,  and  great  power  of  locomotion 
and  endurance. 

There  are  some  reasons  reckoning  but  three  temperaments  in- 
stead of  four,  by  reducing  the  thoracic  and  abdominal  to  one,  after 
the  manner  of  the  phrenological  Fowlers,  —  especially  as  the  organs 
in  the  chest,  and  their  appendages,  take  an  important  part  in  the  pro- 
cess of  nutrition.  But  as  the  heart  and  lungs  are  placed  in  one  cavity, 
and  the  stomach,  liver,  etc.,  in  another;  and  as  one  set  of  these  organs 
may  be  largely  developed,  and  the  other  defectively,  I  have  thought  it 
most  convenient,  on  the  whole,  and  quite  as  philosophical,  to  retain 
the  four  temperaments. 

These  temperaments  seldom  or  never  appear  single  and  pure.  They 
mix  and  cross  with  each  other  in  all  possible  ways. 

Medication  and  Temperaments. 

The  object  of  speaking  of  temperaments  in  this  work,  is  to  make 
the  reader  acquainted  with  the  principles  upon  which  remedies  are  to 
be  adapted  to  their  development.  The  philosophical-minded  physi- 
cian will,  in  prescribing,  always  keep  the  temperament  in  view. 

Persons  of  a  Cephalic  Temperament  cannot  bear  powerful  medi- 
cines,—  particularly  drastic  purges.  Their  fine,  delicate  and  sensitive 
organizations  would  be  torn  all  to  pieces  by  doses  which  would  hardly 
be  sufficient  in  a  fully -developed  muscular  temperament.  This  should 
always  be  borne  in  mind  in  prescribing  for  persons  of  a  large  brain 
and  delicate  organization. 

In  this  temperament,  too,  fevers,  instead  of  running  a  high  and 
fiery  course,  take  the  low  typhoid  type,  the  patient  becoming  pale, 
and  showing  a  constant  tendency  to  sink.  Such  patients  would  be 
killed  by  purging,  leeching,  cupping,  sweating,  and  starving.  They 
want  tonics,  stimulants,  and  every  kind  of  support  which  the  case 
will  possibly  permit 

Persons  of  a  Tlioracic  Temperament,  having  a  rapid  circulation,  and 
a  fulness  of  blood,  are  most  liable  to  inllammatory  diseases.  When 
fever  attacks  them,  they  have  what  is  called  a  "  high  fever."  If  rheu- 
matism comes,  it  is  acute  rheumatism.  Disease  takes  hold  of  them 
sviartly.  As  they  do  everything  with  emphasis  and  energy  when  well, 
so,  when  ill,  they  make  a  business  of  it,  and  are  sick  with  all  their 
mighc. 


.V.n  1'  ,  JK, 


k     ■ 


120 


TEMPEUAMKNTS.  CONSTITUTION,  AND   SYMPTOMS. 


Stimulants  and  tonics  gonprally  make  such  persons  worse.  They 
want  sedatives,  and  diaplioretics,  and  sweats,  and  purgatives,  and 
leeches,  and  cups,  and  low  diet,  and  cold  bathing,  and  whatever  else 
will  slacken  the  ferocious  swiftness  of  their  circulation. 

Those  of  the  AInIoiiiIiuiI  Teni|ierfliiient  are  not  particularly  subject 
either  to  very  high  fevers,  or  to  those  typhoid  forms  which  produce 
sinking.  As  in  the  two  temperaments  noticed  above,  their  com- 
plaints chiefly  attack  1  he  organs  most  largely  developed.  Their  dis- 
eases affect  the  stomach,  t'...;  liver,  the  spleen,  and  the  bowels.  These 
are  the  largest  organs  in  tho'r  bodies,  and  are  most  used  ;  and,  being 
overworked,  they  fall  into  diaease. 

As  these  persons  are  slothful  in  all  their  habits,  so  their  diseases 
run  a  sluggish  course.  They  are  not  so  liable  to  sudden  de;  h  as 
persons  of  either  of  the  preceding  temperaments.  They  have  all 
sorts  of  chronic  diseases  which  linger  a  great  while,  and  are  cured 
with  much  difficulty. 

These  persons  will  bear  larger  doses  of  medicine  than  either  of 
the  preceding.  Neither  do  their  constitutions  respond  as  readily  to 
medicine.  A  physician  will  be  disappointed  if  ne  expects  to  see 
them  recovering  as  fast  under  its  use. 

Those  of  a  Huscuhir  Tempeniment,  having  little  fondness  for  any- 
thing but  a  hardy,  active  life,  are  much  exposed  to  the  elements. 
Though  strong  and  long-enduring,  the  hardship  of  their  lives  often 
breaks  them  down,  and  when  '/elled  by  disease,  »  jy  are  oftentimes 
shockingly  racked  and  torn  by  it. 

These  persons  bear  large  tloses  of  medicine,  and  when  sick,  need 
to  be  treated  with  an  energj'  proportioned  to  the  strength  of  their 
constitution.  Rheumatism,  which  affects  the  joints,  the  ligaments, 
and  the  tendons,  is  an  affection  from  which  they  suffer  severely. 

The  Constitution. 

In  prescribing  for  disease,  it  is  of  very  great  importance  to  take 
notice  of  the  constitution.  This  is  a  different  matter  from  the  tem- 
peraments. Persons  of  the  same  temperament  are  often  quite  unlike 
in  the  strength  of  their  constitution.  And  those  having  good  natural 
constitutions,  frequently  abuse  them  by  improper  habits  and  indul- 
gences, and  at  length  come  to  have  broken  and  very  feeble  ponstitu- 
tions. 

Some  persons'  muscles  and  other  tissues  are  put  together  as  if  they 
were  intended  never  to  come  apart.  Like  some  of  the  woods  of  the 
forest,  —  the  lignum  vitae  for  example,  —  they  are  fine-grained  ?nd 
tough.  A  real  smart  boy  will  wear  out  an  iron  rocking-horse  sooner 
than  one  of  these  persons  can  exhaust  their  constitution  by  hard  work. 
Others,  to  outward  appearance  equally  well  made,  have  very  little 
endurance,  break  down  easily  under  hard  work,  and  lose  their  flesh 
from  trifling  causes. 

The  r  tate  of  the  constitution,  therefore,  should  always  be  learned 
before  much  medicin'  is  given  ;  for  what  a  person  of  a  strong  const!- 


.■5a,*tii-,t.Etii'^-- 


TEMPERAMENTS,  CONSTITUTION,  AND   SYMPTOMS. 


121 


tntion  will  need,  may  greatly  injure  a  feeble  person,  even  of  the  same 
temperament. 

Ililbite.  —  These  must  likewise  be  attended  to.  Persons  using 
stimulants  require  larger  doses  of  medicine  to  affect  them  than  other 
persons. 

Climate. —  Medicines  act  differently  on  the  same  persons  in  sum- 
mer and  winter.  Narcotics  act  more  powerfully  in  hot  weather  and 
climates  than  in  cold,  and  must  be  given  in  smaller  doses. 

Idiosjucrasy. —  Medicines  of  only  ordinary  activity,  act  very  power- 
fully, and  even  violently  on  some  persons.  This  •  -ring  to  a  pecu- 
liarity of  stomach,  or  constitution,  called  idiosyncr  It  makes  tho 
person,  in  this  particular,  an  exception  to  the  gent,  rule.  And  no 
physician  can  know  beforehand  in  what  particulars  this  exceptional 
disposition  will  show  itself.  Persona,  however,  learn  their  own  idio- 
syncrasies, and  should  make  them  known  to  those  who  prescribe  for 
them  for  the  first  time. 

The  Sex.  —  The  peculiarities  of  each  sex  should  never  be  forgotten 
in  prescribing  for  the  sick. 

Males  are  not  so  sensitive  as  females.  They  will  bear  more  medi- 
cine, and  their  nervous  system  is  not  so  readily  excited  by  it. 

Influence  of  A^.  —  Human  life  is  divided  into  infancy,  childhood, 
youth,  manhood,  and  old  age.  Each  of  these  periods  has  peculiarities 
which  modify  disease. 

Tlie  First  Period,  extending  from  birth  to  the  age  of  seven  years, 
is  marked  by  tenderness  and  excitability,  and  is  alive  to  every  irrita- 
tion. Teething  and  other  disturbances  occur  at  this  period,  and  need 
careful  management. 

The  Second  Period  extends  from  seven  to  fourteen,  and  is  quite 
subject  to  disease,  including  the  second  dentition.  During  these  two 
periods,  there  is  no  great  diflference  between  the  sexes ;  both  are  ten- 
der, and  need  careful  watching. 

Darings  the  Third  Period,  the  changes  occur  which  mark  and  sepa- 
rate the  sexes.  This  is  a  developing  period,  when  the  functions 
become  established,  and  the  frame  acquires  form,  proportion,  and 
strength. 

At  this  time,  hereditary  tendencies  to  disease,  latent  till  now,  begin 
to  show  themselves,  and  call  for  every  possible  endeavor  to  break  them 
up,  and  fortify  the  constitution. 

The  Fourth  Period  embraces  the  vigorous  maturity  of  life,  when 
the  powers  of  body  and  mind,  in  both  sexes,  are  at  the  summit  of 
their  excellence.  The  functions  are  now  well  established.  It  is  dur- 
ing this  period  that  the  female  is  subject  to  most  of  the  harassing 
ailments  peculiar  to  her  sex.  So  numerous  are  these  complaint^i,  and 
so  large  and  valued  the  class  of  persons  affected  by  them,  that  he  who 
treats  them  with  the  greatest  skill,  and  with  the  delicacy  which  their 
nature  demands,  may  be  said  to  be  at  the  head  of  his  profession. 


.. 


i.'t  ■  fcA-. 


122 


TEMPERAMENTS,  CONSTITUTION,  AND   SYMPTOMS. 


Iff' 


The  Fifth  Period  is  that  of  old  age,  when  the  functions  arc  declin-, 
ing,  and  tlie  frame  is  bending  under  the  weight  of  years.  Old  age 
begins  earlier  with  females  than  with  males.  Many  ailments  are 
common  to  this  period,  which  require  peculiar  management,  both 
medicinal  and  hygienic. 

Proper  Frequency  of  Dose. — Each  succeeding  dose  should  be  given 
before  the  effect  of  the  preceding  is  gone.  If  this  rule  is  not  attended 
to,  the  cure  does  not  advance.  What  is  gained  by  each  dose  is  lor^t 
by  the  rallying  of  the  disease  in  the  interval.  Care  must  be  taken, 
however,  not  to  apply  this  rule  too  strictly  with  very  active  medicines. 

How  to  Examine  a  Patient. 

When  a  patient  is  presented  for  examination,  having  observed  the 
temperament,  constitution,  sex,  and  age, 

1.  Learn  the  causes  of  the  disease,  whether  local,  specific,  or  gen- 
eral, and  also  its  history. 

2.  Search  out  its  nature  and  character,  whether  febrile  or  other- 
wise. 

3.  Take  notice  of  the  whole  train  of  symptoms,  —  embracing  the 
pulse,  the  condition  of  the  mouth,  tongue,  and  digestive  organs,  the 
breathing,  the  urine,  the  fecal  discharges,  the  condltiou  of  the  brain 
and  nervous  system,  the  state  of  the  skin,  etc. 


Brief  Table  Explanatory  of  Symptoms. 

GENERAL    APPEARANCE    OF    PATIENT. 


1.  Tonic  spasm  of  the  trunk. 

2.  Distorted  features,  altered   position, 
and  impaired  motion  of  limbs. 

3.  Irresular  and  perpetual  motion. 

4.  Entire  and  absolute  immobility. 

5.  Great  and  unnatural  boldness. 

6.  Great  and  unusual  languor. 

7.  Ability  to  lie  only  upon  the  back. 


8.  Lying  upon  the  face. 

9.  Lying  upon  one  side. 


10.  Muntoining  the  sitting  posture  only. 

11.  The  head  thrown  back. 

12.  Riistlessness  and  tosaings. 

13.  General  enlarsemeut  of  bodv. 


1.  Locked  jaws. 

2.  Paralysis  of  one  side. 

8.  St  Vitus's  dance. 

4.  Catalepsy. 

5.  Insanity  or  delirium. 

6.  The  beginning  of  an  acute  diseaas, 
or  tlie  prwress  of  a  chronic  one. 

7.  Apoplexy.  Organic  disease  of  the 
brain  or  spinal  marrow.  Acute  inilamma* 
tion  of  the  lining  of  the  abdomen.  Klieu- 
matism  of  the  joints. 

8.  Several  kinds  of  cholics. 

9.  Pleurisy,  or  inflammation  of  the  Iung& 
When  one  lung  only  is  affected  in  con- 
sumption, the  patient  generally  lies  on  the 
diseased  side. 

10.  Disease  of  the  heart  or  lungs,  whicL 
interferes  with  breathing. 

11.  Severe  diseases  of  the  larynx  and 


1 2.  The  beginning  of  acute   inflamma- 
tion.   Fevers.    Diilirium,  and  acute  mania. 

13.  Ccll-di-opsy.     Emphysema  from  a 
wound  of  the  chest 


TP^MPEUAMKNTS,  CONSTITUTION,  AND   SYMPTOMS. 


123 


clecliiii 
Old  age 
nts  are 
nt,  both 


be  given 
attenili'd 
is  l()!(t 
)e  taken, 
edicines. 


irved  the 

c,  or  gen- 

or  other- 

acing  the 
rgans,  the 
the  bidin 


Head]  Face,  and  Neck. 


icute  diseas», 
)ne. 

isease  of  th« 
ute  inflamma» 
)Dien.     Ulieu- 


n  of  the  lungb 
eeted  in  coo- 
lly lies  on  the 

r  lungs,  whicl: 

e  larynx  and 

lite  inflamma- 
\  acute  mania, 
^seoia  from  a 


1.  Head  bent  to  one  side. 


2.  Head  increased  in  size. 

3.  Swollen  scalp. 

4.  Dull  expression  of  fatre. 

5.  Full,  red  face,  with  blood  vessels  of 
eyes  injected. 

6.  Pinched,  contracted  countenance. 

7.  Pinched  nose,  sunken  eyes,  hollow 
temples,  skin  of  forehead  tense  and  dry, 
complexion  livid. 

8.  Wrinkles  across  the  forehead. 

9.  AV'rinkles  from  forehead,  vertically, 
to  root  of  nose. 

10.  A  white  line  from  inner  angle  of 
the  eye  to  just  below  the  cheek  bone. 

11.  White  line  from  the  upper  border 
of  the  wing  of  the  nose  (ala  nasi),  curved 
to  the  outer  margin  of  the  orb  of  the  eye. 


12.  The  white  line  in  children  from  an- 
gle of  mouth  to  lower  part  of  face. 

13.  A  white  line  external  to  the  last 
two,  in  a  semicircular  direction  towards  the 
chin. 

14.  Swelling  of  face  and  eyelids. 

15.  Transient  redness  or  flu.shing  of  face. 

16.  Hectic  flush. 

1 7.  Paleness  of  face. 


18.  Dingy,  white,  or  greenish  face. 

19.  Yellow  tint. 

20.  A  citron  tint. 

21.  A  bluish  tint 

22.  Perpetual  motion  of  eyelids. 

23.  Forcible  closure  of  eyelids. 

24.  Eyelids  remaining  open. 

2.').  Balsy  of  the  upper  lid. 

2G.  Flowing  of  tears  over  the  cheek. 

27.  Nostrils  dilating  forciblv  and  rapidly, 

28.  Itching  of  nostrils  in  children 


1.  Convulsions.  Paralysis  of  one-half 
the  body.  Dislocation  of  bones  of  neck. 
Swellinjj;  of  glands  of  neck. 

2.  Chronic  hydropholus.  Enlarged 
brain. 

3.  Erysipelas.     Small  po.x. 

4.  Typhoid  fever. 

5.  Swelling  of  heart  Congestion  rf 
brain. 

6.  Acute  inflammation  of  peritoneum. 
Exposure  to  severe  cold. 

7.  Chronic  disease  just  before  death. 


8.  Excessive  pain  arising  externally. 

9.  Distress,  anxiety,  and  severe  inter- 
nal pain. 

10.  In  children,  a  brain  or  nervous  af- 
fection ;  in  adults,  abuse  of.  the  generative 
organs. 

11.  In  consumption  and  wasting  of  flesh. 
The  lower  part  of  the  line  indicates  dis- 
ease of  stomach ;  the  upper  part,  some  affec- 
tion of  upper  part  of  bowel.  When  united 
with  the  white  line  named  above,  and  with 
a  drawing  in  of  the  cheek,  fixed  pyc*,  and 
a  wan  complexion.  It  implies  worm .. 

12.  An  affection  of  the  chest,  with  diffi- 
culty of  breathing. 

13.  Chronic  and  obstinate  disease  in  the 
chest  or  belly. 

14.  Albumen  in  the  urine. 

15.  Suffering  from  the  monthly  irregu- 
larity. 

16.  Consumption.     Chronic  affections. 

1 7.  Cold  stage  of  fever.  Acute  inflam- 
mation. '  Chronic  diseases,  especially 
Bright's  disease,   during  recovery. 

18.  A  low  and  deficient  state  of  blood. 

19.  Jaundice. 

20.  Cancerous  disease. 

21.  Poor  circulation  in  the  veins.  Chol- 
era.    Typhus  fever.     Blue  disease. 

22.  Mania  and  idiocy. 

23.  Intolerance  or  dread  of  light. 

24.  Orbicularis  pal|)ebranim.  Paralysis 
of  the  niuscje  which  closes  the  eye. 

25.  Injury  of  the  third  pair  of  nerves. 

26.  Obstnu-iion  of  the  lachrymal  duct 

27.  Diflicultv  of  breathing. 

28.  Worms  in  the  bowels. 


The  Tongue. 


1.  Surface  of  tongue  covered  with  a 
layer  of  whitish,  soft,  mucous  substance, 
which  may  partially  be  taken  off  with  a 
icraper,  —  also,  clammy  mouth. 


1 .  Derangement  of  stomach,  or  bowels, 
or  both. 


124 


TEMPERAMENTS,  CONSTITUTION,  AND   SYMPTOMS. 


1 


red, 


white 
ith  fur. 


2.  State  of  tonpie  a«  above,  with  clammj 
mouth,  bitter  taste,  and  fetid  breath. 

3.  Great  load  on  tongue  an        vn,  which 
peeU  off,  leaving  the  tougui 
and  tender. 

4.  Tongue  slightly  white fron. 
pointa,  and   somctnncs  covered 
like  the  fibres  of  coarse  velvet. 

5.  Tongue  pale,  tumid,  clean,  and  very 
■nooth. 

6.  Tongue /wrrerf  and  dry. 

7.  Tongue  white  and  loaded,  with  much 
thirst. 

8.  As  above  at  first,  —  afterwards  clean, 
red,  and  dry. 

9.  Tongue  white  and  loaded,  with  dry- 
ness. 

10.  Tongue  dry,  parched,  tender,  and 
dark  brown  or  black.  Pushed  out  with 
great  difficulty  and  trembling. 

11.  Tongue  loaded  with  white,  through 
which  numerous  elongated,  very  red  pap- 
illte  protrude  their  pointo. 


2.  Acute  dyspepsia.    Asthma. 

3.  Severe  cases  of  acute  dyspepsia. 

4.  Chronic  dyspepsia.     Some  aflectioQ 
of  the  liver,  if  I'he  fur  be  yellow. 

6.  Chlorosis  or  green  sickness.    '• 

6.  Violent  local   inflammation.     Irrita- 
tion in  bowels. 

7.  Inflammatory  fever. 

8.  Protracted  inflammatory  fever. 

9.  Mild  typhus  fever. 

10.  Severer  forms  of  typhus  fever. 

11.  Scarlet  fever. 


The  Throat. 


1.  Throat  enlarged. 

2.  Violent  pdsation  of  carotid  arteries. 


S.  Pulsation  of  the  nameless  artery 
(arteria  innominata)  above  the  breast 
bone,  and  to  the  right  of  the  windpipe. 

4.  Circumscribed  swelling  about  throat 


1.  The  approach  of  pubertjr  in  females. 

2.  Acute  mania.  Inflammation  of  brain. 
Enlargement  of  heart,  and  dilation  of  right 
ventricle.    Anemia. 

S.  Regurgitation  from  aorta. 


4.  Enlargement  of  glanda. 


1.  General  enlargement  of  one  side  of 
chest 

2.  Bulging  at  the  b(  w  of  a  lung. 

3.  Bulging  at  front  upper  part  of  chest 

4.  Bulging  right  hypochondrium  (See 
Fig.  96). 

6,  Bulging  in  region  of  heart 

6.  Tumor  where  the  third  rib  joins  the 
breast  bone. 

7.  Tumor  between  the  base  of  the  shoul- 
der blade  and  the  spine. 

8.  Depression  or  retraction  of  one  side 
of  chest 

9.  Breathins  increased  in  rapidity.  Gen- 
erally, in  healui,  about  twenty  breaths  are 
taken  in  a  minute. 

10.  Breathing  diminished  in  rapidity. 


The  Chest. 

1.  Large  effusion  of  water  fW)m  pleurisy. 


2.  Water  from  pleurisy  settling  to  the 
bottom. 

3.  Emphysema. 

4.  Enlargement  of  liver. 

6.  Water  in  heart-case.    Enlargement 
of  heart 

6.  Aneurism  of  the  ascending  aorta. 

7.  Aneurism  of  the  descending  aorta. 

8.  Consumption.     Absorption  of  fluid, 
effused  by  pleurisy. 

9.  Spasmodic  asthma. 


10.  Pleurisy.  Paralysis  of  respiratory 
muscles.  Inflammation  of  lungs.  Emphy- 
sema.   Pneumothorax.     Consumption. 


.■•.AlBUlfffcjt  ^ 


ppsuk 
afiection 

1.     Irritv 
Iver. 
svep. 


'  in  females, 
ion  of  braii\. 
,tion  of  right 


■cm  pleurisy, 
tiling  to  the 

Bnlargement 
ng  aorta, 
ling  aorta, 
ion  of  fluid, 


respiratory 
gg.  Emphy- 
umption. 


■Jp^^MtJ 


TEMPERAMENTS,  CONSTITUTION.  AND   SYMPTOMS. 


125 


11.  Jerking  respiration. 

12.  Breathing  with  muscles  of  ribs  only. 


11.  Spasmoflic  asthma.     Obstruction  in 
larynx  and  windpipe. 

12.  Abdominal   inflammation.     Inflan>' 
mation  of  diaphragm. 


The  Belly. 


1.  Increased  size  of  belly. 


2,  Enlargement  in  cpigaiitrium.    Fig.  93. 
8.  Enlai^enient  in  hypogastrium.  Fig.  95. 


i.  Belly  diminished  in  size. 


bowels.     Inflam- 
Ohstruction    ia 


1.  Dropsy.    Wind  in 
mation   of  perilonuum. 
bowels.     Hysteria. 

2.  Hysteria.     Cancer  of  stomach. 

3.  Distension  of  bladder.     Ovarian  tu- 
mors.    Accumulation  of  feces  in  bowels. 

4.  Chronic  dysentery.   Letul  colic.  Aim 
in  most  chronic  diseases. 


Private  Organs. 


1.  Enlarjred  penis  in  children. 

2.  Drawing  up  of  testicles. 

3.  Enlargement  of  scrotum. 


1.  Stone  in  bladder.    Masturbation. 

2.  Stone  in  kidneys. 

3.  Hydrocele.    licmatocele.    Sarcocele. 


The  Limbs. 


1.  The  limbs  immovable. 

2.  Limbs  contracted  and  rigid. 
.1.  General  swelling  of  limbs. 
4.  Swelling  of  joints. 

6.  Limbs  diminished  in  size. 


1.  Paralysis. 

2.  Softening  of  the  brain. 

3.  Defective  circulaiion  of  blood. 

4.  Rheumatism.      Water  in  the  Joints. 
White  swelling. 

6.  Paralysis. 


The  Nervous  System. 


1.  Morbidly  increased  sensation. 

2.  Tensive  pain. 

t.  Dull,  heavy  pain. 


4.  Smarting  pain. 

6.  Shooting,  tearing  paint. 

9.  Boring  pains. 


7.  Contusive  puna. 

8.  Itching, 
lag  over  the  skin. 

9.  Exaltation  of  viaon. 


aaofutioreep- 


10.  Black  flecks  floating  bdbre  dw  ejea. 

11.  PainAiUyacnte  hearing. 

12.  Dull  hearing. 

18.  Increase  of  itrengtb. 

14.  Debilitj. 


1.  Acute  inflammation  Af  bnun  and 
spinal  marrow.    Fevers.     Hysteria. 

2.  Phlegmonous  inflammation. 

8.  Enlara-ed  internal  organs.  Internal 
ttunor.  Enunon  of  water  into  cavities 
lined  with  serous  membranes.  Felt  in  the 
loins  previous  to  discharge  from  menstrua' 
tioQ,  and  from  piles. 

4.  Scarf  skin  remoTed. 

5.  Neuralgia.     Cancer. 

6.  Constitutional  syphilis.  Bheumatiaos 
Goat    Inflammation  of  periosteum. 

7.  Bruises.     Acute  diseases. 

8.  SevenJ  diseases  of  the  skin. 

9.,  Ophthalmia.  Inflammation  of  brair- 
Some  nervous  diseases. 

10.  Afiections  of  the  brain  and  optio 
nerve.    Dyspeptna. 

11.  Inflammation  of  brain.    Hysteria. 

12.  Typhus  fever. 

18.  Delirium.     Inflammation  of  bnun. 
Mania. 

14.  Most  diseases. 


I 


till 


JJL 


26 


TEMPERAMENTS,  CONSTITUTION,  AND   SYMPTOMS. 


16.  Trembling. 


16.  Rigidity  of  upper  extremSdefl. 

17.  Cramp. 

18.  Temporary  spafm. 

19.  Pain  at  extremity  of  penis. 

20.  Pain  in  rij^ht  shoulder. 

21.  Pain  in  lefl  shoulder. 

22.  Exaltation  of  affections. 

23.  Loss  of  moral  sensibility. 


24.  Exaltation  of  intellect 


U 


15.  Cold  stage  of  fever.  Nervous  affec- 
tions. Old  age.  Action  on  the  systt-ni  of 
lead,  mercury,  strong  coffee,  alcoholic 
drink,  tobacco,  opium. 

Ifi.  Softening  of  the  brain.  Infiltration 
of  blood  into  the  brain.     Hysteria. 

17.  Pregnancy.  Hysteria.  Painters* 
colic. 

18.  In  convulsions  of  children.  Somo 
affections  of  the  brain. 

19.  Stone  in  bladder. 

20.  Congestion  of  liver.  . 

21.  Disordered  stomach. 

22.  Hypochondriasis. 

23.  Mania.  Typhus  fever.  Masturba- 
tion. 

24.  Melancholy.  Sometimes  indicates 
close  of  life. 


The  Breathing. 


1.  Stiffnes)*  of  chest    7 

2.  Pressure  upon  parts. 

8.  Obstruction  of  air-tubes. 


4.  Compression  of  lungs. 


6.  Fain  in  parts  moved  in  breathing. 

6.  Paralysis  of  muscles  of  chest 

7.  Spasm  of  muscles  of  chest 

8.  Deficiency  of  red  blood. 


1.  Cartilages  turned  to  bone.  Pleura 
hardened.     Distortion  from  rickets. 

2.  Tumors.     Dropsy  of  belly. 

3.  Spasm  of  glott<s.  Spasm  near  the 
small  ends  of  bronchial  tubes.  Mucus, 
etc.,  thrown  out  upon  the  inner  surface. 

4.  Effusions  in  pleurisy.  Water  in 
chest  Air  in  substance  of  lungs.  Aneu- 
rism and  other  tumors. 

5.  Pleurisy.  Inflammation  of  perito- 
neum. 

6.  Injury  of  spinal  marrow. 

7.  Locked  jaw.     Spasmodic  asthma. 

8.  Anaemia.  Chlorosis  or  green  sickness. 


The  Cough. 


1.  Hollow  and  barking  cough. 

2.  Sharp,  ringing  cough. 
8.  Hoarse  cough. 

4.  Wheezing  cough. 
6.  Belching  cough. 

6.  Cough  in  paroxysms. 

7.  Cough  sounding  harsh  and  concen- 
oated  when  listening  with  the  stethoscope. 

8.  Cough  sounding  hollow,  •when  listen- 
ing with  me  stethoscope,  as  though  it  came 
from  a  cavern. 

9.  Cough  having  a  metalic  or  ringing 
sound  when  listening  with  the  stethoscope. 


1.  Last  stage  of  consumption.  Chronic 
bronchitis.    Some  nervous  affections. 

2.  Croup. 

8.  Beginning  of  aold.  Chronic  laryngitis. 

4.  Asthma. 

6.  Some  diseases  of  larynx. 

6.  Hooping  cough.     Hysteria. 

7.  Consumption.  Inflammation  of  the 
lungs.  Pleurisy.  Enlargement  of  bron- 
chial tubes. 

8.  Tuberculous  cavity.  Enlarged  bron- 
chial tubes. 


1*  Scanty  expectoralion. 
t.  Copious  expectoration. 


9.  Large  taberculoua  cavily. 

The  Expectoration. 

1.  First  stage  of  acute,  diseases  of  the 
lungs. 

2.  Decline  of  acute  diseases  of  air  pas' 
sages  and  lungs. 


TEMPERAMENTS,  CONSTITUTION,  AND    SYMPTOMS. 


127 


8.  Waterjr  expectoration. 

4.  Mucous  erpectoration. 
6.  Expectoration  of  pug. 

6.  Expectorated   matter    ahaped    like 
coin  (nummular). 

7.  Muco-purulent,  floculont  expectora- 
tion. 

8.  Tubular  expectoration. 

9    Wiiitish  or  greenish  expectoration, 
that  clings  to  the  vessel. 

10.  Yellow  expectoration. 

11.  Rustv  expectoration. 

12.  Putrid  smell  of  expectoration. 

13.  Faint  and  swcetisu  smell  of  expec- 
toration. 

14.  Expectoration  smelling  like  garlics. 


3.  Beginning  of  bronchitis.     Conges- 
tion of  lungs.     VoHicular  einpiiysema. 

4.  Bronchitis.     Inllamniation  of  lungs, 
ft.  Consumption.     Third   stage  of  m- 

flammation  of  lungs. 

6.  Tubercular  consumption.    Bronchi- 
tis of  mttasles. 

7.  Consumption  far  advanced. 

8.  Plastic  bronchitis.     Pneumonia. 

9.  Acute  affections  of  lungs,  particu- 
larly bronchitis. 

10.  Chronic  bronchitis.     Other  chronic 
aiToctions  of  the  lungs  and  throat. 

11.  Inflammation  of  the  lungs. 

12.  (Jangrene  of  the  lungs. 

13.  Bronchitis.     First  stage  of  consump- 
tion. 

14.  Broncho-pleural  fistula. 


Pain. 


1.  Dull,  heavy,  aching  pain  at  the  base 
of  the  chest. 

2.  Soreni?ss  about  the  breast  bone,  and 
between  the  shoulders. 

3.  Sharp,  sudden,   tearing  pain  below 
the  nipple. 

4.  Pain  darting  from  front  part  of  chest 
to  between  shoulder  blades. 

5.  Constant  pain  between  the  shoulders. 


1.  Acute  bronchitis. 

2.  Acute  bronchitis.        '  ,        .  . 

3.  Pleurisy.  .  '  ' 

4.  Consumption. 

5.  Consumption.  Green  sickness.  Ochei 
chronic  diseases. 


The  Pulse. 


1.  Strong  pulse,  resisting   compression 
by  the  finger. 

3.  Weak  pulse,  easily  pressed  down. 


3.  Full  pulse,  as  if  the  artery  were  in- 
creased in  size. 
4   Small  pulse,  opposite  of  full. 


0.  Hard,  sharp,  contracted  pulse,  —  vi- 
brating like  a  cord  under  the  finger. 

6.  boil  pulse,  yielding  readily  to  pres- 
sure. 

7.  Frequent  pulse. 

8.  Slow  pulse. 


3.  Congestion    of    brain.       Apoplexy. 


1.  Inflammatory  affections,  especially 
of  the  substance  of  large  organs,  as  tlie 
liver,  etc. 

2.  Prostration  from  disease.  Nervous 
and  chronic  affections.  Fear.  Diseases 
of  women  and  children,  and  old  persons. 

3.  Congestion 
Disease  of  heart. 

4.  Inflammations  of  stomach,  bowels, 
bladder,  etc.  Hysteria,  and  other  nervous 
affections. 

5.  Inflammation  of  membranes.  Active 
bleeding.     Lead  colic,  etc. 

6.  Affections  characterized  by  debility. 

7.  Inflammatory  diseases.  Hemorrhages. 

8.  Apoplexy.  Sometimes  in  disease  of 
heart 


1.  Tongue  trembling  and  dry,  and  di- 
minished m  size. 

2.  Voracious  appetite. 


Relating  to  Digestion. 

1.  Typhoid  and  other  low  fevers. 


2.  Pregnancy.       Hysteria.       Insanity. 
Sometimes  in  dyspepsia. 


i 


I 


I 


3 


.  -.u 


*Attmttiim 


(li>«lil  lit  lit  u 


128 


TEMPEUAMENTS,  CONSTITUTION,  AND   SYMPTOMS. 


M''  ^ 


S.  Diminiiihed  appetite. 
4.  Increued  thint 


Thinit  gon«. 
Vomiting. 


T.  Pain  incroued  hj  preuure. 

8.  Fain  relieved  hy  pressure. 

9.  Urgent  dcsii-e  to  go  to  itooL 
iO.  Watery  Htools. 

11.  Mucous  stools,  like  white  of  egg. 

12.  Hard  and  lumpy  stools. 

IS.  Clay-colored  stools. 

14.  Yellow  or  dark-broWn  stOoUt 

15.  Dark-green  stools. 

16.  Stools  red,  and  streaked  with  blood. 

1 7.  Pitfhy  black  stools. 

18.  Stools  pure  blood,  with  nu  colic. 

1 9.  Stools  like  rice-water. 

20.  Black  stools. 

21.  Shreds  of  false  membrane  in  stools. 

22.  Fat  with  stools. 
83.  Fetid  stools. 


8.  In  most  acute  diseases. 
4.  Acute   afiections  of   stomach    and 
bowels. 

fi.  Cerebral  disease,  with  coma. 

6.  Early  pregnancy.   Colic.   Disease  of 
brain.    Innainmalion  of  stomach.    Hernia. 

7.  Inflammation  of  internal  organs. 

8.  Over-diitention  of  boivels.    Neural- 
gia.    Colic. 

9.  Dysentery.    Sometimes  in  diarrhaa. 

10.  Diarrhaa.     Cholera. 

11.  Chronic  inflammation  of  colon. 

12.  Conittipation.      Colic.      Cancer    of 
stomach. 

13.  Deficiency  of  bile. 
Too  much  bile.  « 
Bile  from  children  after  taking  cal- 


14. 
IS. 
omel. 
16. 
17. 
18. 
19. 
20. 
21. 
22. 
23. 


Dysentery. 

Melffina. 

Bleeding  piles. 

Asiatic  cholera. 

Iron  taken  in  medicine. 

Dysentery.     Diarrhoea.     Worms. 

D'abetes.     Consumption. 

Diseases  attended  by  debility. 


The  Urine. 


1  Diminished  secretion  of  urine. 

2.  Retention  of  urine  in  the  bladder. 

3.  Urine  increased  in  amount. 

4.  Red  or  yellow  sand  deposits  in  urine 
(uric  acid). 

5.  White   sediment   in    urine    (earthy 
phosphates). 

6.  Oxalate  of  lime  deposits  in  urine. 

7.  Blood  in  urine. 

8.  Albumen  in  urine. 

9.  Mucus  in  urine. 

10.  Sugar  in  nrine. 


1.  Dropsy.  Inflammatory  and  febrile 
diseases. 

2.  Paralysis.    Typhoid  fever.    Hysteria. 

3.  Diabetes.  Cold  stage  of  fevers. 
Hysteria.     Various  passions  of  the  mind. 

4.  Fevers.  Acute  iv'-eumatism.  Con- 
sumption. Dyspepsia.  Great  indulgence 
in  animal  food. 

5.  Depressed  state  of  the  nervous  sys- 
tem, of  serious  import. 

6.  Derangevaent  of  digestion. 

7.  Bleeding  of  kidneys,  etc 

8.  Bright's  v^iiiease. 

9.  Inflamed  mucous  membrane  of  ure- 
thra, bladder,  etc. 

10.  Diabetes. 


The  Perspiration. 


1.  ProAise  perspiratioB. 


3.  Diminished  perspuntioD. 

9.  Night  sweats. 

4.  Sour  smelling  sweats. 
6.  Fetid  smelling  sweat 

6.  Sweat  with  mouldy  odor. 

7.  Smelling  like  ammonia. 

8.  Sweat  having  the  odor  of  micob 

9.  Sweat  smelling  like  rottea-etone. 


1.  Acute  rheomadsnL  Decline  of  acute 
inflammations  and  fevers,  being  sometimei 
critical. 

2.  Early  st  ige  of  acute  disease.  Jitaptf. 
Diabetes. 

5.  Consumption. 

4.  Rheumatinn.     Crout 
8.  Some  debilitating  fevers. 

6.  Measles.    Scarlet  fever. 

7.  Typhoid  fever  sometinmi 

8.  Insanity. 

9.  Miliary. 


,.&n.^  :>." 


TKMI'KUAMKNTS,  CONSTITUTION,  AND    SYMl'TOMS. 


U>0 


»J 


'x'he  Temperature. 


.  (lonoral  h«at  of  «urfiico. 

.  ExtiTiwil  '(j<'al  liuat.  ^ 

,  Hot  ti)i'cluui(I.  ^ 

.  I  lilt  m'al|i. 

.  Skill  of  cliti.Ht  hot. 

.  Iliiiiils  and  li!t>t  liot 

.  Acrid  liuat,  buruinjj  tho  baud  wLuu 

ilii'd. 

.  ("hilk 

.  l,ow  tciupcrattiiv. 

.  Culd  iiuudi  auU  luet  —         ~ 


17 


1.  Fevers. 

2.  Intlainmation. 
8.  Iloatlachu. 

4.   Disease  of  brain. 
I).  Inllaiuinatioii  in  chMb 
C.  CoiiHUinptioii. 
7.  Typhus  fevtr. 

fi.  Beginning  of  fovor.  • 

n.  Poor  cirrulation. 
10.  Nervous  diseases.     Jjyspcpsia.     I, 
state  uf  tlie  blood. 


■■.     t.j.    /, 


.» I 


SKIN    DISEASES. 


The  skin  is  the  soft  and  pliant  membrane  which  covers  the  entire 
surface  of  the  body.  The  interior,  liite  the  exterior,  is  likewise  covered 
by  a  skin,  which,  from  its  always  being  moist,  is  called  a  mucous 
membrane.  At  the  various  openings  of  the  body,  the  outer  and  the 
inner  skins  are  united,  —  forming  one  continuous  skin,  —  like  the 
same  piece  of  silk  turned  over  the  border,  and  covering  both  the  out- 
side and  inside  of  a  bonnet. 

From  this  continuity  or  oneness  of  tl)e  akin  and  mucous  membrane, 
springs  an  important  medical  law,  namely,  that  a  di.'tease  of  the  skin 
may  spread  to  the  mucous  membrane,  and  a  disease  of  the  mucous 
membrane  may  spread  to  the  skin.  We  see  this  illustrated  by  the 
breaking  out  around  the  lips  which  follows  colds,  and  the  itching  of 
the  nose  of  children  when  the  mucous  membrane  of  the  bowel  is  irri- 
tated by  worms. 

Tlie  Hkia  is  Composed  of  Two  Layers.  —  These  are  separated  from 
each  other  by  the  action  of  a  blister.  The  th<n  portion  which  is 
vaised  up  bv  the  fluid  of  a  blister  is  called  the  tcirf  skin,  the  cuticle, 
or  the  epidermis ;  that  which  remains  in  connection  with  the  body  is 
the  'ensilive  skin,  the  cu/t.«,  the  derma,  or  the  true  %kin.  The  two 
skins  have  very  diiTerent  offices  to  perform.  The  scarf-skin  is  horny 
and  insensible,  and  serves  as  a  sheath  to  protect  th'e  more  sensitive 
skin  under  it.  Were  the  scarf-skin  taken  oif,  we  could  not  bear  to 
have  anything  touch  us. 

The  derma,  or  true  skin,  and  its  glands,  etc.,  are  the  seat  of  all  the 
cutaneous  diseases.  These  may  be  separated  into  four  great  divis- 
ions,-~  namely,  diseases  of  the  true  skin,  diseases  of  the  sweat  glands 
and  tubes,  diseases  of  the  oil  glands  and  tubes,  and  diseases  of  tht 
hairs  and  hair  glands. 

Then  the  diseases  of  tke  true  skin  are  divided  into 

hfiammation  of  the  tnie  skin ; 

EnUvrgemerU  of  the  papilUe  of  the  true  skin  ; 

Dis{)rders  of  the  vessels  of  the  true  slein; 

DisxYFd^rs  of  the  sensibility  of  the  true  sfein ; 

DisitrcCers  of  the  color-producing  function  of  the  true  skin. 

The  inflammation  of  the  true  skin  is  conveniently  divided  into  two 
grouptt,  —  na.^ely, 


^ 


(U 


(^ 


o 


CO 


1^1. 


w» ;'" 


SKIN  DISEASES. 


131 


Such  fts  are  marked  by  inflammation  of  the  derniix  and  mucous 
'nK'Uibrunt's,  wif/i  conslitutiofuil  symptoms  of  a  specijic  kind,  and 

Huch  !i»  ftie  distinguit<hed  by  iiiHammation  of  the  derma,  withoxU 
constitutional  s//rnptomg  of  a  specific  kind. 

Coni^^estire  Inflammation  of  the  True  Skin. 

Tlic  First  of  these  Groups,  —  t!io«e  characu'rlzrd  by  iddamnmtion 
nf  the  cutis,  wilh  consiituliondl  syruptums  of  a  sptcifn:  kind,  —  cmbrace^^ 
measles^  scarlet  fever,  varioloid,  small-pox,  and  cow-pox. 

Measles. — Rubeola. 

Mp.aples  ia  an  acnte  inflainmation  of  tiic  entire  skin,  botii  external 
and  iiiK'rnal,  at-ociiitod  with  an  infectious  and  contagious  fever. 

Jfiyniptoms.  —  The  disease  sets  in  witli  chills,  Huceeederl  by  burning 
heat,  lirttlessness,  languor,  drowsiness;  pains  in  the  head,  back,  and 
limbs;  frequent  pulse;  soreness  of  the  throat;  thirst,  nausea,  vomit- 
'i:iit,  t'retpient  dry  cough  and  high-colored  urine.  These  symptonis 
iiierearte  ill  violence  for  four  days.  On  the  third  d.ay  the  eyes  b/ecome 
inllanifd,  cannot  bear  the  light,  and  pour  fourth  a  profusion  of  tears. 
! "his  last  symptom  is  called  toryza.  The  nose  likewise  discharges  a 
lirge  quantity  of  watery  secretic/U,  ami  sni^ezing  is  fiet|uput.  The 
Jiirjnv,  windpipe,  and  bronchial  tubes  become  intlamed,  and  hortr.->«i- 
i.tsi-,  r«aroness  of  the  breast,  etc.,  are  the  result, 

TIr'  redness  of  the  skiji  and  breaking  out  appear  about  the  fourth 

day,  and  produce  heat  and  itching.     This  breaking  out  is-  eliaraoter- 

i^e4  by  n  pafchy  redness,  which,  on  close  inspection,  is  found  to  consist 

;   'ii'Uberless  minute  red  points  and  pimples,  collected  into  patches 

;ne  5vhape  of  a  half  or  quarter  moon.     Tlity  appear  first  on  the 

I  '.,-.nJ  and  front  of  the  neck,  then  upon  the  cheeks  and  around  the 

■  ■  '■  mid  mouth.     On  the  fifth  day  they  reach  their  height  in  this 

;>,  ind  then  appear  upon  the  body  and  arms,  and  on  the  sixth 

.  jf>oii  the  legs.     The  color  of  the  skin  wheo  the  inflammatioti  is 

".   Height,  is  of  a  bri-g-lU  raspberry  red.     The  decline  of  the  rash 

-  oJace  in  the  same  order  in  which  it  comes  out.     The  redness 

.  ^  i^ti  the  sixth  day  upon  the  face  ;  on  the  seventh,  upon  the  body 

•,bij;  On  the  eighth,  upon  the  backs  of  the  hands.     The  cory/a, 

rseness,  and  the  cough,  decline  about  the  seventh  day,  while  a 

!  a  comes  on  about  the  eighth  or  tenth,  —  showing  that  the  in- 

iiion  of  the  mucous  membrane  is  subsiding.     When  the  irj« 

ii.iion  disappears,  the  whole  scarf-akin  peels  off  in  the  forr-  -•'f  a 

,  .^uurf.     The  artist  has  given  a  good  picture  of  the  disease  in  the 

-lUfiUly  colored  lithograph,  Plate  I,  Fig.  1.     This  plate  is  admi- 

■    -  done. 

•^i-wHtHieilt  —  When  the  disease  is  mild  and  regular  in  its  cor.se, 

v   anything  will  be  required,  except  mild  diet,  slightly  acid 

,  i^ith  fiiX-seed  tea,  slippery  elm,  or  some  equivalent,  to  quiet 

4<ugh.     Sponging  with  tepid  water,  if  done  with  frequency,  mod. 


m\ 


^ME;,^V:i>m0jliiMm^Smmr;ixm>,.-.- 


Ah 


Pi 

CO 


■m'- 


...1 


^^rfn 


SKIN  DISEASES. 


131 


Such  as  are  marked  by  inflammation  of  the  derma  and  mucous 
membranes,  with  constitutional  symptoms  of  a  specific  kind,  and 

Such  as  are  distinguished  by  inflammation  of  the  derma,  without 
constitutional  symptoms  of  a  specific  kind. 

Congestiye  Inflammation  of  the  True  Skin. 

The  First  of  these  Groups,  —  those  characterized  by  inflammation 
of  the  cutis,  with  constitutional  symptoms  of  a  specific  kind, — embraces 
measles,  scarlet  fever,  varioloid,  small-pox,  and  cow-pox. 

Measles. — Rubeola. 

Measles  is  an  acute  inflammation  of  the  entire  skin,  both  external 
and  internal,  associated  with  an  infectious  and  contagious  fever. 

Symptoms.  —  The  disease  sets  in  with  chills,  succeeded  by  burning 
heat,  listlessness,  languor,  drowsiness;  pains  in  the  head,  back,  and 
limbs ;  frequent  pulse ;  soreness  of  the  throat ;  thirst,  nausea,  vomit- 
ing, frequent  dry  cough  and  high-colored  urine.  These  symptoms 
increase  in  violence  for  four  days.  On  the  third  day  the  eyes  become 
inflamed,  cannot  bear  the  light,  and  pour  fourth  a  profusion  of  tears. 
This  last  syntiptom  is  called  coryza.  The  nose  likewise  discharges  a 
large  quantity  of  watery  secretion,  and  sneezing  is  frequent.  The 
larynx,  windpipe,  and  bronchial  tubes  become  inflamed,  and  hoarse- 
ness, soreness  of  the  breast,  etc.,  are  the  result. 

The  redness  of  the  skin  and  breaking  out  appear  about  the  fourth 
day,  and  produce  heat  and  itching.  This  breaking  out  is  character- 
ized by  a  patchy  redness,  which,  on  close  inspection,  is  found  to  consia' 
of  numberless  minute  red  points  and  pimples,  collected  into  patches 
in  the  shape  of  a  half  or  quarter  moon.  They  appear  first  on  the 
forehead  and  front  of  the  neck,  then  upon  the  cheeks  and  around  the 
nose  and  mouth.  On  the  fifth  day  they  reach  their  height  in  this 
region,  and  then  appear  upon  the  body  and  arras,  and  on  the  sixth 
day,  upon  the  legs.  The  color  of  the  skin  when  the  inflammation  is 
at  its  height,  is  of  a  bright  raspberry  red.  The  decline  of  the  rash 
takes  place  in  the  same  order  in  which  it  comes  out.  The  redness 
fades  on  the  sixth  day  upon  the  face  ;  on  the  seventh,  upon  the  body 
and  limbs ;  on  the  eighth,  upon  the  backs  of  the  hands.  The  coryza, 
the  hoarseness,  and  the  cough,  decline  about  the  seventh  day,  while  a 
diarrhoea  comes  on  about  the  eighth  or  tenth,  —  showing  that  the  iii' 
flammation  of  the  mucous  membrane  is  subsiding.  When  the  in> 
flammatioii  disappears,  the  whole  scarf-skin  peels  on  in  the  form  of  a 
tcaly  scurf.  The  artist  has  given  a  good  picture  of  the  disease  in  the 
beautifully  colored  lithograph,  Plate  I,  Fig.  1.  This  plate  la  admi< 
rably  done. 

Treatment.  —  When  the  disease  is  mild  and  regular  in  its  cox'.se, 
scarcely  anything  will  be  required,  except  mild  diet,  slightly  acid 
drinks,  with  flax-seed  tea,  slippery  elm,  or  some  equivalent,  to  quiet 
the  cough.     Sponging  with  tepid  water,  if  done  with  frequency,  mod. 


'    Mi 


I    if 

a 


;  l; 


tl 


A^i^i^^'.i'- .. 


132 


SKIN  DISEASES. 


crates  the  fever,  and  adds  to  the  comfort  of  the  patient.  If  the  fever 
runs  high,  take  half  an  ounce  of  rochelle  salt,  and  use  recipe  51. 
Should  the  eruption  "  strike  in,"  apply  leeches  or  cups,  over  the  inter- 
nal organ  affected,  if  any,  and  recall  the  rash  by  a  mustard  bath. 

Those  who  have  been  <\posed  to  the  contagion,  and  are  liable  to 
have  the  disease,  should  *  oid  all  unnecessary  exposure  to  wet  or 
cold,  —  keeping  the  feet  warm  and  dry,  and  the  whole  body  well  clad. 
With  these  precautions,  and  a  mild,  unstimulating  diet,  much  of  the 
force  of  the  disease  may  be  broken. 

During  the  first  stages  of  the  disease,  batiiing  the  feet  once  or  twice 
a  day  with  hot  water,  and  freely  using  warm,  sweating  drinks,  as 
saffron,  summer-savory,  pennyroyal,  balm,  and  mullein  tea,  and  put- 
ting mustard  drafts  to  the  feet,  will  hasten  the  coming  out  of  the 
eruption. 

Should  the  breaking  out  be  delayed  by  excessive  fever,  give  full 
doses  of  tincture  of  veratrum  viride,  or  nauseating  doses  of  ipecac, 
antimony,  lobelia,  or  hive-syrup,^  and  teaspoonful  doses  of  compound 
tincture  of  Virginia  snake-root. 

Beside  the  milder  forms  of  the  disease,  cases  occur,  chiefly  in  broken- 
down  constitutions,  in  ^  l)ich  the  rash  delays  its  coming  out  till  the 
seventh  day,  and  is  tlun  nangled  with  dark  and  livid  spots,  whicii 
remain,  often,  for  ten  or  twelve  days.  The  fever  is  of  a  low,  typhoid 
kind,  and  the  patient  is  extremely  weak  and  languid. 

In  this  condition  of  things,  the  patient  must  be  supported  by  tonics 
(49),  and  stimulants  (134),  and  expectoration  promoted  by  some  ap- 
propriate remedy  (106),  (J24). 

If  at  any  stage  of  the  disease,  there  should  be  fixed  pain  in  any 
part  of  the  chesty  which  is  made  worse  by  coughing,  or  by  taking  a  full 
breath,  we  may  conclude  there  is  some  inflammation  of  the  chest; 
and  it  must  be  treated  as  directed  for  pneumonia. 

Scarlet  Feyei.  — Scarlatina. 

This  is  likewise  an  acute  inflammation  of  the  entire  covering  of 
the  body,  both  external  and  internal,  connected  with  fever  which  is 
infectious  and  contagious. 

Symptoms.  —  The  fever  comes  on  somewhere  between  the  second 
and  tenth  day  after  exposure.  On  the  second  day  of  the  fever,  the 
eruption  comes  out  in  the  form  of  very  small  points  and  pimples, 
which  appear  either  in  patches,  or  constitute  a  general  redness,  of  a 
bright  scarlet  color.  In  Plate  I,  Fig.  2,  the  artist  has  given  a  fine 
picture  of  the  disease. 

The  disease  begins  with  languor,  pains  in  the  head,  back,  and  limbs, 
with  drowsiness,  nausea,  and  chiUs ;  and  these  are  followed  by  heat, 
thirst,  etc.  When  the  redness  appears,  the  pulse  is  quick,  and  the 
pa.'ent  is  anxious,  restless,  and  sometimes  delirious.  The  eyes  are 
red,  the  face  swollen,  the  tongue  covered  in  the  middle  with  white 
mucus,  and  is  studded  with  elevated  points  of  extreme  redness. 
The  tonsils  are  swelled,  and  the  throat  red.     The  greatest  degree  of 


-  —'■  i./->«t«?*Sat 


SKIN  DISEASES. 


133 


Fio.  72. 


redness  is  reached  on  the  evening  of  the  third  or  fourth  day  from  its 
beginning,  wlicn  a  gentle  moisture  appears,  the  disease  begins  to 
decline,  with  itching,  and  the  scarf-skin  falls  off  in  branny  scales. 

A  swelling  or  putfiness  of  the  flesh,  which  spreads  out  the  lingers 
in  a  singular  manner,  seems  to  be  peculiar  to  scarlet  fever. 

In  the  first  stage  of  the  complaint,  the  tongue,  as  stated  above,  is 
covered  with  a  fur ;  but  as  it  advances,  the  tongue  often  becomes 
suddenly  clean,  and  presents  a  glossy,  fiery-red  surface,  which  is 
rtometimes,  with  the  whole  lining  of  the  mouth,  raw  and  tender. 

is  peculiar  in  this  complaint,  that  the  inflammation  of  the  throat 
almost  always  runs  into  a  state  of  ulceration.  As  far  as  can  be  seen, 
on  pressing  down  the  tongue,  the  throat  is  swollen  and  of  a  deep, 
florid  red;  and  on  the  tonsils  may  be  seen  white  or  gray  ulcers.  This 
makes  swallowing  very  diflicult,  and  aggravates  the  sufferings  of  the 
patient.  The  great  amount  of  mucus  in  these  parts  causes  also  a 
continual  rattling  in  the  throat. 

The  eustachian  tube,  which  extends  up  to  the  ear,  is  apt  to  get 
involved  in  the  inflammation,  and  cause  swelling  and  pain  in  that 

region.  The  glands  under  the  ear  and  jaw 
sometimes  inflame,  and  after  a  time,  they  oc- 
casionally break.  Abscesses  formed  in  the 
ear,  frequently  produce  some  deafness  which 
is  not  easily  cured. 

In  the  cell-dropsy,  which  sometimes  appears 
after  scarlet  fever,  the  crystals  of  urate  of 
ammonia  may  often  be  found  in  the  urine 
with  the  microscope  (Fig.  72). 

This  disease  resembles  measles;  but  may 
be  distinguished  from  it  by  the  absence  of 
cough  ;  by  the  eruption  being  finer,  and  of  a 
more  scarlet  color  (see  plate) ;  by  the  rash  coming  out  on  the  second 
day  instead  of  il.e  fourth;  and  by  the  ulceration  in  the  throat 

Treatment. —  In  ordinary  cases,  the  treatment  should  be  very  simple. 
The  apartment  should  be  kept  cool,  and  the  bed-covering  light.  The 
whole  body  should  be  sponged  with  cool  water  as  often  as  it  is  hot  and 
dry,  and  the  patient  be  permitted  to  take  cooling  drinks.  Beside  this, 
in  many  cases,  very  little  is  needed,  except  to  give  a  few  drops  of  the 
tincture  of  belladonna,  night  and  morning. 

In  some  cases  where  there  is  a  good  deal  of  fever  and  soreness  of 
throat,  give  tincture  of  veratrum  (124)  often  enough  to  keep  down  the 
pulse.  It  would  be  well  also  to  begin  the  treatment  of  such  cases 
with  an  emetic,  (1)  (4)  (2).  In  addition  to  this,  the  feet  and  hands 
should  be  soaked  in  hot  water,  with  a  littlu  ground  mustard,  or  pul- 
verized cayenne,  stirred  in.  This  bath  should  be  continued  twenty 
minutes,  twice  a  day,  for  two  or  three  days. 

The  cold  stage  having  passed,  and  the  fever  set  in,  warm  water  may 
be  used  without  the  mustard,  etc.  If  the  head  be  afl'ected,  put  mus- 
tard draftti  upon  the  feet.  Should  the  bowels  be  costive,  they  may  be 
gently  opened  by  some  very  mild  physic. 


'- !l 


-;^ 


No  solid  food  should  be  allowed ;  but  after  the  first  shock  of  the 
disease  is  passed,  drinks,  in  reasonable  quantities,  will  be  advisable, — 
such  as  cold  water,  lemonade,  barberry  and  tamarind  water,  rice 
water,  balm  or  ilax-seed  tea,  and  some  thin  water  gruel. 

To  promote  the  action  of  the  skin,  the  spirits  of  nitre,  with  other 
articles  (125),  adapting  the  dose  to  a  child,  will  be  found  useful.  The 
nitrate  of  potash  is  useful,  given  in  one  to  three-grain  doses,  dissolved 
in  water,  every  three  or  four  hours.  i 

Tiie  muriatic  acid,  forty-five  drops  in  a  tumbler  filled  with  water, 
and  sweetened,  and  given  to  a  child  in  teaspoonful  doses,  is  a  good 
remedy 

In  very  violent  attacks,  the  system  sometimes  inclines  to  sink  im- 
mediately; typhoid  symptoms  show  themselves  ;  there  is  great  pros- 
tration ;  the  eruption  strikes  in;  the  skin  changes  to  a  purple  or 
mahogany  color;  the  tongue  is  of  a  deep  red,  or  has  a  dark-brown 
fur  upon  it,  and  the  ulcers  in  the  throat  become  putrid.  This  is  called 
scarlatina  maligna ;  but  it  is  only  a  sevt-rer  form  of  the  same  disease. 

The  treatment  of  this  form  must  be  dill'erent  from  that  recom- 
mended above.  It  must  be  tonic,  tiuinia  (Go)  must  be  freely  given. 
Wine  whey,  mixed  with  toast  water,  will  be  useful.  Tincture  of 
cayenne,  in  sweetened  water,  may  be  given  often  in  small  doses. 
Ammonia  (135)  may  likewise  be  given  as  a  stimulus.  Gargles  (245) 
(244)  (243)  are  also  required. 

A  dropsical  afi'ecticn  is  one  of  the  most  frequent  results  of  scarlet 
fever.  It  is  believed  that  this  seldom  occurs,  if  the  warm  bath  is 
daily  used,  as  soon  as  the  skin  begins  to  peel  off.  After  the  dropsy 
has  set  in,  give  the  warm  bath  twice  a  week,  and  encourage  perspira- 
tion by  the  compound  tincture  of  Virginia  snake-root,  and  similar 
articles.  The  child  should  have  a  generous  diet,  at  the  same  time,  to 
bring  up  its  strength. 

Small-Pox.—  Variola. 

Tins  is  another  d'sease  characterized  by  acute  inflammation  of  the 
entire  skin,  both  external  and  internal,  connected  with  infectious  and 
contagious  fever.  The  eruption  has  the  form  of  red  points,  which 
Kjon  become  pimples,  then  vesicles,  then  flattened  and  scooped-out 
vesicles,  then  pustules,  and  finally  hard  brown  scabs.  These  last  fall 
oft"  from  the  eleventh  to  the  twenty-fifth  day,  and  leave  behind  them 
small  pits  and  scars.  The  fever  is  remittent,  and  precedes  the  eru|>- 
tion  some  three  or  fou"^  lays,  —  ceasing  when  the  eruption  is  devel- 
oped, and  returning  wlien  it  has  reached  its  height.  The  period 
between  exposure  and  the  attack  of  the  disease,  called  incubation,  is 
from  five  or  six  to  twenty  days, — being  short  in  the  severe  cases,  and 
longer  in  the  milder  ones. 

Symptoms.  —  The  disease  begins  with  languor  ana  lassitude,  with 
shivering,  and  p^ins  in  the  head  and  loins ;  with  hot  skin,  and  quick- 
ened pulse  and  breathing;  with  thirst,  loss  of  appetite,  and  furred 
tongue ;  with  nausea,  vomiting,  constipation,  restlessness,  and  uni- 


SMALL  POX 


Pie 


^^ 


§  0 


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r.^:" 


/■^flai/     2¥<lmj  .i'Mu/     j'hfaif       S^day        /4Mty       /7'M'i/ 


**,iai/  6'J'daff 


Sip  (it  11/ 


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'•mmKmijfB 


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BKIN  UTSF.ASKS. 


No  f«<)li(l  food  Hliould  b<'  nlU»w«>d;  bat  aft«  i 
discHMf  ij<  ]>at<HC(.l,  drinks,  ill  r«nu«»iial>!<!  (|uniii.iti  -  •-• 
hiii'li    an   fold   watrr,   IcnioiiiiiK',  L»ttrtwrry  i»ii;J    ' 
wutrr,  >»;iliii  or  /iaX-MT-d  ft  a,  uiid  .■»oiiiir  ihin  wtitt  • 

To  |>roiMofo  111*;  ndion  <»f  llii*  nkin,  th»^  ««piv" 
Hrticlt':!  (125),  adapting 'h«  dew;  to  a  child,  will  ;/. 
iiifruK*  of  }>«>ii!r^h  is  ust-ful,  glvrn  in  on«*  t«»  rhrer-Mi  i 
111  wiiUr,  I'vtTV  thr<  f  or  four  lioiirs. 

'l':ii*  ninriuiiu  urid.  forty-five  drops  in  u  iuiiij>M  • 
Toid  MW«'cl<'tied,  and  given  to  a  ciiild  in  tt'vi-<|>«iyjifi 
reiriiily 

ill  very  violent  Httarkx,  the  nystem  soinctinn  * 
•ncdiarely;  ty|>lioi<l  nymptoins  show  tlieiJi«<'lvc 
tr»»ion  ;  Tiie  eruption   strikes  in  ;   li)''   s*'-.!!!   th- 
Muihogiiny  cvtiof ;  the  tongue  is  of  u  deej»  ti-d. 
fur  U}M)n  it,  and  the  uleers  in  the  throat  Itts -oine  pw*' 
searlntina  maligna  ;  but  it  is  «>i»ly  u  m-v* 

'l"!ie  treaiuiont  of  \U'i»   form   iiiii-l   I" 
mended  ntwve.     It  must  l>e  tuiiic.     (.iuijii a  • 
Wine  whey,  mixed  •-vith  loatt  wuier,  wiii    .»: 
OHyeiwji',.  ui   sweeteueil   W!t!er,  inuv   he   given    ••■ 
Aiitrnonia  (KV))  niny  likewise  tn;  given  au  a  vii' 
(2U)  ('4\'3)  iue  nlr-o  reejuired. 

A  droDHical  ntii-e'ion  i.s  oii»;  of  the  raost  fr^^  ; 
fever.      It  i»  belle.vtd  that  thi.-*  seldom  ti^vriiiv,  it  ' 
daily  nscd,  bh  ?(0(H1  as  thu  cikin  begins  to  pvi  o*' 
hii.'<  .ser.  in,  give  the  warm  bath  twiec  a  week,  -w 
fion  by  the  compound  tincture  of  Virgiioi   ^i      » 
artie.lt  !<.     Tht.  •  luld  should  have  a  gei'irouA  ili*   ,  ^ 
i»ririg  i»p  its  Htrength. 

Small-Pox. -~  Fmriofri. 


fwgnssof 
Small  Pox 


J>    / 


Tmm  irt  another  disrasR  characterized  by  «i;\ji- 
entire  -kin,  both  extf-nial  and  internal,  eoiiite- ;.  « 
coidaj^ioiis  fever.     The  eruption  hart  the  loc.i  .. 
(•uon  become  pim}>les,  then  "efiidea,  then  llatt-  , 
vosieles,  then  pustule.-,  and  fim.jly  hard  HroM'M    ■ 
oH  from  th<!  elevenili  to  the  twenty-liflh  day,  h>; 
small  pitH  and  s«',ars.     The  fever  is  remitt4Mit,  a'Ji'J 
tion  scmic  three  or  t'our  days,  —  cert-'  g  wh«'n  \it*^ 
oped,  and  returning  when   it  has       ached  iix  H*' 
t»etween  exposure  and  the  attack  of  the  dt^'n-ie.  < 
from  five  or  six  to  twenty  daya,  —  being  r^h  r^  ...  m 
longer  in  the  milder  ones. 


ttpgmspf 
\mlpul 


rt'»*ijMd<,».  V.  i;. 
kJH,  and  quu  k 


Syinptoim.  —  The  disease  begins  with  lungoor  ni.< 
hhivering,  and  pains  in  Jhe  head  and  loiu,;^ ;  .with  hoi  .• 
i'i»4-d  pulse  and  breathing;  with  tliiist,  k>s«  of  appetite,  nnd  iurrf-n 
t*»uyne  ;   with  nausea,  vomiting,  CM>ns«ipation,  resUesane*!,  aiMi  iW"' 

^    _. ,^,  _, ,    ,,^,_^ 


SMALL  POX 


4  * 


^ 


.7  ^'^     *!: 


,.#; 


P1.2 


Dogma  of 
Small  Ii)x 


•  9  «  0  @ 


/My     2¥(iay  .i'Mm/     ^^daif       S*^y        mdny       /7'Miij 


yoriolput 


fi^day     21'*day  J^^day       4?day  S^day 


/O'i'day 


^msvf 


t 


^'i'day  dfjtday 


P^dny 


K^l 


^ 


8K1N  DISKASKS. 


l\i!i 


vcrsal  prostrntion.  To  these  Bymptoms  somctimos  Hucrofd,  diincult 
breathing,  cuugh,  drowMiii*>!4<i,  aiul  cvoii  inHnnibiiity.  The  toiiguo, 
white  at  firHt,  soon  b<'<'i)iiu'«  rrtl  nt  the  point,  und  over  the  whole 
KiirfiUM*.  The  fever  iq  highest  during  the  night.  The  con.stitutionul 
Hyrnptoms  are  more  vioh-nt  juHt  before  the  eruption,  but  innuediiitely 
HubsiUe,  and  soon  dinappear,  when  the  breaking  out  in  CHtubhttheu. 
The  eruption  i»  at  firat  in  tiie  shape  of  ninall  red  points,  whieh  are 
bard  to  the  toueh,  and  Hhaped  like  u  cone,  and  are  proportionate  in 
number  to  the  subflequent  puHtules.  In  Pi.atk  H,  the  artist  has  well 
exhibited  the  developed  disease,  as  well  as  the  progret«s  of  the  erup- 
tion  from  day  to  day. 

TreMtmeut.  —  Like  the  two  preceding  diseases,  the  ordinary,  un- 
complicated form  of  this  requires  only  the  most  simple  treatment 
Not  much  is  wanted,  except  confinement  in  bed,  cooling  drinks,  cool 
and  even  temperature,  frequent  change  of  linen,  and  sponging  the 
body  with  cool  water.  But  when  what  is  calh-d  the  fever  of  invasion 
is  pa-'t,  and  the  eruption  i»  fulli/ developed,  aud  has  brought  along  with 
it  the  secondary  fever,  then  some  recipe,  as  131,  (124)  (12''))  will  be 
in  place,  and  some  gentle  laxative  to  keep  the  bowels  open  (8), — also 
gentle  injections,  (249)  and  opiates  to  relieve  sleeplessness  and  ner- 
vous symptoms. 

Should  the  system,  at  this  period,  appear  to  bo  sinking,  a  more 
generous  diet,  and  a  little  wine  may  be  allowed.  If  the  brain  sutlers, 
apply  leeches  to  the  mucous  membrane  of  the  nose,  or  behind  the  ears, 
and  put  the  feet  in  a  mustard  bath  (242).  If  the  breaking  out  appear 
with  difficulty,  put  the  patient  into  a  warm  bath,  and  tartrate  of  anti- 
mony, (104)  or  Dovers  powders  may  be  employed.  Gargles  will 
frequently  be  needed  for  the  inflammation,  and  dryness  of  the  mouth 
and  throat  (243).  Cold  sponging  may  be  considered  as  highly  bene- 
ficial, in  both  the  primary  and  secondary  fever.  The  belladonna  like- 
wise is  a  useful  remedy,  used  in  the  same  way  as  in  scarlet  fever. 
The  plaster  288,  applied  to  the  face,  will,  it  is  said,  arrest  the  formation 
of  maLt^r,  and  prevent  the  unsightly  scars  which  so  often  cover  the  face 
of  per:u>nB  who  have  suffered  from  small-pox.  Paint  the  face  once  or 
tvice  a  day  with  glycerine,  which  will  effectually  prevent  pitting. 

Varioloid. — Varicella. 

Varioloid,  or  modified  small-pox,  begins  with  symptoms  similar 
to  those  of  small-pox,  but  much  milder  in  degree.  These  symptoms 
are  feverishness,  nausea,  vomiting,  pains  in  the  loins  and  head,  and  a 
quickened  pulse.  The  eruption  comes  out  on  the  third  or  fourth  day, 
and  looks  like  that  of  small-pox.  It  reaches  its  height  the  fourth  or 
fifth  day,  and  then  declines  without  any  secondary  fever.  The  pus- 
tules dry  up  and  form  brown  scabs  which  fall  off  in  a  few  days,  and 
leave  slight  pits,  and  a  few  red  or  purple  spots. 

Varicella  appears  under  a  variety  of  forms,  called  "  hives,"  "  swine- 
pox," "chicken-pox,"  «  horn-pox,"  etc.  But  they  all  have  a  family 
likeness,  and  need  not  be  described.  The  treatment  of  all  these  forms 
must  be  conducted  on  the  same  principles  with  small-pox.    Sponging 


the  nkin  in  nil  thrne  iiillnmrnntory  coiidttioiin  has  the  happiest  efTcct, 
and  should  seldom  be  omitted. 

Cow-Pox. — Vaccina. 

This  disenso  exists  to  some  extent  among  lower  animals,  and  is 
identical  with  smnll-pox  in  man.  The  immortal  Jcmier  taught  the 
world  that  the  pus,  taken  from  the  cow  haviiig  this  disease,  and  intro* 
dueed  under  the  skin  of  man,  would  produce  an  eruption  sirtiilar  to 
that  of  small-pox,  and  that  this  would  protect  the  systt^m  from  thi^ 
latter  diHcase.  This  was  an  immensely  important  discovery,  and  will 
render  the  name  of  Jcnner  famous  through  all  time. 

It  is  a  question  of  great  importance  how  far  vaccination,  or  inocu- 
lation  with  the  matter  of  cow-pox,  does,  in  fact,  protect  the  system 
from  small-pox.  That  it  is  a  protection,  to  a  certain  extent,  is  doubted 
by  none.  That  in  some  instances  it  protects  through  life,  is  likewise 
generally  admitted.  Is  it  a  protection  in  all  cases,  and  through  the 
whole  life  ?  Perhaps  not,  tfiough  this  is  a  disputed  point.  Proba- 
bly the  mild  form  of  the  vaccine  disease  does  not  impress  the  system 
powerfully  enough  to  lust  more  than  a  certain  number  of  years.  Most 
thinking  physicians  now  believe  it  is  wise  to  revaccinate  occasionally, 
to  make  sure  of  the  protection.  It  is  done  with  little  trouble,  and 
may  save  a  terrible  infliction.  Plate  II,  Fig.  4,  gives  a  good  idea 
of  the  appearance  and  progress  of  the  eruption. 

Tlie  Second  Group  of  diseases,  characterized  by  inflammation  of 
the  true  skin,  without  constitutional  symptoms  of  a  specific  kind,  are 
Erysipelas,  Nettie-Rash,  False-Measles,  and  Inflammatory  Blush. 

Erysipe'las.  —St.  Anthony's  Fire. 

Erysipelas  is  a  diffused  inflammation  of  the  skiu,  affecting  only  a 
part  of  the  surface  of  the  body,  and  is  accompanied  by  a  fever,  which 
is  generally  thought  to  be  infectious  and  contagious.  The  local  in- 
flammation is  disposed  to  spread ;  it  extends  deep,  and  is  attended 
by  swelling,  a  tingling,  burning,  and  pungent  heat,  and  by  a  redness, 
which  disappears  when  the  skin  is  pressed  by  the  finger,  and  returns 
on  remitting  the  pressure. 

Syniptonis.  —  The  constitutior  ptoms  are  chilliness  and  shak- 

ing, succeeded  by  heat ;  low  spirits,  lassitude,  pains  in  the 

back  and  limbs,  pains  in  '  quick  and  hard  pulse,  thirst,  loss 

of  appetite,  white  and  (  jngue,  bitterness  of  mouth,  nausea, 

vomiting,  pain  in  stomaci         u  costiveness. 

These  symptoms  go  before  the  local  inflammation  several  days; 
they  increase  with  the  redness  of  the  skin,  and  disappear  upon  its 
decline.  The  nervous  system  is  sometimes  severely  affected,  and 
indicated  by  low,  muttering  delirium.  At  the  close  of  the  inflam- 
mation there  is  generally  a  relaxation  of  the  bowels,  and  the  scarf- 
skin  peels  off.  Sometimes  matter  forms  under  the  skin,  and  occa- 
sionally mortification  occurs.     The  face  is  the  most  frequent  seat  of 


EBY31PELA.) 


?13 


Furf 


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-^  -^nf 


S-w  '-'7.   - 


'■i-fe-V 


i;^  %2 


/ 


-^•■-^--'•— ^^^^ 


lae 


errr.-.r'juss 


*>«\i»  DISKASB8. 


thi<  skiii  in  a'f  Mif«it»  T  ■  '.>rY  <'onditjon9  has  the  happiest  titticy 


:.-j 


liivw  - 1^0  X . — T^ttiv^iw^i. 


'^1 


vm 


R.:- 


;.! 


T»r«  di.HPrtM.  f-,'«:ft  t<i  Rorno  n?,tr'rit  among  Iow'T  animals,  aii4  is 
it^riitip^l  with -n  -jJiXT  in  nifin.  'l'l)t;  ininiortiil  J<Minf  f  taught  l*:- 
%'oriil  that  tht-  i-  nkm  frotu  the  r^)W  hnviii>T  this  disease,  and  inrr»- 
duffd  nnder  li  '  '"km  of  Diaii,  woui<l  produce  an  erujHion  himilar  *■■> 
that  of  Hniul'-f'»«,  and  thnt  this  would  prot'Jct  tho  syateni  from  ilv 
latter  di;«'a-'<  This  was  mt  iiiipictis^^ilv  important  diticovery,  and  v  i, 
render  tJjn  !i»*>k'.^  of  Jcnnrr  famouM  thnKisrh  hU  time. 

It  in,  y  m<sf;on  of  gn?at  irnf>ortm>»>'  how  far  vaccination,  or  ino«,u- 
lation  w'«n  tfe*  niitter  of  oo\*-{v>x,  <i^   -^  in  fact,  protect  the  »YPtt!i« 

from  »»ipt'.i**p».ix.    Thai  it  i«  -i  j>r*xi<j»;ti toacTtanv  extent,  is  doubt«><i 

by  n"'         ^"'  '  •'»  ■'!"!>•'   M»  l»^An-  >'♦  rm»te<l*i  through  life,  ks  liive\vii<»» 
]S^'?  •   •  1  in  aU  ca»v^,  and  through  \tf 

vvi;  .  -  •     s  if*  it  ditpuiefl  point.     Prub>»» 

iHv  . '.  ,ise  doi'5".  not  impress  the  systcn* 

jMv  i>o  Hwrf.Hui  iimTjfcter  of  years.    Most 

thi  '        A  i£  \B  wis?  to  rf-vacfjiriiite  otf'asionallY, 

Ut    .  .1  ►ii.     It  IS  done  with  Ittdo  trouble,  and 

rnay  k  ion.     Platk  il,  Fig.  4,  gi^es  a  good  ide* 

of  th^  au,a  ,iiJi.,xi  .iwi  pi  ogress  of  the  eruptu'n. 

Xhe  !!K*f©liil  <)lroU{t  of  diseases,  chamoteri/od  by  iidlamniatiou  ot 
the  tr;ic  akin,  vnfhoul  const itvtmntii  si/mpfoins  of'  a  .yiecijlc  Idiul,  are 
Erysipelatt,  Nettit!>Raah,  Faise-Measiei^,  and  Ldlaminutory  IJlush. 

Kryajpelfts. — St  Anthonys  Fire. 

Ervp'p?:uak  i-x  a  diflTose^  fnflamrnatioi)  of  the  skin,  aflPectin/?  only  a 
pjujl  i-f  *h<^  «jn-face  of  the  bmly,  and  is  a'Hompanied  by  a  fever,  whieh 
w  (i»p;ie»  (Hy  liwinjj^ht  lo  be  infoctiou*  and  contagious.  Tlie  local  in* 
tlixrnrnatjetj  it*  disposed  to  -•pread  :  it  ext*?nd>'.  deep,. and  is  attended 
&y  MWtillfiig,  a  tnigling,  bnruinijf,  and  pungent  heat,  v^xmS.  by  a  redness 
whi^^h  disappears  wlien  the  »kin  is  pres8(."d  by  the  fujger,  and  return* 
c»fi  jenjitting  the  pressure. 

>»\  I  iptoms,  —  The  eonstiUitioiiul  symptoros  ar>j  ohidiuesa  and  sliuk- 
iog,  Niieeeetled  l>y  heat;  lowiifsg  ot  spirit*,  la.«;titTide,  pains  in  the 
back  and  Hrobs,  pains  in  the  head,  quick  and  har(i  pu!!»e,  thirst.,  loan 
of  appetite,  whitt;  and  coated  tongue.  bitteriM-.s.^  of  mouth,  nauseji, 
votaitsng,  pain  in  stomach,  and  costiveness. 

Tbei-e  symjitoms  go  before  th(!  local  innammaiicn  sever;il  days; 
they  increase  with  the  redness  of  the  ekin,  and  disappear  viporj  ii» 
«i«s)'line.  The  nervous  Hy»t<.MTi  is  liotaetimen  severt'iy  nti'ccted,  and 
■  :  I'.-'.l  by  low,  muttering  delirium.  At  the  ikwe  of  the  inflam- 
,u  i  t'horcis  generuily  a  relaxatitni  of  the  bowels,  and  the  searf- 
altui  pp«fl«  otr,  .  BometinuH  uiatter  formic  under  tho  skin,  and  v-ccu- 
.!•-.''  ■  "u-vtiheation  occurs.     Tho  face  is  the  nuwt  frequent  seat  of 


ti 


V  if-f-;-^; 


ERYSIPELAS 


P1.3. 


■  i:r,> 


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« 


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^^dm 


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SKIN  DISEASES. 


137 


the  disease.  It  commonly  begins  on  one  side  of  the  nose,  and  «ooii 
spreads  over  one  side  of  the  face,  closing  up  the  eye,  and  changing 
the  features  in  a  shocking  manner.     See  Plate  III,  Fig.  1. 

Somewhere  about  the  third,  fourth,  or  fifth  day,  very  minute  blisters 
appear  on  the  inflamed  parts,  filled  with  water,  which  increases  until 
the  blisters  break  and  let  it  out.  The  disease  comes  to  a  head  on  the 
eighth  or  ninth  day,  when  the  blistered  parts  dry,  and  the  skin  begin? 
to  peel  off. 

Treatment. —  In  the  treatment  two  things  are  to  be  done,  —  to  sub- 
due the  fever,  and  the  local  inflammation.  The  fever  is  assuaged  by 
rest,  mild  diet,  gentle  laxatives,  (26)  (21),  etc.;  and  by  the  use  of 
tincture  of  veratrum.  For  the  local  inflammation,  various  things  have 
been  advised,  but  nitrate  of  silver,  on  the  whole,  has  the  preference. 
First  wash  the  inflamed  part  with  soap  and  water  to  remove  any 
oily  substance,  and  wipe  the  skin  dry.  Then  moisten  the  inflamed 
and  surrounding  p!..in,  and  pass  over  it  a  stick  of  nitrate  of  silver, 
touching  not  only  the  inflamed  part,  but  going  even  an  inch  beyond 
it  on  all  sides.  Or,  a  solution  of  nitrate  of  silver  and  nitric  acid,  (214) 
will  in  many  cases,  according  to  Dr.  Higginbottom,  do  even  better. 
A  solution  of  coperas  (215)  is  a  good  application.     So  is  303. 

In  mild  cases,  flour  may  be  dusted  on  the  inflamed  part  from  tin* 
dredging-box.  Warm  fomentations  are  also  useful,  and  cloths  wet 
with  water,  and  laid  on.  A  solution  of  per.  chloride  of  iron,  applied 
to  the  inflamed  skin,  is  much  used  now. 

In  erysipelas  the  powers  of  the  system  are  generally  reduced,  and 
ton'cs,  such  as  quinine,  wine,  etc.,  are  generally  required.  Dr.  Robert 
Williams,  —  high  authority  in  these  matters,  —  says  he  puts  his  pa- 
tients upon  milk  diet,  gently  opens  the  bowels,  and  gives  them,  daily, 
from  four  to  six  ounces  of  port  wine,  together  with  sago,  and  that  he 
seldom  has  to  changu  this  course,  whatever  the  symptoms. 

For  the  inflamed  skin,  a  tea  made  of  buckwheat  meal,  is  a  good 
wash.  Alcohol  and  water,  or  new  rum,  may  be  used  for  the  same 
purpose. 


Nettie-Rash. — Urticaria. 


Nettle-rash  begins  with  fever,  which  lasts  two  or  three  days, 
when  wheals  of  various  shapes,  round,  oval,  and  oblong,  appear  in 
the  midst  of  red,  slightly  elevated  patches,  attended  by  great  itching 
and  tingling,  as  if  the  common  nettle  had  been  applied  to  the  skin. 
The  wheals  go  off  during  the  day,  and  come  again  at  night.  The 
eruption  is  often  a  symptom  of  other  diseases,  or  of  mental  anxiety. 
Sometimes  it  is  the  effect  of  articles  of  diet.  Children  have  it  occa- 
sionally while  cutting  teeth.  A  lighter  form  of  the  disease  exists,  in 
which  the  wheals  appear  and  disappear  at  short  intervals,  according 
to  the  heat  of  the  weather,  the  exercise,  diet,  etc. 

Treatment.  —  The  treatment  varies  according  to  the  cause  of  the 
disease.  If  this  be  anything  offending  the  stomach,  especially  if  it  be 
putrid  fish,  an  emetic   (2)    (4)  will   be  required,  followed  by  brisk 


If- 


physic  (29).  After  which  take  a  few  doses  of  quinine  (67).  For  exter- 
nal application,  the  lotioa  (216)  or  common  vinegar  and  water  (215) 
will  be  useful.  Dr.  Wilson  recommends  corrosive  sublimate,  etc.  (217) 
as  the  very  best  lotion  to  apply  outwardly. 

The  diet  should  be  simple  and  cooling,  all  stimulating  food  and 
condiments  being  avoided. 

Rose  Rash. — Roseola. — False  Measles. 

Symptoms.  —  The  summer  rose  rash  appears  first  on  the  arms,  face, 
and  neck,  tlience  it  spreads  over  the  whole  body,  producing  tingling 
and  itching.  It  is  usually  preceded  by  the  symptoms  of  fever-chills, 
succeeded  by  flushes  of  heat,  languor,  pains  in  the  head,  back,  and 
limbs,  restlessness,  quick  pulse,  and  thirst.  The  rash  appears  in  small 
irregular  patches,  paler  than  those  of  measles,  and  of  a  more  roseate 
hue.  There  is  some  hoarseness  from  inflammation  of  the  throat  The 
rash  never  continues  more  than  five  days,  unless  it  be  merely  partial, 
in  which  case  it  sometimes  comes  ancl  goes  at  intervals  for  weeks. 
If  it  "strike  in,"  it  generally  produces  disturbance  of  the  stomach, 
headache,  and  faintness,  which  are  relieved  by  its  reappearance. 

The  autumnal  rose  rash  is  in  more  distinct  patches  than  the  for- 
mer, of  a  circular  figure,  slightly  elevated,  and  of  a  dark  damask-rose 
hue.     Seldom  any  fever,  or  itching  and  tingling. 

Treatment.  —  For  the  first-described  form  of  the  disease,  light  diet, 
acid  drinks,  and  gentle  laxatives  ;  for  the  second,  recipe  59,  or  51,  ac- 
cording to  convenience. 

Inflammatory  Blush. — Erythema. 

What  is  called  marginated  inflammatory  blush,  is  a  mottled,  red, 
smooth  fulness  of  the  skin,  occurring  on  the  extremities  and  loins,  in 
irregular  patches,  bounded  on  one  side  by  a  hard,  elevated,  red  border. 
This  species  of  the  disease  attacks  old  people,  and  indicates  some 
internal  disorder,  which  is  dangerous. 

Another  form  of  the  complaint  appears  on  the  arms,  neck,  and 
breast,  in  extensive,  bright-red,  irregular  patches,  slightly  elevated. 
The  redness,  at  its  height,  is  very  vivid,  and  continues  about  a  fort- 
night, when  it  assumes  a  purplish  hue  in  the  centre. 

Treatment  —  Light  diet,  gentle  purgatives  (21),  opiates  (218)  to 
dUay  the  tingling  and  secure  sleep,  and  the  mineral  acids  (63),  with 
bitter  tonics,  comprise  all  that  is  required,  except  sponging  with  water, 
and  friction. 

Watery  Pimples. 

"We  now  come  to  a  class  of  diseases  characterized  by  watery  pim- 
ples. Wilson  says  they  are  distinguished  by  "  effiisive  inflammation 
of  the  derma,"  which  means  that  there  h  inflammation  of  Iho  irnt- 
»kin,  which  causes  water  to  be  poured  out  on  top  of  the  derma,  and 


I 


./__... 


pr  c.xtvr- 
2t  (215) 
b.  (217) 

^od  and 


s,  face, 

tingling 

r-chills, 

ck,  and 

in  »mali 

roseate 

t    The 

partial, 

weeks. 

itomach, 

;e. 

the  for- 
ask-rose 


SKIN  DISEASES. 


139 


underneath  the  acarf-skin,  causing  the  latter  to  be  lifted  up  in  the  form 
of  small  or  large  blisterH,  or  vesides.  At  first  the  fluid  in  these  pim- 
ples is  transparent,  but  in  a  short  time  becomes  milky.  Sometimes 
this  fluid  absorbs ;  at  other  times,  it  dries  up,  and  with  the  cuticle, 
scales  off  as  scurf. 

/  ''',■■ 

Salt  Kheura. — Eczema.    , 

An  eruption  of  minute,  round  pimples,  about  the  size  of  a  pin's 
head,  filled  with  a  colorless  fluid,  and  terminating  in  scurf.  It  is  gen- 
erally a  symptom  of  a  feverish  state,  and  is  preceded  by  languor, 
faintncss,  perspiration,  and  a  pricking  and  tingling  of  the  skin. 

Another  species  of  this  disease  is  called  sun  heat,  which  is  an  erup- 
tion of  vesicles  without  any  redness,  of  a  white  or  brownish  color. 
These  vesicles  generally  terminate  in  brownish-yellow  scabs.  It  oc- 
curH  only  in  summer,  and  atfects  those  parts  which  are  uncovered. 

In  still  another  species,  the  eruption  is  attended  with  pain,  heat, 
itching,  intense  smarting,  and  a  swelling  of  the  affected  part.  When 
the  blisters  break,  the  water  which  runs  out  irritates  and  inflames  the 
skin,  which  becomes  red,  rough,  and  thickened,  —  covered  sometimes 
with  a  thick  crust. 

Treutmeut,  —  Low  diet,  cooling  drinks,  gentle  purgatives,  wami 
baths.  In  old  chronic  cases,  apply  externally  either  lime  water,  or 
corrosive  sublimate  (212)  in  solution.  In  the  second  and  third  forms 
of  the  affection,  apply  externally,  a  solution  of  nitrate  of  silver  (219). 

Tetter— Shingles. — Herpes. 

After  a  slight  feverish  attack,  lasting  two  or  three  days,  clusters 
of  small,  transparent  pimples,  filled  sometimes  with  a  colorless,  some- 
times with  a  brownish  lymph,  appear  on  the  cheeks  or  forehead,  or 
oi;  the  extremities,  —  and  at  times  on  the  body.  The  pimples  are  a 
•irtle  larger  than  in  eczema,  —  about  the  size  of  a  pea.  After  a  few 
days,  the  vesicles  break,  pour  out  their  fluid,  and  form  brown  or  yellow 
trusts,  which  fall  otT  about  the  tenth  day,  leavinsj  the  surface  red  and 
irritable.  The  eruption  is  attended  with  heat,  '  l)ing,  tingling,  fever, 
and  restlessness,  especially  at  night.  Ringworm  is  a  curious  form  of 
her|)es,  iji  which  the  inflamed  patches  assume  the  form  of  a  ring. 

Treatment.  —  Light  diet,  gentle  laxatives.  If  the  patient  be  ad- 
vanced in  life,  and  feeble,  a  tonic  (64)  will  be  desirable.  For  external 
application,  white  vitriol  (220),  or  an  ointment  of  sulphuret  of  lime 
(174),  or  elder-flower  ointment,  etc.  (175). 

Itch.  —  Scabies. 

To  this  disease  all  classes  are  liable,  though  it  is  much  less  cv>m- 
mon  than  in  former  years.  It  is  found  freciuently  among  the  poor, 
whose  condition  in  life  does  not  give  them  the  means  to  guard  at  all 


Jl 


140 


SKIN  DISEASES. 


"  " 


points  against  it ;  but  it  is  most  common  among  such  as  neglect  per- 
sonai  cleanliness. 

Symptoms. —  An  eruption  of  distinct,  cone-like,  watery  pimples, 
which  are  transparent  at  the  summits,  and  are  accompanied  by  an 
excessive  itching,  which  is  made  worse  by  high-seasoned  food,  by 
drinking  liquor,  and  by  the  "heat  of  the  bed.  When  those  pimples  are 
scratched  and  torn,  a  sticky,  watery  fluid  is  poured  out,  which  forms 
email  scabs ;  and,  in  time,  if  the  disease  is  not  cured,  these  scabs  lieing 
often  torn  off,  extensive  sores  are  made. 

Cause.  —  It  will  excite  the  wonder  of  many  readers  to  state  that 
animals  of  so  small  a  size  as  scarcely  to  be  seen  with  the  naked  eye 
exist  in  the  skin  of  man.  Yet  such  is  the  fact;  and  it  is  the  prt  L'nce 
of  these  minute  creatures,  or  the  effect  of  their  presence,  which  con- 
stitutes the  disease  called  itch.  The  little  creature  (acarus  scabiei, 
by  name),  a  species  of  mite,  is  one  seventy-seventh  part  of  an  inch  in 
length ;  and  when  closely  inspected  under  the  microscope,  is  really  a 
beautiful,  I  may  say  an  elegant,  animal.  Here  are  a  front,  a  side,  and 
a  back  view  of  him,  well  done  by  the  artist. 


Fia.  78. 


Fio.  74. 


Flo.  76. 


His  Method  of  Attack.  —  When  placed  upon  the  skin,  the  little 
fellow,  like  the  squirrel  and  other  ground  animals,  sets  himself  to  make 
a  hole  through  the  scarf-skin  with  his  head  and  fore  feet.  Into  this 
he  pushes  his  whole  body.  He  then  begins  to  burrow  himself  in  the 
derma  or  true  skin  —  making  a  channel  many  times  his  own  length, 
at  the  end  excavating  a  chamber  where  he  sleeps,  and  whence  he  goes 
out  to  do  his  day's  work  at  mining,  or  boring  for  food.  When  tired 
of  this  sleeping  apartment,  he  digs  onward  and  scoops  out  another. 

This  travelling,  and  boring,  and  turning  about  in  an  organ  as  sensi- 
tive as  the  true  skin,  must,  of  course,  occasion  a  tickling  and  itching' ; 
and  from  this  circumstance  the  disease  took  its  name  of  itch.  But 
this  itching  is  not  painful.  James  the  First  is  said  to  have  remarked 
that  the  itch  was  fitted  only  for  kings  —  so  exquisite  is  the  enjoyment 
of  scratching.     Probably  it  is  a  royal  luxury.     Be  that  as  it  may,  n|ost 

Kersons  would  consent  to  have  it  all  done  by  royal  fingers.     They 
ave  been  used  for  meaner  purposes. 


SKIN  DISEASES. 


141 


'ct.  per- 


■■J  •III 
<1,  by 
)lort  are 
form,-* 
Ix'ing 


Treutineiit.  —  Whatever  will  kill  the  little  animal  described  above, 
will  cure  the  itch.  Various  agents  have  been  employed  for  this  purpose, 
l)ut  none  have  been  found  equal  to  sulphur.  '1  he  compound  sulphur 
ointment  is  a  sovereign  remedy  for  the  disease.  Four  ounces  of  this 
should  be  well  rubbed  into  the  skin,  before  the  fire,  morning  and  even- 
ing, for  three  or  four  days.  This  will  put  an  end  to  the  whole  colony 
of  these  sovereign  squatters  upon  forbidden  soil. 

Two  ounces  of  sulphuret  of  potash,  and  the  same  amount  of  soft 
soap,  dissolved  in  a  pint  of  water,  and  applied  well  to  the  skin,  is 
used  in  many  cases  with  good  eflect. 

Caustic  |)otash,  one  part  to  twelve  parts  of  water,  applied  in  a  sim- 
ilar way,  is  said  to  be  a  pretty  sure  remedy. 

A  solution  of  the  chloride  of  lime,  used  as  a  wash,  will  often  eftect 
a  cure. 

The  ointment  of  the  American  hellebore  sometimes  does  well. 

Before  applying  any  of  these  preparations,  let  the  skin  be  washed 
with  warm  water  and  soap,  and  well  dried. 


Rupia. 

This  is  from  a  Greek  word  which  means  dirt,  from  the  dirt-colored 
crusts  which  are  formed  after  the  breaking  of  the  large  watery  pim- 
ples. The  vesicles  are  like  those  of  eczema  and  herpes,  except  that 
they  are  larger.  This  is  distinguished  from  all  other  skin  diseases  by 
the  for.nation  of  unhealthy,  foul,  and  burrowing  sores,  which  |X)ur  out 
a  reddish  matter  in  such  quantities  that  it  collects  and  dries  upon  the 
sore,  and  forms  a  crust  of  great  thickness,  —  sometimes  of  the  size 
of  an  oysteVshell.  Rupia  has  its  origin  in  a  weakly  and  debilitated 
constitution,  and  cannot  be  cured  without  renovating  the  whole  sys- 
tem. 

Treatment.  —  Warm  baths  once  or  twice  a  week,  with  generous 
and  nutritious  diet.  Tonic  medicines  (63)  (51)  (67)  (61)  (65)  will  be 
required.  For  external  treatment,  dust  the  surface  of  the  ulcers  with 
cream  of  tartar,  or  apply  nitrate  of  silver  (214)  (219)  (220),  white 
vitriol,  etc. 

Pemphigus. — Pompholix. 

The  first  of  these  t^rms  is  from  the  Greek,  and  means  a  btibble;  the 
second,  pompholix,  is  from  the  same  language,  and  means  a  vxder- 
l/iibble.  This  is  still  more  applicable  to  the  disease  in  hand,  which 
consists,  in  fact,  in  the  raising  up  of  the  scarf-skin  in  the  shape  of 
bubbles,  containing  a  watery  fluid.  These  bubbles  are  just  like  com- 
mon blisters.  They  vary  from  the  size  of  a  split  pea,  to  that  of  a 
hen's  egg.  They  rise  up  very  rapidly,  and  break  in  two  or  three  days, 
leaving  a  raw  surface  which  soon  becomes  covered  by  a  thin  crust. 

Treatment.  —  Similar  to  thatibr  Rupia,  with  the  addition  of  iodide 
of  potassium  (140),  and  applying  the  stick  nitrate  of  silver  to  the 


142 


SKIN  DISEASES. 


whole  surface  of  the  ulcer,  and  a  short  distance  beyond  it  on  all  sides, 
or  the  ointment  (176). 

Mattery  Pimples. 

Another  natural  group  of  skin  diseases  are  distinguished  by  an 
eruption  of  pimples,  nlled,  not  with  water,  like  those  just  described, 
but  with  matter.  The  pimples  of  this  class  are  not  transparent,  or 
whitish,  but  opaque  and  yellow  from  the  first  The  matter  is  poured 
out  upon  the  true  skin,  and  raises  up  the  scarf-skin,  in  the  same  way 
as  the  watery  pimples.  As  in  the  preceding  diseases,  too,  the  drying 
up  of  the  matter  forms  crusts.  But  these  pimples  are  never  so  small 
as  those  of  eczema,  nor  so  large  as  those  of  pemphigus. 

Crusted  Tetter. — Impetigo. 

This  eruption  consists  at  first  of  slightly-elevated  pustules  or  pim- 
ples, closely  congregated,  with  an  inflamed  border.  These  break,  and 
the  surface  becomes  red,  excoriated,  shining,  and  full  of  pores,  through 
which  a  thin,  unhealthy  fluid  is  poured  out,  which  gradually  hardens 
into  dark,  yellowish-green  scabs.  These  scabs  sometimes  look  like  a 
dab  of  honey  dried  upon  the  skin.  This  has  given  impetigo  the 
name  of  "  honey  disease,"  or  honey  scab.  This  honeyed  look  is  well 
represented  in  the  crusts  which  form  on  the  lips  and  ears  of  children. 
Sometimes  these  scabs  cover  nearly  the  whole  face,  and  are  called  the 
milk  crust  This  is  putting  the  agreeable  words  viilk  and  honey  to 
rather  questionable  uses !  When  this  crusted  tetter  invades  the  head 
or  scalp,  it  causes  the  hair  to  fall,  and  becomes  what  is  called  a  scall. 

Treatment. —  The  vapor  bath,  and  water  dressing.  The  following 
ointments  are  useful :  oxide  of  zinc,  white  precipitate,  or  diluted 
nitrate  of  mercury  (178).  Hydrocyanic  acid  (221),  applied  externally, 
has  a  fine  effect  The  crusts  should  first  be  removed  by  a  weak  lye 
made  from  hard-wood  ashes,  or  potash ;  then,  after  applying  one  of 
the  ointments  above,  or  the  lotion,  cover  the  part  with  oil-skir.  If 
the  crusts  are  on  the  head,  the  hair  should  be  cropped  off  before  the 
remedies  are  applied. 

Papnlons  Soall. — Ecthyma, 

The  mattery  pimple  called  ecthyma  is  developed  on  a  highly  in- 
flamed skin.  The  bladders  are  about  the  size  of  a  split  pea,  and  are 
surrounded  by  a  broad  ring  of  redness.  They  are  generally  separate, 
not  clustered  like  impetigo.  They  are  scattered  over  various  parts  of 
the  body,  and  are  followed  either  by  a  hard  black  crust,  or  by  a  sore. 
The  disease  is  either  acute  or  chronic.  The  latter  attacks  weakly 
children,  and  persons  reduced  by  sickness  or  low  living. 

Treatment.  —  For  the  acute  form,  low  diet,  gentle  laxatives,  with 
ointment  (176),  and  the  cold  sponge  bath  on  the  sound  parts.   For  the 


SKIN  DISKASES. 


143 


aides, 


|b^  an 

'nbed, 
Mit,  or 
^oured 
way 
iryiiig 
small 


chronic  form,  (140)  (65)  (63)  (61)  (48)  to  be  taken  internally,  and 
(176)  (175)  (214)  (211)  for  external  application. 

Scaly  Eruptions. 

The  scaly  eruption  is  called  dry  tetter.  It  is  an  inflammation  of 
the  true  skin,  and  is  distinguished  from  the  rashes  and  pimples  by  the 
alteration  of  the  scarf-skin.  The  diseases  forming  this  gt-  ip  are 
three  in  number,  —  lepra,  psoriasis,  mid  pityriasis. 

I, 

Leprosy. — Lepra. 

In  this  disease,  the  eruption  makes  its  appearance  as  a  small, 
salmon-red  spot,  raised  a  little  above  the  surrounding  skin,  and  cou- 
stituting,  in  fact,  a  flat  pimple,  almost  as  large  at  the  top  as  at  the 
bottom.  On  top  of  this  pimple,  the  scarf-skin  becomes  rough,  and 
after  a  little  while,  a  thin  scale  is  produced.  New  layers  are  added 
to  its  under  surface,  and  it  accordingly  grows  thicker.  It  has  a  bright, 
silvery  lustre.  These  scaly  spots  multiply,  and  become  the  form  of 
leprosy  called  lipra  g'utlata,  from  the  Latin  <futta,  a  drop,  the  scales 
looking  like  drops  of  water  on  the  skin. 

But  the  eruption  more  frequently  spreads  out  into  circular  patches, 
of  the  size  of  a  lil'ty  cent  piece.  These  generally  appear  below  the 
elbows  and  knees,  and  on  the  breast  and  shoulders,  and  back  of  the 
hands.  Sometimes  the  entire  hand  is  covered  with  scales  of  a  pecu- 
liar silvery  whiteness.     These  patches  heal  from  the  centre. 

Psoriasis. 

This  differs  from  lepra  in  the  eruption  being  more  irregular.  The 
spots  sometimes  come  out  in  thick  clusters,  and  blend  in  various  ways. 
Instead  of  appearing  in  distinct  circular  forms,  as  in  leprosy,  the 
patches  are  irregular,  and  of  every  size.  Instead  of  one  well-formed 
and  thick  scale,  there  are  many  small  and  thin  ones.  And  instead  of 
a  depressed  centre  with  rising  edges,  the  surface  is  level.  While  lep- 
rosy is  a  circular  dry  tetter,  this  is  an  irregular  dry  tetter. 

Pityriasis. 

This  is  much  like  the  two  preceding,  except  that  it  gives  rise  to  a 
copious  production  of  very  small  bran-uke  scales.  Indeed,  its  '^ame 
is  from  the  Greek,  and  means  chaff  or  bran.  It  is  a  branny  ^^cter. 
It  may  occur  on  any  part  of  the  body. 

Treatment  —  When  the  skin  is  highly  inflamed,  and  stiff  with  heat, 
pain,  and  itching,  the  diet  should  be  light,  and  the  drinks  of  a  cooling 
and  unexciting  kind.  The  warm  bath,  and  gentle  friction  of  the  skin 
are  useful.  Laxatives  or  tonics  may  be  employed,  according  to  the 
indications,  —  frequently  laxatives  first,  and  tonics  afterwards.  The 
specific  remedies  for  curing  the  disease  are,  corrosive  sublimate  (139), 


w 


fii 


:. 


f 


144 


SKIN  DISEASES. 


.odide  of  potassium  (140),  arseniatc  of  iron  (68),  Fowler's  solution, 
in  two-drop  doaos,  three  times  a  day;  or  Donovan's  solution,  in  fivt'. 
drop  doses,  three  times  a  day.  For  external  application,  use  a  nap- 
thaline  ointment  (177),  zinc  ointment,  white  precipitate  ointment, 
diluted  nitrate  of  mercury  ointment,  or  solution  of  corrosive  subli- 
mate (212). 

Dry  Pimples. 

These  are  distinguished  by  the  high  degree  of  irritation  of  the  nkiii 
which  they  create.  They  are  exceedingly  troublewome,  not  only  fioin 
the  distress  and  itching  they  occasion,  but  because  (hey  are  likely,  in 
consequence  of  this  to  be  torn  into  painful  and  obstinate  sores. 

When  appearing  in  children,  they  are  called  red  g^iim^  and  tooth- 
rash.  In  grown  persons,  one  form  is  named  lichen.,  and  another,  dis- 
tinguished by  excessive  itching,  prurigo. 

In  this  form  of  pimples,  the  (luid  is  not  poured  out  upon  the  sur- 
face of  the  true  skin,  —  as  in  several  of  the  preceding  diseases,  —  but 
is  collected  within  the  tissue  of  this  organ,  and  the  pimples  feel  hard 
under  the  finger. 

The  tooth  rash  of  infants  is  always  accompanied  with  some  fever- 
ishness,  caused  generally  by  irritation  of  gums  from  growing  teeth, — 
occasionally  by  Hannel  worn  next  the  skin. 

Lichen  has  a  variety  of  forms.  In  one  case  the  pimples  are  of  a 
bright  red,  in  another,  bluish  or  livid.  In  one  case  they  appear  in 
circular  groups,  in  another,  they  produce  great  disorganization  of  the 
skin,  and  occasion  terrible  suflering. 

■'  Pruri(^  is  a  still  more  cruel  disease  than  lichen.  The  pimples  are 
not  very  manifest,  but  the  skin  is  thickened  or  swollen,  and  condensed. 
The  suffering  from  it  is  terrible.  It  givea  one  no  sleep,  night  or  day. 
That  form  of  it  called  ant-bite  prurigo,  gives  the  sensation  of  millions 
of  ants  eating  the  flesh,  or  as  many  red-hot  needles  piercing  it  This 
renders  the  existence  of  many  elderly  persons  a  terrible  burden. 

Treatineilt.  —  Careful  diet,  and  gentle  cathartics  or  tonics,  accord- 
ing to  the  condition  of  the  system.  Externally,  the  cold  salt-water 
sponge  bath,  and  glycerine,  applied  with  a  soft  sponge,  vinegar  and 
water,  corrosive  sublimate  (222),  creosote  ointment,  the  diluted  nitrate 
of  mercury  ointment,  laudanum  and  sulphur  (179),  prussic  acid,  etc 
(171).  For  relieving  the  terrible  itching  of  the  private  parts,  which 
females  sometimes  suffer,  I  have  found  morphine  (223),  for  external 
use,  very  effectuaL 

Lupus. 

This  makes  its  appearance  in  the  form  of  one  or  more  drcnlai 
elevations,  of  a  dull  red  or  salmon-color,  and  partially  transparent. 
When  pressed  under  the  finger,  these  elevations  are  found  to  be  soft, 
and  when  the  finger  is  removed,  they  are  flat  and  whitened.  They 
generally  appear  on  the  face,  and  particularly  the  noee. 


N     M 


SKIN  DIS'.i  8E8. 


143 


fm.  7e. 


In  another  and  worse  form  of  the  disease,  the  tubercles  are  harder ; 
and  after  a  time,  they  become  covered  with  thin  brown  scabH,  wliich 

are  scratched  ott",  and  followed  by  others, 
and  thcwe  by  others,  until  ulcers  appear, 
which  are  eometiiiu'S  Blow  and  some- 
times rapid  in  their  progress.  The  whole 
nose  has  been  destroyed  by  them  in  a 
month.  (See  Fig.  76.)  This  is  one  of 
liR'  diseases  which  Erasmus  Wilson 
thinks,  and,  in  my  judgnrent,  correctly, 
fo  be,  like  scrofula,  the  result  of  tin' 
syphilitic  poison,  filtered  throtigh  llii 
blood  of  several  generations.  (See  col- 
ored Plate  IV.)  The  artist  haa  here 
given  a  beautiful  likeness  of  the  disease. 

Treatment.  —  The  internal  remedies 
are  iodide  of  arsenic  (141),  and  iodide  of 
potassium  (140) ;  the  external,  vinegar  of 
Spanish  flies ;  and  to  promote  the  heal- 
ing of  the  ulcers,  a  weak  solution  of  nitrate  of  silver  (211)  (214)  is 
adapted. 

Warts  3.nd  Corns. — Verruca  —  Tylosis  —  Clovus. 


They 


I.N  the  derma  or  true-skin,  there  are  a  great  many  small  arteries, 
veins,  and  nerves,  united  together,  and  formed  into  loops  (see  cut  43), 
resembling,  in  shape,  the  peaks  of  miniature  mountains.  These  are 
called  papilla:.  These  loops,  frequently,  without  any  apparent  cause, 
take  on  a  disposition  to  grow,  and  by  extending  themselves  upward, 
they  carry  the  scarf-skin  along  with  them,  which  is  thickened ;  and 
together  they  form  what  is  called  warts.  Corns  are  formed  by  a 
somewhat  similar  growth  of  the  papillffi,  brought  about  by  the  pres* 
sure  and  friction  of  tight  boots  and  shoes. 


Treatment.  —  For  warts,  take  a  piece  of  diachylon  plaster,  cut  a 
hcle  in  the  centre  the  size  of  the  wart,  and  stick  it  on,  the  wart  pro- 
jecting through.  Then  touch  it  daily  with  aqua  fortis.  Nitrate  of 
silver  sometimes  answers  well  for  touching  it  They  may  be  taken 
off  very  neatly,  sometimes,  by  tying  a  string  tight  around  them. 
Corns  should  be  shaved  down  close,  after  being  soaked  in  warm 
water  and  soap,  and  then  covered  with  a  piece  of  wash-leather,  ot 
buckskin,  on  which  lead  plaster  is  spread,  a  hole  being  cut  in  the 
leather  the  size  of  the  corn.  They  may  be  softened,  so  as  to  be 
easily  scooped  out,  by  rubbing  glycerine  on  them.  Manganic  acid  de- 
stroys warts  and  corns  rapidly.  Bunions,  which  affect  the  joint  of  the 
great  tot,  must  be  treated  with  fomentations,  and  sugar  of  lead  water 
(224),  when  there  is  considerable  inflammatlcn,  with  rest  and  a  hori- 
zontal position.  But  the  best  cure  xor  corns  and  bunions,  is  to  put 
away  tight  shoes. 


4m' 


146 


8K1N  DIHEASE8. 


Mother's  Marks.  —  Nevus. 

The  Bmall  vessels  of  the  skin,  called  capilluries,  sufTer  certain  alter- 
ations of  structure  which  pass  under  the  name  of  mother's  marks. 
These  marks  are  simply  a  great  dilatation  of  these  minute  l)lood 
vesstUs.  These  marks  vary  in  size  from  a  mere  point  to  a  patch  of 
several  inches  square. 

The  smallest  of  all  is  the  spider  mark.  It  is  a  small  rrci  point, 
from  which  several  little  straggling  vessels  spread  out  on  all  sides. 
Sometimes  this  is  of  the  size  and  appearance  of  a  red  currant ;  at 
other  times,  of  a  strawberry  or  raspberry ;  and  occasionally  it  is  even 
much  larger,  and  is  compared  to  a  lobster. 

When  the  circulation  is  active  through  them,  or  the  individual  is 
excited  by  exercise,  or  by  moral  causes,  these  marks  are  of  a  bright 
red  color.  Some  are  naturally  livid  and  dark-colored,  and  look  like 
blackberries,  and  black  currants.  The  blueness  of  these  is  owing  to 
the  vessels  being  still  more  stretched  and  dilated,  and  to  the  conse- 
quent slower  passage  of  the  blood  througu  them,  which  gives  more 
time  for  its  change  from  the  arterial  red  to  the  venous  blue. 

Treatmeilti  —  If  the  mark  is  not  making  progress,  it  had  better  be 
let  alone,  or  only  subjected  to  gentle  pressure  by  putting  a  piece  of 
soap  plaster  over  it.  When  its  course  is  threatening  mischief,  it  h 
sometimes  cured  by  pencilling  a  small  portion  of  its  surface,  from 
time  to  time,  with  nitric  acid. 


; 


Disordered  State  of  the  Nerves  of  the  Skin. 

Itching^.  —  Pruritus.  This  is  supposed  to  be  dependent  on  an 
altered  condition  of  the  nerves  of  the  skin,  and  consists  in  a  painful 
sensation  of  itching.  There  is  no  perceptible  alteration  in  the  ap- 
pearance or  structure  of  the  skin.  This  itching  is  thought,  generally, 
to  be  a  result  of  sympathy,  through  the  nerves,  with  some  diseased 
and  excited  condition  of  a  distant  part.  The  itching  is  brought  on 
by  the  most  trifling  causes,  and  for  hours  may  deprive  the  sufferer  of 
every  particle  of  repose.  It  more  frequently  affects  the  fundament, 
or  the  private  parta,  particularly  the  scrotum. 

Treatment  —  As  this  disease  is  only  a  symptom  of  several  others, 
the  constitutional  treatment  belongs  under  the  heads  of  these  other 
diseases.  The  Uxjal  applications  for  relieving  the  itching  are,  a  solu- 
tion of  sugar  of  lead  (224),  of  white  vitriol  (220),  of  corrosive  subli- 
mate (212),  diluted  nitrate  of  mercury  ointment,  and  poppy  fomenta- 
tions.    Also  (223). 

Disorders  Affecting  the  Color  of  the  Skin. 

Colored  Patches. — Macula;.  The  depth  of  color  in  the  skin  depends 
on  the  amount  of  a  certain  coloring  matter,  called  pigment,  incorpo- 
rated with  the  deeper  and  softer  portion  of  the  scarf-skin.     In  the 


LUPUS  nm  EXEDENS 


PI  4 


r,. 


14 


1 

1 

f 

146 


SKIN  DISEASES. 


Mother's  Marks.  —  Xevus. 

T,if,  an.'ill  ves«"ls  o(  the  akin,  cillcd  cii|jillarieti,  isaficr  ccrtaJn      •  •- 
atht>'  of  Blructore  wliioh  pas.i   under  the  name  of  mother's  H; 
TUt  •«  marka  arc  »imply  a  great  dilatiition  of  these  minute  >  . 
VfRsi^ijt.     These  marks  vary  iu  size  from  a  mere  point  to  a  paU^fe  wi 
Kt-vcnil  inehett  .square. 

The  8tnaUe*t  of  ail  is  the  spider  mark.     It  is  a  small  red  p- 
from  \vhl<  li  f<.fVKritl  jiTfle  fitrriggliug  vesrtela  spread  out  on  al!  : 
Sonielum?)  Th»«  i»  of  tlie  size  and  appearance  of  a  red  curran' 
oilier  time:*,  of  a  »?ra\vb<?rry  or  ra.>jpberry ;  and  occa9i«>nally  it  i.- 
J  '■■■  coinpivred  to  a  iobster. 

• '  iution  i>  active  through  them,  or  the  individii. 
;,  or  by  moral  causes,  these  marks  are  of  a  h. 
.tre  iiiituraliy  livid  and  dark-colored,  and  look      > 
i-X  black  currants.     The   blucnesss  of  these  is  owiutt  '* 


inn<  1-  i;irv.M 
V,'h<.--     ,.. 
ej.eispd  Uy 
nd      ' 

tiv- 

ti'u 


'fnne;  siiU  more  stretched  and  dilat<!d,  and  to  the  coiiw 
<r  paoHjji^  of  (he  blood  through  ihem,  which  gives  m<..»' 
-  vhun^je  from  the  arterial  red  to  the  venous  !  Lue. 

tr^twrnt.  - If  the  mark  is  not  making  progress,  it  bad  better  t)e 

Ic*.  Akvne.  or  only  s'ibjected  to  gentle  pressure  by  putting  a  piece  of 
MMp  plaster  v>ver  it  VVlicn  its  coiuse  is  threatening  mischief,  it  is 
sometimes  cured  by  jjencillinga  small  portion  of  its  surface,  from 
vane  to  time,  with  nitric  acid. 

Disordered  State  of  the  Nerves  of  the  Skin. 

Iti'Uinjg;.  —  Pruritus.  This  is  supposed  to  be  dependent  on  i !! 
altered  e<;ndition  cf  the  nerves  of  the  skin,  and  consists  in  a  painfvi 
(•eu.'wttion  of  itching.  There  is  no  perceptible  {sl'^ration  in  the  c 
j^M-amnCf;  or  structure  of  the  ski.n.  This  itching  h  thought,  gencra.Uv , 
to  be  a  nwult  of  sy.npathy,  through  ,the  nerves,  with  some  diseai^^'i 
and  evrittid  condition  of  a  distant  part.  The  itching  is  brought  ou 
by  the  most  tritling  causes,  and  fur  hours  may  deprive  the  suderer  >>f 
rvery  parti(;le  of  repose.  It  more  frequently  affects  the  fundameii 
<w  the  private  parts,  particularly  the  scrotum, 

Tr<*«fJneiit,  —  As  this  diseases  is  only  a  symptom  vi  several  oth>:r> 
the  constitutional  treatment  belongs  imder  the  heads  of  these  oth  ; 
diseas«;js.     The  local  applications  for  relieving  the  itching  are,  a  soiu- 
tiou  of  sugar  of  lead  (224),  of  white  vitriol  (220),  of  corrosive -subi! 
mat(^  (212),  diluted  nitrate  of  menrurj-  ointment,  and  poppy  fomenta- 
tions.    Also  (223). 

Disorders  Affecting  the  Color  of  the  Skin. 

folored  l*n(eb<'.s. — Mavuia:  The  depth  of  color  in  the  skin  depeitd* 
oa  tiwi!  amount  of  a  certain  coloring  mutter,  called  iMgmcnt,  incor)»o- 
mted  '.vith  th«:  deejH^r  and  softer  portiou  of  the  Bcarf-skiii.     In  the 


T 


t 


•'^ 


III 


ef,  it  i8     i'j 
e,  from 


! 


LUPUo  NQN  EXEDENS 


PI  4.. 


SKIN  DISEASES. 


147 


Bcarf-skin  of  the  inhabitants  of  northern  latitudes,  there  is  but  little 
of  this  pigment ;  in  that  of  the  dwellers  in  Africa,  there  is  a  great 
deal ;  among  the  inhabitants  of  Southern  Europe,  the  quantity  is 
intermediate  between  the  two. 

The  depth  of  color  in  the  skin,  depends  on  the  energy  of  iia  action. 
In  the  tropica,  where  light  and  heat  are  in  exces.s,  the  skin  is  stimu- 
lated to  great  action,  just  as  vegetation  is,  and  the  color  is  increased 
and  intensified.  This  is  illustrated  every  year  before  our  eyes.  In 
summer  under  the  heat  of  the  sun  and  the  flood  of  light,  the  pigmi  - 
forming  power  is  increased,  and  the  fairest  skin  is  browned  ;  while 
the  withdrawal  of  these  forces,  leaves  the  winter's  scarf  without  pig- 
ment, and  blanched. 

What  the  sun  and  light  do,  under  natural  circumstances,  disea:;cd 
action  may  etfect.  Hence  we  occasionally  meet  with  alterations  of 
color  in  the  skin,  from  a  disordered  state  of  the  system.  We  witness 
the  formation  of  patches  of  dark  color  and  irregular  shape  on  various 
parts  of  the  body.  Sometimes  they  are  raised  above  the  level  of  the 
skin,  and  are  called  moles.  At  other  times,  they  have  no  elevation, 
and  spread  over  the  whole  body. 

Occasionally,  from  some  peculiarity  of  constitution,  the  pigment  is 
diminished,  and  white  patches  appear  all  over  the  body.  At  other 
times,  a  black  person  will  become  completely  white.  Such  are  called 
albinos. 

In  many  cases  the  coloring  of  the  skin  has  varieties  of  tint,  as 
when  persons  of  light  complexion,  are,  in  the  summer  season,  covered 
with  yellow  spots,  like  stains.  These  spots  are  known  by  the  name 
of  freckles,  or,  in  learned  language,  lentigo. 

Treatment.  —  It  is  generally  best  not  to  meddle  with  a  mole.  If  it 
be  very  unsightly,  let  it  be  removed  by  two  incisions,  taking  out  an 
elliptical  portion  of  skin,  and  closing  the  wound  with  sticking  plaster. 
In  the  case  of  bleached  places,  apply  the  shower  bath,  tonics,  and  a 
stimulating  liniment  (163)  to  the  faded  spots.  For  the  change  of  color 
called  sun-burn,  a  liniment  (191)  of  lime  water,  etc.,  is  the  best  pre- 
paration. For  freckles,  use  lime  water  (191),  or.  perhaps,  still,  better 
(222). 

Disorders  oT  the  Sweat  Glands. 

The  perspiration  is  sometimes  greatly  increased  above  nature's  de- 
sign. This  is,  technically,  idrosis.  In  other  instances  there  is  too 
Jittle  sweating.  This  is  called  anidrosis.  Sometimes  the  perspiration 
is  so  altered  in  its  physical  qualities  as  to  have  some  peculiar  smell. 
This  is  osmidrosis.  In  some  rare  instances,  according  to  old  writers, 
she  sweat  was  changed  in  color.  This  was  chromidrosis.  And  now 
and  then  a  case  occurs  of  bloody  perspiration,  of  which,  the  most 
memorable  case  on  record,  is  that  of  the  Redeemer  of  men,  who,  in 
the  garden,  sweat  great  drops  of  blood.  Several  cases  of  this  are 
recorded  in  medical  books.     It  is  called  hasmidrosis. 

The  proper  action  of  the  skin  being  so  vitally  important  to  health, 
these  changes  often  involve  very  serious  consequences. 


.•J^ 


148 


SKIN  DISEASES. 


Treatllieilt.  —  Eith.^r  too  much  or  too  little  sweating  can  generally 
be  corrected  by  the  cold  or  warm  bath,  friction,  tonics,  and  proper 
clothing. 

Disorders  of  the  Oil-Olands  and  Tubes. 

That  the  skin  may  be  limber,  healthy,  and  fit  for  use,  it  is  neces- 
sary to  have  it  oiled  every  day.  For  this  object,  the  Creator  has 
wisely  provided,  by  placing  in  the  true  sUin  a  large  number  of  very 
riiiiall  glands  and  tubes,  whose  office  it  is  to  jircparf,  and  pour  out 
upon  the  surface  the  proper  amount  of  oil.  The  gland,  regular 
!  itle  oil-pot,  is  in  the  true  skin;  and  from  it  a  piece  of  hose  or  tube 
mis  up  through  the  scarf-skin,  through  which  the  oily  fluid  is  poured 
out.  Some  of  these  tubes  are  spiral,  others  are  straight.  On  some 
parts  these  vessels  do  not  exist;  on  others  they  are  quite  abundant, — 
art  on  the  face,  nose,  ears,  head,  eye-lids,  etc.  They  produce  the  wax 
of  the  ears;  and  on  the  head,  they  open  into  the  sheath  of  the  hair, 
and  furnish  it  with  a  hair-oil  or  pomatum  better  than  the  chemist  can 
make. 

These  little  vessels  are  always  at  work,  when  the  skin  is  healthy ; 
and  no  persons  need  be  afraid  to  wash  all  over  every  day,  lest,  as  the 
IJoston  Medical  Journal  taught,  the  skin  will  be  injured  by  having  the 
oil  removed  from  it.  You  might  as  well  be  afraid  to  eat  a  meal  of 
victuals,  lest  the  saliva  should  all  be  swallov/ed  with  it,  and  none  be 
left  for  future  use.  There  is  oil  enough  where  that  upon  the  skin 
comes  from,  and  the  vessels  which  produce  it  are  not  injured  by  work, 
any  more  than  the  muscles  of  the  legs  are  by  walking. 

Grubs  or  Worms.  —  But,  unfortunately,  the  skin  is  not  well  taken 
care  of  in  all  cases,  as  in  cities  and  towns  where  sedentary  habits  pre- 
vail. Here,  the  actions  of  the  skin,  instead  of  being  regular  and  com- 
plete, are  often  sluggish  and  imperfect;  and  the  contents  of  the  oil- 
cells  and  tubes,  instead  of  flowing  easily,  become  hard  and  impacted, 
and  the  vessels  are  not  emptied.  When  this  matter  becomes  station- 
ary, dry,  and  hard,  it  distends  the  tube,  and  fills  it  to  the  surface ;  and 
then  coming  in  contact  with  the  dust 
and  smoke  of  the  atmosphere,  the  ends 
become  black,  and  look  like  the  heads  of 
worms.  These  spots  are  common  on 
the  nose  and  fac^  of  persons  who  have 
a  sluggish  skin.  They  may  be  squeezed 
out  by  pressing  the  nails  on  each  side  of 
them.  These  are  called  grubs  and 
worms,  or,  technically,  comedones.  When 
this  matter  produces  inflammation  of  the 
tube,  there  is  then  a  black  spot  in  the 
middle  of  a  red  pimple,  and  the  disease 
is  called  spotted  acne.  Now  and  then 
the  oily  matter  becomes  very  hard,  pro- 
ducing spine-like  growths,  and  even  horns  (Fig.  77) ;  ai;d  again,  it  ool- 


Fio.  77. 


lects  and  forms  soft  tumors,  as  wens,  etc.     These  are  technically 


^C>£i^ 


.^  !>   ^   ^.. 


SKIN  DISEASES. 


149 


called  encysted  tumors.  Someti'  les  the  action  of  the  glands  is  too 
great,  and  oil  is  poured  out  so  j  'usely  that  the  face  shines  with  it. 
At  other  times  there  is  so  little  that  the  skin  is  dry  and  harsh.  In 
the  hardened,  oily  matter,  which  constitutes  grubs,  are  found  small 
animals,  which  Dr  Wilson  calls  the  "  animal  of  the  oily  product  of 
the  skin."     Here  are  three  views  of  him. 


■•f  1 


Flo.  78. 


Fio.  79 


Fio.  80. 


Treatment  —  For  roughness  and  harshness  of  skin,  wash  with  soap 
and  water  every  night,  and  rub  well  into  the  skin  after  the  bath,  and 
in  the  morning,  the  ointment  (180),  and  take  a  dose  of  sulphur,  etc. 
(23),  twice  a  week.  Or,  rvb  the  skin  every  morning  with  a  damp 
sponge,  dipped  in  fine  oat-meal,  and  after  drying  the  surface,  the 
liniment  (164)  may  be  applied.  The  spinous  variety,  or  porcupine 
disease,  requires  washing  with  a  quart  of  warm  water,  having  a  large 
teaspoonful  of  saleratus  dissolved  in  it,  and  the  use  of  the  ointment 
(181)  twice  a  day.  For  grubs,  stimulate  the  skin,  by  washing  it  with 
strong  soap  suds,  twice  a  day,  and  rubbing  briskly  with  a  coarse  towel ; 
and  by  using  the  corrosive  sublimate  (225)  as  a  lotion. 

A  spare  diet  will  do  much  towards  improving  the  skin  in  many 
cases. 

Barbers'  Itch— Jackson's  Itch. — Sycosis. 

This  is  very  much  like  acne, — only  differing  from  it  in  its  location. 
It  appears  chiefly  on  the  hairy  parts  of  the  face,  —  the  chin,  the  upper 
Up,  the  region  of  the  whiskers,  the  eyebrows,  and  the  nape  of  the 
neck.  It  consists  in  little  conical  elevations,  which  maturate  at  the 
top,  and  have  the  shaft  of  a  hair  passing  through  them.  These  pim- 
ples are  of  a  pale  yellowish  color.  In  a  few  days  they  burst,  and  the 
matter  running  out,  forms  into  hard,  brownish  crusts.  These  crusts 
fall  off  in  one  or  two  weeks,  leaving  purplish,  sluggish  pimples  behind, 
which  disappear  very  slowly. 


150 


SKIN  DISEASES. 


The  crnption  is  preceded  by  a  painful  sensation  of  heat,  and  tight- 
ness of  tlie  skin. 

The  disease  is  supposed  to  be  brought  on  frequently  by  using  a 
dull  razor  in  shaving.  It  is  v(;ry  obstinate,  —  often  lasting  for  many 
months,  and  even  for  years. 

Treatment.  —  The  most  important  part  of  the  treatment  is  the  re- 
moval of  the  cause.  The  beard  must  not  be  pulled  with  a  dull  razor ; 
the  shaving  had  better  be  discontinued  altogether,  and  the  beard  be 
merely  cropped  off  with  scissors  instead.  All  intemperance  in  eating 
and  drinking,  and  exposure  of  the  face  to  heat,  must  be  avoided.  A 
light,  cool  diet  will  do  much  towards  curing  the  disease. 

The  nitrate  of  mercury  ointment,  and  a  solution  of  oxalic  acid,  are 
the  best  applications.     If  one  does  not  succeed,  try  the  other. 

Disorders  of  the  Hair  and  Hair  Tubes. 

The  hair  is  an  appendage  to  Ih:;  scarf-skin,  and  is  intended  to  be 
both  useful  and  ornamental. 

It  is  subject  to  several  disorders.  It  may  grow  too  long,  or  too 
thick,  or  it  may  appear  in  an  improper  place.  This  last  happens  in 
the  case  of  those  little  spots  and  patches,  which  disfigure  the  face, 
and  are  called  moles.  The  hair  may  be  defective  in  its  growth,  or 
may  fall  oft'  prematurely  from  various  causes,  or  in  the  natural  course 
of  things  from  old  age.  This  last  is  called  calvities.  It  may  change 
its  color,  too,  under  a  great  variety  of  circumstances,  and  at  nearly 
every  age.  It  is  not  very  uncommon  to  find  a  single  lock  varying  in 
color  from  that  which  surrounds  it.  Old  age,  the  winter  of  life,  nat- 
urally brings  the  frosted  locks  ;  but  they  frequently  appear  also  upon 
the  heads  of  younger  persons.  Strong  mental  emotions,  such  as  fear, 
grief,  or  sorrow,  may  bring  a  bleaching  of  the  hair  in  a  brief  period, 
or  even  suddenly.  Eyron,  in  his  "  Prisoner  of  Chillon,"  beautifully 
refers  to  this  fact : 

"  My  hair  is  gray,  but  not  with  years, 
Nor  grew  it  white 
In  a  single  night, 
As  men's  have  grown  from  sudden  fears." 

Porrl^O. — There  is  a  troublesome  disease  of  the  hair  and  hair  tubes 
called  porrigo.  It  begins  with  the  formation  of  a  thin  layer  of  scurf 
either  around  single  hairs,  or  in  patches  which  enclose  several.  These 
patches  frequently  have  a  circular  form,  which  give  to  the  affection 
the  character  of  a  rinffioorm.  The  hair  tubes  are  generally  a  little 
elevated,  in  the  shape  of  papillae,  which  gives  to  the  diseased  scalp  the 
appeaiance  of  "  goose-flesh."  These  hairs,  losing  their  proper  nour- 
ishment and  healthiness,  break  off"  at  unequal  distances  from  the  skin, 
leaving  their  rough  ends,  twisted,  and  bent,  and  matted  into  thick 
grayish  and  yellow  crusts.  Upon  the  surface  of  these  crusts  may 
generally  be  seen  the  ends  of  a  few  hairs,  looking  like  the  fibres  of 
hemp  or  tow.  The  scratching  causes  inflammation  of  the  skin  after 
a  tiine,  and  matter  is  poured  out,  which  still  further  mats  the  hair, 


•tHutitv 


■ntth'-  L««£*ra&a 


SKIN  DISEASKS. 


151 


tight- 

fing  a 
many 


the 


re- 


to  bo 


and  thickens  the  crusts.  There  are  several  varieties  of  this  disease, 
dilferiiig  slightly  from  each  other ;  but  this  general  description  will 
answer  all  practical  purposes  for  this  work. 

The  reader  will  often  notice  a  disease  of  the  hair-glands,  character- 
ized by  a  yellowish  and  dirty-looking  powder,  covering  the  scalp  and 
hairs.  This  matter  is  collected  at  the  mouths  of  the  follicles,  and 
considerable  of  it  is  strung  upon  the  hairs  like  beads.  Pull  out  a  hair, 
and  the  root  will  be  found  thin,  dry,  and  starved  in  its  appearance. 
In  this  disease,  it  is  difficult  to  keep  the  hair  cleansed,  or  to  prevent 
its  falling  oflT. 

Faviis.  —  Still  another  disease,  called  favvs,  is  known  by  the  collec- 
tion of  a  yellow  substance,  at  first,  around  the  cylinder  of  the  hair. 
This  substance,  after  a  time,  spreads  out  upon  the  scarf  skin,  and 
dries  into  yellow  crusts,  in  the  form  of  a  cup,  around  the  base  of  each 
hair.  A  number  of  these  cups,  collected  together,  look  like  the  cells 
of  a  honey-comb.  This  disease  is  contagious,  and  is  communicable 
by  contact  to  any  part  of  the  skin. 

Treatment  —  For  removing  the  hair  from  particular  parts  of  the 
scalp,  it  is  common  to  resort  to  depilatories.  Of  these,  the  recipes 
260,  261,  262,  are  frequently  used,  and  are  as  good  as  those  adver- 
tised ;  indeed,  they  are  the  same. 

To  prevent  loss  of  hair,  and  to  restore  it  when  lost,  the  circulation 
should  be  stimulated  in  the  small  vessels  of  the  scalp.  With  this 
view,  washing  the  head  every  morning  with  cold  water,  drying  it  by 
friction  with  a  rough  towel,  and  brushing  it  to  redness  with  a  stiff 
hair-brush,  are  excellent.  To  these  should  be  added  some  stimulating 
ointment  (183),  or  liniment  (257)  (258)  (259).  These  last  are  about 
the  best  known  preparations  for  causing  the  growth  of  the  hair. 

Rin^orni  of  the  scalp  requires  attention  to  the  diet,  and  such  rem- 
edies as  will  improve  the  general  health,  with  stimulating  application.^ 
externally  (257)  (258)  (259). 

To  color  the  hair,  several  preparations  are  used.  Of  these,  263  is 
about  the  best.  It  produces  a  beautiful  black.  A  preparation  of  sul- 
phur and  sugar  of  lead  (264)  is  t!ie  famous  compound  recommended 
by  General  Twiggs,  and  extensively  used.  Preparations  of  nitrate 
of  silver  (265)  (266)  (311)  are  much  in  use  in  some  quarters.  They 
perhaps  give  a  finer  black  to  the  hair,  but  they  render  it  dry  and  crisp, 
and  they  will  stain  th6  skin,  if  care  is  not  used  in  applying  them. 

In  Favns,  the  two  great  objects  to  be  gained  are,  to  remove  all  local 
causes  of  irritation,  and  to  excite  the  diseased  hair  glands  to  healthy 
action.  The  first  object  is  effected  by  cutting  off  the  hair  with  the  scis- 
sors, and  removing  the  crusts  by  washing  the  scalp  with  castile  soap 
and  water.  It  may  be  well  first  to  wet  the  crusts  through  with  corro- 
sive sublimate  (212),  in  weak  solution.  The  washing  with  soap  and 
water  should  be  repeated  every  day,  and  be  followed  by  rubbing  into 
the  scalp  a  stimulating  ointment  (183).  A  very  weak  solution  of  the 
acid  nitrate  of  mercury  (226),  applied  every  other  day,  with  a  camel's 
hair  brush,  sometimes  produces  excellent  effects. 


,»> 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


f  ' 


The  brain  and  spinal  cord  are  the  great  centres  of  the  nerroui 
§y8t«m. 

The  brain  produces  sensation,  tfioiight,  and  voluntary  motion.  When 
this  organ  is  diseased,  therefore,  we  may  expect  one  of  these  functions 
to  be  either  disturbed  or  destroyed. 

Of  Sensation  there  are  various  disturbances,  perversions,  and  sus- 
pensions, caused  by  disease  of  the  brain  and  nerves ;  such  as  nausea, 
giddiness,  specks  floating  before  the  eyes,  ringing  in  the  ears,  decep- 
tive tastes  and  smells,  intolerable  itching,  neuralgic  pains,  boisterously 
high  spirits,  depression  without  apparent  cause,  anxiety,  and  dread. 

Tliought,  in  like  manner,  is  disturbed  and  perverted  in  many  ways. 
There  is  high  delirium,  dulness  and  confusion,  loss  of  memory,  weak- 
ened judgment,  and  every  degree  of  stupor,  down  to  entire  loss  of 
consciousness. 

Tolnntary  IKotion  is  perverted  and  destroyed  in  muscular  twitcli- 
ings,  trembling  of  the  limbs,  spasmodic  stiffness,  involuntary  jerkings, 
convulsions,  muscular  debility,  and  palsy. 

The  brain  is  composed  of  three  parts,  —  the  cerebrum,  the  cerehel' 
hum,  and  the  medulla  oblongata.  These  are  all  contained  within  the 
skull  bones,  and  are  immediately  covered  by  three  membranes,  called 
the  dura  mater,  the  arachnoid,  a  -1  the  pia  maier.  The  dura  mater  is 
a  fitrofig,  fibrous  membrane  lying  next  to  the  skull-bones.  The  arach- 
noid is  a  serous  membrane,  lying  next  below,  and  the  pia  mater,  which 
means  pious  mother,  is  a  vascular  membrane,  lying  next  to  the  brain, 
dipping  into  it  in  places,  and  containing  the  vessels  which  bring  to  it 
all  its  nutrient  materials.     Hence  its  name. 

These  membranes  are  all  liable  to  be  inflamed, — and  so  is  the 
brain 


Inflammation  of  the  Dura  Mater. 

The  inflammation  of  this  membrane  does  not  often  occur  sponta- 
neously ;  but  it  happens  frequently  from  external  injuries,  as  blows 
up<in  the  head. 

After  a  blow  upon  the  head  which  stuns  him,  a  man  may  recover 
himself,  and  for  some  days  remain  in  perfect  health.     Then  he  has 


nftsosnpF 


DISEASES  OF  THE  BRAIM  AND  KEllVES. 


153 


Gain  in  the  head,  is  restless,  cannot  sleep,  has  a  flushed  faee,  red  eyes, 
ot  skin,  hard  pulse,  rigur,  nausea,  vomiting,  —  ending  with  convul- 
sions  and  delirium. 

This  disease  is  often  caused  by  v  Hat  Is  called  otilis,  or  inflamma- 
tion of  the  internal  ear.  In  such  cases,  inflammation  will  arise  within 
the  tympanum,  causing  intense  earache;  matter  comes  at  length  from 
the  external  ear,  but  the  pain  does  not  stop;  the  patient  shivers,  be- 
comes drowsy,  perhaps  delirious,  and  finally  sinks  into  stupor.  The 
dura  mater  is  inflamed. 

Tretltmeilt. —  When  the  disease  arises  from  inflammation  in  the 
ear,  leeches  are  to  be  applied  behind  the  ear,  and  blisters  and  other 
irritants  afterwards.  Other  modes  of  treatment  will  be  mentioned 
after  the  next  two  forms  of  disease. 

Inflammation  of  the  Arachnoid  and  Pia  Mater. 

Arachnitis. 

These  two  membranes  are  generally  inflamed  together.  They 
are  so  intimately  connected  that  each  involves  the  other  in  its  own 
trorables. 

Generally  this  is  divided  Into  three  stages  : 

Tlie  Irritative,  characterized  by  wakefulness,  irritable  temper,  re- 
pugnance to  strong  light,  and  contraction  of  the  pupils. 

The  Inflammatory  stage,  known  by  transient  pains  in  the  head, 
alternating  with  similar  ones  in  the  bowels,  increased  restlessness  and 
irritability,  a  quick  and  tense  pulse,  an  expression  of  discontent  on 
the  face,  the  eye-brows  knit  and  frowning,  the  eye-lids  half  closed, 
retxshing  and  vomiting,  deep  sighing,  and  torpid  bowels. 

The  Depressing^  Sta^e,  in  which  the  delirium  is  more  contmuous, 
the  countenance  has  a  look  of  surprise  and  stupor,  the  pupils  are 
contracted  or  dilated,  the  white  of  the  eyes  injected  and  red,  the 
pupils  rolled  up  during  sleep,  constant  sleepiness,  inattention  to  sur- 
rounding objects,  torpidity  of  mind,  gradually  increasing  until  com- 
plete coma  closes  all  the  senses. 

The  disease  does  not  always  exhibit  all  these  symptoms,  or  come 
(Ml  in  the  regular  way  described.  Sometimes  the  first  thing  noticed  is 
11  long-contiimed  paroxysm  of  general  convulsions.  Again  these  con- 
vulsions will  come  on  after  violent  pains  in  the  head,  and  are  at- 
tended with  screaming. 

Inflammation  of  the  Brain.— Brain  Fever. 

Encephalitis.  —  Phrenitis. 

Acute  and  general  inflammation  of  the  brain  and  its  membranes 
has  two  stages. 

The  Sta(i;e  of  Excitement,  in  which  there  is  intense  and  deep-seated 
pain  in  the  head,  extending  over  a  large  part  of  it,  a  feeling  of  tight- 
ness across  the  forehead,  throbbing  of  the  temporal  arteries,  a  flushed 


I  .mi  a^w 


face,  injected  eyes,  looking  wild  and  brilliant,  contraction  of  the  pupils, 
great  slirinking  from  light  uiul  Hound,  violent  delirium,  want  of  sleep, 
general  convulsions,  a  parched  and'dry  tikin,  a  quick  and  hard  pulse, 
a  white  tongue,  thirut,  nau»ea  and  vomiting,  and  conatipatiun  of  the 
bowels. 

The  Stage  of  €olltipse,  in  which  there  are  indistinct  mutteringa,  dull 
and  perverted  hearing  and  vision,  double  vision,  the  pupil  from  being 
contracted  expands  largely  and  becomes  motionless,  twitchings  of  Mb 
muscles,  tremors  and  palsy  of  some  of  the  limbs,  a  ghastly  and  ca- 
daverous countenance,  cold  sweats,  profound  coma,  and  death. 

The  disease  will  not  show  all  these  symptoms  in  any  one  case.  It 
runs  a  rapid  course,  causing  death,  sometimes,  in  twelve  or  twenty- 
four  hours ;  or  it  may  run  two  or  three  weeks. 

Trentllient. —  This  should  be  energetic  and  administered  earli/. 
The  measures  usually  employed  are  blood-lettings  purffing",  and  th  > 
application  of  cold  to  the  head. 

General  Blood-lettin)i;.  —  This  is  much  approved  by  many ;  for  my- 
self, 1  do  not  like  it  Wet  cups  and  leeching  are  about  the  extent  to 
which  1  would  ever  carry  the  abstraction  of  blood  in  these  diseases. 
These  may  sometimes  be  applied  with  advantage  to  the  neck,  and 
behind  the  ears. 

Cold  Applications.  —  These,  applied  to  the  head,  are  of  great  im- 
portance. First,  shave  the  head,  and  put  on  cloths  wetted  in  water 
as  cold  as  it  can  be  made,  changing  them  often ;  or,  put  powdered 
ice  in  a  flexible  bladder,  and  lay  it  upon  the  head,  —  taking  care  not 
to  make  it  too  heavy. 

Por^iuj^.  —  This,  while  the  inflammation  is  in  the  active  stage, 
should  be  thorough  and  energetic.  To  effect  it,  many  use  calomel 
and  other  forms  of  merc-.ry.  They  are  not  needed.  Croton  oil  is 
one  of  the  best  articles  (31),  or  calacynth,  gamboge,  etc.  (32),  without 
the  oil,  or  the  compound  powder  of  jalap. 

In  the  stage  of  collapse,  if  there  is  pallor  of  the  countenance,  a 
feeble  and  flying  pulse,  great  debility  and  tremors,  coldness  of  the 
extremities,  etc.,  give  wine  and  other  stimulants. 

See  that  the  bladder  is  emptied  every  day. 

The  feet,  in  the  early  stage  of  the  complaint,  should  be  bathed  in 
warm  water,  or  mustard  and  water  (242).  Mustard  d.'aaghts  must 
also  be  put  upon  the  feet. 

The  tincture  of  veratnim,  given  in  full  doses,  to  bring  down  the 
pulse,  and  produce  sweating,  must  not  be  omitted. 

Softening  of  the  Brain. — Ramollissement. 

Inflammation  of  the  brain,  when  it  haa  run  its  course,  sometimes 
leaves  this  organ,  or  portions  of  it,  in  a  softened  condition.  The 
same  mischief  may  happen  to  the  brain  from  the  blood-vessels  which 
run  to  it  being  diseased,  so  as  not  to  be  able  to  carry  blood  for  its 
proper  nourishment. 


Siii 


DISEASBS  OF  TIIR  BHAIN  ANM)  NKUVE8. 


15(5 


SyniptoillM. —  Thu  moHt  rcinitrkahic  Hvinptoin  of  tliin  diMciiHc  is  the 
rigid  contmctioii  of  tin;  iiiuwlcrt  which  iimvv  up  tin;  liiiilw;  tht;  ir.iiid 
niiiy  be  clenched  and  prcsrtcd  ugiiinst  the  nhuuldcr,  or  tlie  licci  curried 
u|>  to  the  hip. 

The  other  synnptoniH  are  varioiis, —  tingling  nnd  nnmhnewrt  in  the 
rnd»  of  the  fingers;  pervertx'd  vision,  and  sotnetirncH  blindness;  |)arui- 
yf»i«  of  one  limb,  or  half  the  body;  dilliculty  of  answering  quotations; 
forgetfulncHH,  making  it  diliicult,  at  tiineH,  for  tlie  patient  tu  renieuiber 
biu  own  name. 

Suppuration  and  Absoeets  of  the  Brain. 

Whkn  a  diseuHcd  brain  i<  examined  after  death,  Bometimes  matter 
is  found  mixed  in  with  the  >H)ftened  portion.  This  shows  that  suppu- 
ration took  place.  At  other  times,  the  matter  is  found  in  a  cavity, 
which  shows  that  an  abscess  had  formed  during  life. 

The  symptoms  of  these  mischiefs  am  convulsions  in  the  earlier 
stages,  and  palsy  in  the  latter. 

Induration  of  the  Brain.     ,     '       -  ,  ' 

Instead  of  softening  the  brain,  inflammation  sometimes  docs  the 
very  opposite,  —  it  hardens  it,  —  producing  a  change  eomething  like 
that  which  happens  to  white  of  egg  when  dip|)ed  in  hot  water. 

Convulsions  appear  as  the  result,  of  tiiis  change,  as  in  suppuration 
and  abscess  ;  palsy  much  more  seldom. 

Tumors  of  the  Brain. 

Tumors  infect  the  brain,  occasionally,  —  growing  around  it,  on  all 
sides,  pressing  themselves  into  its  substance,  and  causing  many  dis- 
turbances. Cancers  and  hydatids  are  found  there.  The  signs  which 
these  irritating  bodies  produce,  are  like  those  of  other  diseases  of  the 
brain,  and  therefore  cannot  be  distinguished  during  life. 

Delirium  Tremens.— Drunkards'  Delirium. 

Mania  a  Potu. 

This  is  often  mistaken  for  brain  fever;  but  it  is  quite  a  different 
disease.  It  is  not  the  result  of  inflammation  of  the  brain,  but  of 
irritation.  It  is  important  to  distinguish  it  from  inflammation,  be- 
cause the  remedies  which  are  employed  for  that  would  be  injurious 
if  used  for  this. 

TIic  Symptoms  are  incessant  talking,  fidgeting  with  the  hands,  trem- 
bling of  the  limbs,  a  rapid  pulse,  profuse  sweating,  utter  sleeplessness, 
and  a  mingling  of  the  real  with  the  imaginary  in  the  busy  talk.  The 
patient  is  apt  to  think  some  one  is  about  to  do  him  a  great  injury, 
yet  is  unwilling  to  be  alone.  His  fane  is  pale  and  sallow  (sometimes 
red  and  .   .o.ied),  his  eye  is  rolling,  quick  and  expressive,  his  speech 


\      !  J 


■It; 


•tuttering  niul  innrticulatc, —  bodily  nud  inrntiilly,  lu;  in  busy  day  «nd 
night,  and  can  with  didiculty  be  confnicd  to  \m  bed  or  rimrn.  As  thu 
diseaHe  advances,  and  he  has  been  long  without  sleep,  he  imagines 
vermin  to  be  crawling  upon  his  scalo  and  bixly ;  troops  of  rats  rnu 
across  his  bed,  or  look  at  iiim  out  of  the  wall ;  giant  lK)xers  confront 
him,  and  he  squares  oH'  for  a  round  nt  fistieufFs  ;  animals,  figures  of 
all  shapes,  and  horrible  monsters,  frighten  his  imagination  ;  devils 
laugh  at  him,  and  dance  before  him.  In  long  an<l  sleepless  hours,  ha 
talks  and  chatters  with  these  spectral  phantoms,  —  now  beckoning 
them,  now  shrinking  from  them,  till  he  wears  out  and  sinks  from  ex- 
haustion. This  is  a  disease  of  drunkards  and  opium  eaters.  The 
attack  generally  occurs  in  consequence  of  the  withdrawal  for  three  or 
fouv  days  of  the  accustomed  stimulus. 

Trea^nent — Opium  and  its  preparations  are  the  sovereign  remedy. 
Give  one-third  of  a  grain  of  morphia ;  if  this  does  not  quiet  tln^ 
patient,  give  thirty  drops  of  laudanum  every  two  hours,  till  sleep  is 
produced.  Sleep  will  cure  him,  and  nothing  else  will.  A  draught  or 
two  of  his  accustomed  drink,  brandy,  gin,  or  whatever  it  may  be,  will 
also  generally  dispose  him  to  sleep. 

Recently,  a  very  effectual  remedy  has  been  found  in  the  use  of 
tepid  baths,  prolonged  from  four  to  ten  hours,  in  connection  with 
cold  applications  to  the  head.  In  connection  with  this,  small  doses 
of  opium  are  required ;  but  the  treatment  may  yet  prove  to  be  very 
valuable  by  enabling  us  to  dispense  with  excessive  doses  of  opium. 

Enlargement  of  the  Brain. — Hypertrophy. 

This  is  chiefly  a  disease  of  childhood.  It  consists  in  an  unnatural 
growth  of  the  brain.  Sometimes  the  skull  grows  with  it,  and  there 
may  not  be  any,  or  only  slight,  symptoms  of  disease. 

The  complaint  is  sometimes  congenital,  —  the  child  being  born 
with  a  heacl  far  above  the  natural  standard  of  size.  Sometimes  a 
child's  head,  from  this  disease,  will  reach  the  size  of  an  adult's,  by  the 
time  it  is  live  or  six  years  old.  This  is  not  necessarily  a  disease, 
though  children  that  suffer  from  it  are  very  apt  to  die  finally  of  soinif 
affection  of  the  brain. 

Symptoms.  —  Dulness  of  intellect,  indifference  to  external  objects, 
great  irritability  of  temper,  inordinate  appetite,  giddiness,  and  an  ha- 
bitual headache,  which  at  times  is  very  severe.  In  addition  to  these, 
there  are,  at  times,  convulsions,  epileptic  fits,  and  idiocy.  There  is  a 
peculiar  projection  of  the  parietal  bones,  which  serves  well  to  distin- 
guish this  disease  from  acute  hydrocephalus. 

Treatment.  — As  far  as  possible,  suspend  and  repress  all  exercise  of 
the  mind.  Take  the  child  from  school  as  soon  as  the  disease  is  dis- 
covered, and  put  it  to  the  most  active  muscular  exercise  in  the  open 
air.  The  moment  there  is  any  excitement  of  the  brain,  or  heat  on 
the  top  of  the  head,  apply  cold  water,  ice,  or  cold  evaporatmg  lotion-*. 
If.  ««  the  child  grows  up,  the  signs  of  mischief  increase,  the  diet  m 


f>»m 


MMlB 


r — 


DI8EA8KS  OV  THE  DKAIN  AND  MEUVE8. 


107 


Im'  Hirnph*,  niid  carefully  regulated.     Bread  and  milk  only  is  some- 
tiiriett  advittable. 


Shrinking  of  the  Brain. — Atrophy. 

This  \»  a.  dirton's(^  in  wljich  the  volume  of  tin*  hrjun  is  diminished. 
Tliere  arc  two  forms  of  it;  one  is  con^ciiifal,  the  brain  not  being 
pro[)erIj  develupcd  at  i)irth  ;  the  other  occurs  in  conse(|ucnce  of  dis- 
ease either  in  the  membranes  or  tlie  arteries.  The  symptoms  are  not 
distinguishable  during  life  from  those;  of  other  brain  alVections,  and 
tJierefore  it  can  only  be  treated  according  to  general  |)rinci|)let«. 


Water  in  the   Head. — Acute  Hydrocephalus. 

This,  like  eidargement  of  the  brain,  is  likewise  a  disease  of  child- 
hood, and  often  attacks  scrofulous  eliildren. 

Being  an  intlaiTunatory  disease,  it  is  important  to  have  early  notice 
of  its  existence,  and,  if  possible,  to  be  aware  of  its  approach;  which 
we  may  be,  frequently,  by  observing  the  following ///•ewo«i7or^ 

Symptoms ;  namely,  a  disturbance  of  the  disgestive  functions,  Indi- 
cated by  a  capricious  appetite,  —  the  food  at  one  time  being  disliked, 
at  another  devoured  greetlily;  afoul  tongue,  oflensive  breath,  enlarged 
and  sometimes  tender  belly,  torpid  bowels,  stools  light-colored  from 
having  no  bile,  or  dark  from  vitiated  bile,  fetid,  sour-smelling,  slimy 
and  lumpy.  The  child  loses  its  uealthy  look,  and  grows  paler  and 
thinner.  Its  customary  spirit  and  activity  are  gone  ;  it  is  heavy,  lan- 
guid, dejected ;  it  is  fretful,  irritable,  uneasy ;  and  sometimes  is  a 
little  tottering  in  its  gait. 

After  these  warning  symptoms,  the  disease  may  begin  in  one  of 
three  wajis : 

The  pains  in  the  head  become  more  severe  and  frequent,  and  are 
sharp  and  shooting,  causing  the  little  patient  to  wake  and  shriek  out. 
As  the  drowsy  state  advances,  the  shrieking  gives  place  to  moaning. 
Beside  these  symptoms,  there  are  stiffness  in  the  back  of  the  neck, 
pain  in  the  limbs,  great  tenderness  of  the  scalp,  vomiting,  sighing, 
intolerance  of  light,  knitting  of  the  brows,  increased  disturbance  of 
htomach  and  bowels.  This  stage  may  last  ten  to  fourte*Mi  days,  the 
(ihild  growing  more  weak  and  peevish. 

Another  form  of  attack  is  marked  by  acute  pain  in  the  head  and 
high  fever,  convulsions,  flushed  face,  brilliant  eyes,  intolerance  of  light 
and  sound,  pain  and  tenderness  in  the  belly,  stupor,  great  irritability 
of  stomach,  causing  retching  and  vomiting  upon  every  attempt  to  sit 
up  in  bed. 

The  third  mode  of  attack  is  very  insidious,  —  the  early  symptoms 
being  mild  and  hardly  noticeable,  or  not  even  occurring  at  all.  In 
such  case,  the  convulsions  or  palsy  come  suddenly,  without  notice, 
bringing  swift  and  unexpected  destruction.  This  has  sometimes  been 
called  water-stroke. 


"il 


The  First  Sttig^e  is  the  period  of  increased  sensibility  and  yxcite- 
rnent,  caused  by  inflammation,  in  which  the  pulse  is  quick  and  irreg- 
ular. 

The  Second  Stag^e  is  one  of  diminished  sensibility,  or  lethargy,  dur- 
ing which  water  is  effiTsed  upon  the  brain,  and  the  pulse  is  slow. 

Tlie  Tliinl  Period  is  one  of  palsy  and  convulsions,  with  squinting 
of  the  eyes,  rolling  of  the  head,  stupor,  and  a  rapid,  thread-like  pulse. 

Treatment.  —  In  the  first  or  inflammatory  stage,  purging  is  very 
important,  and  it  must  be  continued  for  three  or  four  days.  Scam- 
mony  and  croton  oil  (33)  may  be  chosen  for  this  purpose.  Apply 
cold  water,  ice,  etc.,  to  the  head. 

In  the  second  stage,  put  blisters  upon  the  back  of  the  neck,  and 
one  upon  the  bowels  if  they  are  very  tender. 

In  the  third  stage,  effusion  having  taken  place,  use  the  warm  bath, 
or  the  vapor  bath,  —  also  digitalis,  squills,  and  iodide  of  potassium, 
(144)  (128)  (302)  (130). 

Confine  the  child  to  a  darkened  room,  of  moderate  temperature,  — 
excluding  all  noise  and  causes  of  excitement,  and  let  him  lie  upon  r 
hair  mattress,  with  his  head  somewhat  elevated. 

Diet,  —  Gruel  only  during  the  stage  of  excitement,  — ^-  during  that 
of  collapse,  it  should  be  nourishing,  but  mild  and  easy  of  digestion, 
as  beef  tea,  plain  chicken  or  mutton  broth,  find  animal  jellies.  At 
the  same  time,  support  the  patient  by  the  cautious  use  of  the  aro- 
matic spirit  of  ammonia,  ten  drops  every  four  hours,  valerian,  wine 
whey,  and  infusion  of  getitian,  columbo,  or  quassia,  (64)  (66). 

Dropsy  of  the  Brain. — Chronic  Hydrocephalus. 

Acute  hydrocephalus  is  an  inflammation;  chronic  hydrocephalus, 
now  to  be  con^'  iered,  is  a  dropsy.  It  often  begins  before  birth.  It  con- 
sists in  the  accumulation  of  enormous  quantities  of  water  within  the 
brain,  sometimes  within  its  ventricles,  at  other  times,  upon  its  surface. 
When  it  occurs  soon  after  birth,  it  advances  slowly,  and  impercepti- 
bly,—  the  enlargement  of  the  head  being  the  first  thing  noticed. 

The  skull  being  tender  in  infancy,  it  separates  at  the  fontanellcs^  as 
the  fla'.d  accumulates,  and  ihe  head,  at  times,  attains  an  enormous 
size, — so  great  that  the  child  cannot  carry  it  upright,  but  lets  it  droop 
iaterally  upon  the  shoulder,  or  forward  upon  the  breast. 

As  the  disea&e  advances,  the  senses  become  blunted,  the  child  is 
deaf  or  blind,  the  intellect  is  weakened,  perhaps  idiocy  appears,  the 
flesh  and  strength  pass  away,  convulsions  and  paralysis  come  la  their 
turn,  and  a  stupor  is  apt  to  occur  which  ends  in  death. 

Treatment  —  The  remedies  may  be  external,  or  internal,  or  both. 

Internal!  Remedies.  —  Tnese  ehould  dp  pi.gatives  (33)  (31),  or  di- 
uretics and  alteratives  (302)  (145)  (144). 

ExtemtU  Remedies.  —  Apply  an  ointment  of  the  iodide  of  potas- 
siui ..  '  1  the  scalp  every  night  (185).     A  tight  bandage  applied  over 


DISEASES  OF  THE  BRAIN  AND  NERVES 


159 


jotas 


the  whole  head  will  sometimes  have  a  favorable  effect.  Another  ex- 
pedient ia  to  puncture  the  akull  and  draw  oflF  the  water.  Tapping 
the  brain  has  effected  a  cure  in  many  cases,  and  perhaps  promises  the 
most  relief  of  any  remedy  we  have. 

Diseases  of  the  Spinal  Cord. 


Fl*.  81. 


£-4 


occurring  in 


There  are  few  diseases  more  interesting,  as  a  study, 
than  those  which  affect  the  nervous  cord  which  runs 
1  through  the  centre  of  the  back-bone.  This  cord  is  a 
(Continuation,  an  appendage  or  tail  of  tlie  brain.  (Set; 
Figure  81.)  It  is  the  seat  and  centre  of  certain  ner- 
vous functions,  called  reflex^  by  which  so  many  move, 
ments  take  place  which  are  not  under  the  control  of  the 
will 

In  order  that  we  may  feel  what  takes  place  in  any 
part  of  the  body  or  limbs,  and  that  the  will  may  have 
power  to  move  such  part,  it  is  necessary  that  nervous 
matter  should  be  continuous  and  unbroken  between  the 
part  in  question  and  the  brain. 

If  llie  spinal  cord  be  cut,  broken,  or  crushed  at  any 
point,  all  those  parts  which  receive  nerves  from  below 
the  injury,  lose  their  power  of  motion  and  their  feel- 
ing. Wlicn  the  injury  is  in  the  upper  part  of  the  cord, 
the  breathing  and  the  circulation  will  stop,  and  death 
is  the  immediate  consequence.  If  the  middle  portion 
of  the  cord  be  the  seat  of  the  injury,  the  bowels  and 
other  organs  may  lose  their  motion  and  feeling ;  if  the 
lower  portion,  then  the  lower  limbs  only  will  be  the 
sufferers. 

Disease  or  inju:/  in  the  upper  part  of  the  cord  is 
therefore  much  more  dangerous  than  the  same  thing 
the  lower. 

t 

Inflammation  of  the  Spinal  Cord. 


The  membranes  which  surround  the  cord  may  be  inflamed  just  as 
those  are  which  enclose  the  brain ;  but  as  the  cavity  running  through 
the  spine  is  quite  small,  there  cannot  vpry  well  be  inflammation  of 
the  membranes  without  its  involving  the  cord  at  the  same  time.- 

Symptoms.  —  Pains,  often  intense,  running  alcr.g  the  spine,  extend- 
ing out  into  the  limbs,  and  made  worse  by  motion.  They  are  similar, 
ia  some  respects,  to  rheumatic  pains.  There  is  rigid  contraction,  and 
sometimes  violent  spasms  of  the  mu  (es  of  .^iie  back  and  neck,  -  -  so 
great,  at  times,  as  too  bend  the  body  back  into  the  shape  of  a  hoop ; 
also  a  feeling  of  constriction  in  various  parts,  a3  if  they  were  girt  by 
a  tight  string ;  a  sense  of  suffocation  ;  retention  of  urine ;  a  most 
obstinate  constipation  ;  and  frequent  chills  or  rigors.  The  pain  which 
is  felt  along  the  cord  is  aggravated  by  rapping  upon  the  spine,  but 
not  by  pressure. 


I'TT" 


160 


DISEASES  OF  TUK  BKAIN  AND  NEUVES. 


The  above  symptoms  are  supposoil  to  be  the  result  of  inflammation 
predominating  in  the  membranes.  When  itd  seat  is  more  particularly 
in  the  substance  ex'  the  cord,  the  symptoms  are,  —  convulsive  aftec- 
tions  of  the  head  and  face,  inarticulate  speech,  loss  of  voice,  squint- 
ing, and  difficulty  of  swallowing,  if  the  extreme  upper  part  of  the 
cord  is  inflamed;  if  the  disease  be  slightly  lower,  difficulty  of  breath- 
ing, irregular  action  of  the  heart,  and  tightness  of  the  chest ;  if  lower 
still,  vomiting,  pain  in  the  belly,  sensation  of  a  cord  tied  round  iiie 
abdomen,  pain  and  heat  in  passing  water,  retention  of  the  urine,  ina- 
bility to  retain  the  lirine,  desire  to  go  to  stool,  or  involuntary  stools. 

Spasm  and  stiffness,  then,  are  the  results  of  inflainination  of  the 
membranes;  convulsions  and  palsy,  of  the  same  alfection  of  the 
cord. 

Treatment  —  "When  the  inflammation  is  acute,  apply  a  few  leeches 
or  wet  cups  along  the  sides  of  the  spine.  In  chronic  inflammation, 
powerful  friction,  or  mustard  draughts,  stimulating  liniments  (190), 
or  plasters,  will  generally  answer  the  purpose. 

Apoplexy. 

Apoplexy  is  that  conaition  in  which  all  the  functions  of  animal 
fife  are  suddenly  stopped,  except  the  pulse  and  the  breathing;  —  in 
which  there  is  neither  thought,  nor  feeling,  nor  voluntary  motion ;  in 
which  the  person  falls  down  suddenly,  and  lies  as  if  in  a  deep  sleep. 

Nodes  of  Attack. —  There  are  at  le-^st  three  ways  in  which  this 
terrible  disease  may  make  its  assault. 

The  First  Form  of  attack  is  a  sudden  falling  down  into  a  state  of 
Insensibility  and  apparently  profound  sleep, — the  face  being  generally 
flushed,  the  breathing  stertorous  or  snoring,  the  pulse  full  and  not 
frequent,  with  occasional  convulsions. 

From  this  mode  of  attack  some  die  immediately,  others  get  entirely 
well,  and  others  get  off  with  the  exception  of  paralysis  on  one  side, 
or  the  loss  of  speech,  or  some  one  of  the  senses. 

Tlic  Second  mode  of  attack  begins  with  sudden  pain  in  the  head. 
The  patient  becomes  pale,  faint,  sick,  and  vomits,  —  has  a  cold  skin 
and  feeble  pulse,  and  occasionally  some  convulsions.  He  may  fall 
down,  or  be  only  a  lilile  confused,  but  will  soon  recover  from  all  the 
symptoms,  except  the  headache,  —  this  will  continue,  and  the  patient 
will  sooner  or  later  become  heavy,  forgetful,  unable  to  connect  ideas, 
and  finally  sink  into  insensibility,  from  whicl-  he  never  rises. 

This  mode  of  invasion,  though  not  appearing  so  frightful  as  the 
first,  is  of  much  more  serious  import.  * 

In  the  Third  form  of  attack  there  is  sudden  loss  of  power  on  one 
side  of  the  body,  and  also  of  speech,  but  not  of  consciousness.  The 
patient  retains  his  mind,  and  answers  questions  either  by  words  or 
signs.  This  may  be  called  paralytic  apoplexy.  The  patient  may 
either  die  soon,  or  get  well,  or  live  for  years,  with  imperfect  speech, 
or  a  leg  dragging  after  him,  or  an  arm  hanging  useless  at  his  side. 


7 


,  ina- 
itools. 
of  the 
of  the 


in 
ill 


DISEASES  OF  THE  nUAIX  AND  NEllVES. 


1(51 


Tlie  Persons  Attncked  are  apt  to  have  large  head;*,  red  faces,  short 
and  thick  necks,  and  a  short,  «tont,  square  build,  though  it  occurs 
often  among  those  who  are  thin,  pale,  and  tall.  The  tendency  to  it 
increases  in  advanced  life. 

The  Forerunners  of  apoplexy  are  headache,  vertigo,  slight  attacks 
of  palsy,  double  vision  or  seeing  two  objects  when  there  is  but  one, 
faltering  speech,  inability  to  remember  certain  words,  sometimes  a 
sudden  forgetfulness  of  oneV  own  name,  a  frequent  losing  of  tlie 
thread  of  ideas  attempted  to  be  pursued,  and  occasionally  an  unac- 
countable dread,  for  which  no  reason  can  be  given. 

Exciting  Caases.  —  Whatever  hurries  the  circulation  of  the  blood, 
as  strong  bodily  exercise,  is  an  eJcciting  cause.  So  are  all  those  tilings 
which  cause  the  blood  to  flow  towards  the  head,  as  coughing,  sneez- 
ing, laughing  and  crying,  straining  at  stool  when  costive,  lifting  heavy 
weights,  singing,  and  playing  on  wind  instruments.  To  these  may 
be  added,  exposure  to  the  sun,  the  bid  air  of  crowded  rooms,  holding 
the  head  down,  or  turning  it  around  to  look  backward,  tighl  cravats 
worn  about  the  neck,  and  exposure  to  severe  cold. 

Treatment.  —  If  the  patient  have  the  appearance  of  suffering  from 
fulness  of  blood  in  the  head,  as  evinced  by  redness  and  turgescence 
of  the  face,  and  throbbing  of  the  temporal  arteries,  and  if  the  pulse 
be  full  and  hard,  feeling  like  a  tense  vibrating  rope  under  the  finger, 
place  him  in  a  half-recumbent  posture,  with  his  head  raised ;  loosen 
his  clothes,  particular'^  his  neck-cloth  and  shirt  collar,  and  whatever 
may  press  upon  the  ck,  and  then  as  quickly  as  possible  apply  cold 
wet  cloths  to  his  head,  changing  them  often.  Ice  is  still  belter,  if  it 
may  be  had.  Apply  wet  cups  to  the  nape  of  the  neck,  and  mustard 
draughts  to  the  soles  of  the  feet,  —  at  the  same  time  applying  tight 
ligatures  around  the  limbs,  to  prevent  the  blood  from  returning  rap- 
idly in  the  veins.  The  ligatures  should  be  gradually  removed  when 
the  patient  recovers  his  consciousness.  Also  administer  a  stimulating, 
purgative  injection  (246),  and  place  two  drops  of  croton  oil,  rubbed 
up  with  a  little  pulverized  loaf  sugar,  far  back  upon  the  tongue.  Re- 
peat the  injec^on  every  fifteei.  minutes,  till  the  bowels  are  thoroughly 
moved. 

If  the  patient  be  old,  and  the  pulse  small  and  feeble,  with  no  ful- 
ness or  beating  of  ihe  temporal  arteries,  or  swelling  of  the  veins  of 
the  neck  and  forehead,  the  countenance  being  pinched,  and  the  skin 
bloodlei-s  and  cool,  the  cupping,  purging,  and  applying  the  ligature 
must  be  omitted.  In  this  case  it  will  be  better  to  apply  warm  flan- 
nels and  hot  bricks  to  the  surface,  and  administer  ammonia  and 
camphor  (283)  (135)  internally. 

To  prevent  future  attacks,  gentle  tonics  should  be  used,  and  the 
skin  should  be  kept  healthy  by  daUy  bathing  and  friction.  The  bow- 
els must  not  be  permitted  to  become  costive.  The  diet  should  be 
light,  chiefly  vegetable,  and  almost  entirely  so  in  hot  weather.  The 
food  should  be  well  chewed.  The  mind  should  be  kept  cheerful  and 
hopeful,  and  free  from  great  excitement.  The  sexual  passion  should 
be  restrained,  and  very  rarely  indulged.    Intoxicating  drinks  should  be 

21 


Z62 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


abandoned,  if  used,  and  all  tight  cravats  be  discarded  from  the  neck. 
Direct  rays  of  the  hot  pun  in  summer  should  be  carefully  shanned. 
No  food  should  be  taken  for  three  hours  before  ret'<ing,  and  a  rriat- 
tress  only,  of  some  degree  of  hardness,  nhould  be  fc.^pt  upon,  —  the 
head  being  always  well  elevated.  To  these  precautions,  I  would  add, 
dipping  the  feet  every  night,  before  retiring,  in  cold  water ;  and,  if 
any  tendency  to  cold  feet  be  experienced,  dusting  pulverized  uayenne 
in  the  bottoms  of  the  stockings. 

Sunstroke. —  Coup  De  Soleil. 

This  is  much  like  apoplexy;  in  fact,  it  is  a  kind  of  apoplexy.  It 
occurs  in  warm  climates,  or  in  very  hot  days  in  temperate  regions,  by 
exposure  to  the  sun. 

It  begins  by  headache,  thirst,  dizziness,  and  sometimes  difficult 
breathing  and  bilious  vomiting.  The  patient  drops  down  senseless, 
as  in  apoplexy,  and  unless  immediate  relief  is  obtained,  soon  dies. 

Tretltiiisiit.  —  Take  the  patient  immediately  into  the  shade,  and 
employ  about  the  same  remedies  as  for  apoplexy. 

Palsy.— Paralysis. 

Palsy  is  a  loss  of  the  power  of  voluntary  motion  and  feeling,  one 
or  both  coming  on,  sometimes  gradually,  but  more  often  suddenly, 
and  extending  at  one  time  to  a  part,  at  another  time  to  the  whole 
body.  It  is  a  kind  of  station-house  on  the  way  to  apoplexy,  where 
passengers  stop,  not  merely  to  stay  over  night,  but  to  rest  many  days, 
or  even  years. 

A  great  injury  inflicted  upon  the  brain,  either  by  pressure,  or  other 
cause,  will  induce  a  complete  loss  of  motion  and  Mseling,  and  this  ex- 
tending to  the  whole  structure,  brings  likewise  a  loss  of  conscious- 
ness, which  ia  apoplexy.  A  smaller  degree  of  pressure,  or  a  less 
injury  upon  the  same  brain,  would  occasion  a  loss  of  motion  only,  or, 
if  a  loss  of  feeling  were  experienced  also,  it  would  only  extend  to  a 
part  of  the  body,  and  consciousness  would  remain.  This  would  be 
palsy.  The  disease  is  like  apoplexy  in  kind,  but  stops  short  of  it  in 
degree. 

Hemiphlegia. 

"When  palsy  affects  an  entire  half  of  the  body,  dividing  it  through 
the  centre  of  the  face,  neck,  body,  etc.,  from  head  to  foot,  it  is  called 
hemiphkgia.  It  is  more  nearly  allif"*  o  apoplexy  than  any  other 
form  of  the  disease,  and  is  generally  ,  j..ered  in  by  pretty  well-marked 
apoplectic  symptoms. 

Symptoms. -r-  Sometimes  there  are  no  premonitory  symptoms  ;  but 
often  before  the  attack  there  are  flushed  face,  swelling  of  the  veins 
about  the  head  and  neck,  vertigo,  a  sens<«  of  fulness,  weight,  and 
sometimes  pain  in  the  head,  ringing  in  the  ears,  diow;5iness,  indistinct 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


163 


articulation  of  words,  or  even  loss  of  speech,  confusion  of  mind,  loss 
of  memory,  and  change  of  disposition,  —  amiable  persons  being  made 
sullen  ana  peevish,  and  irritable  ones  mild  and  simpering.  After  the 
attack,  the  countenance  generally  acquires  a  vague  expression ;  the 
mouth  is  drawn  to  one  side ;  the  lower  lip  on  the  palsied  side  hangs 
down,  and  the  spittle  dribbles  away.  The  speech  is  altered,  and  the 
mind  is  generally  impaired. 

In  some  instances,  the  patient  recovers  in  a  /onger  or  shorter  time; 
in  others,  little  or  no  improvement  takes  place,  and  the  patient,  aflei 
remaining  helpless,  often  for  a  long  time,  dies  either  from  gradual 
exhaustion,  or  suddenly  from  apoplexy. 

C'linses.  —  Hemiphlegia  and  paraphlegia,  are  caused  by  pressure 
n;joii  the  brain,  by  the  effusion  U|K)n  it  of  blood  or  water,  by  a  tumor, 
by  inct'hanicai  injuries,  by  the  striking  in  of  eruptions,  and  by  intem- 
perance in  eating  and  drinking,  Paraphlegia  often  results  from  dis- 
ease or  injury  of  the  spinal  marrow. 

Paraphlegia. 

This  form  of  palsy  divides  the  body  transversely,  at  the  hips,  and 
confines  itself  to  the  lower  extremities,  and  to  the  parts  about  the 
pelvis. 

Symptoms.  —  When  it  arises  from  affections  of  the  brain,  it  is  at- 
tended by  pain  in  the  head,  giddiness,  drowsiness,  dimness  of  sight, 
and  impaired  memory.  Numbness  is  sometimes  felt  in  the  upper 
extremities  as  a  forerunner  o ."  this  form  of  palsy  At  first  there  is  a 
slight  stiffness  and  awkwardness  of  the  motions  of  the  legs,  which 
continue  to  increase  till  a  cane  is  needed  to  balance  the  body  and 
make  it  steady.  From  a  paralysis  of  the  neck  of  the  bladder,  the 
stream  of  urine  grows  more  feeble,  and  finally  dribbles  away  involun- 
tarily. The  bowels  are  for  a  time  costive,  but  when  the  circular 
muscle  v'hich  closes  the  fundament  becomes  palsied,  the  feces  pass 
without  consent  of  the  will. 

When  disease  of  the  spinal  cord  is  the  cause  of  the  complaint,  it 
is  apt  to  come  on  gradually ;  languor  and  weakness  are  felt  in  the 
knees,  the  legs  are  not  easily  directed  in  walking,  —  being  thrown 
across  each  other,  causing  tripping  and  stumbling  By  degrees  the 
loss  of  power  increases  in  the  thighs  and  legs,  until  at  length  the 
wliole  lower  extremities  become  palsied  and  useless. 

Local  Palsy. 

Palsy  is  called  local  when  it  is  confined  to  a  single  limb,  or  muscle, 
or  locality.  One  of  these  forms  is  called  facial  palsy.  It  affects 
one  half  of  the  face  only,  and  is  a  good  specimen  of  these  affections. 
It  removes  all  power  of  expression  from  one  half  of  the  face,  and 
leaves  the  features  still,  blank,  and  unmeaning.  With  the  affected 
side  of  the  face,  the  patient  cannot  laugh,  or  weep,  or  frown,  or  ex- 
press any  feeling  or  emotion,  while  the  features  of  the  other  side  are 
in  full  play*  Among  the  ignorant,  who  do  not  comprehend  the  extent 
of  the  evil,  the  droUnesa  of  the  expression  excites  laughter. 


m 


104 


DISEASKS  OF  THE  BRAIN  AND  NERVES. 


Shaking  Palsy.        '  ,   _'        ,  , 

The  nature  of  this  form  of  palsy  is  v/ell  expressed  by  its  name. 

Symptoms. — .The  first  symptom  of  this  complaint  is  a  weakness 
and  tremor  of  the  head  or  hand.  In  about  a  year  the  other  hand,  or 
the  lower  extremities  become  affected  ;  and  the  patient  begins  to  lose 
his  balance  in  walking.  Then  the  trembling  becomes  perpetual ;  no 
litnb  or  part  remains  still.  Reading  and  writing  are  no  longer  possi- 
ble, and  the  hand  cannot  even  carry  the  food  to  the  mouth.  The 
balance  cannot  be  maintained  in  walking;  there  is  a  tendency  to  fall 
forwards,  and  to  avoid  it,  the  patient  is  obliged  to  run  or  move 
(juicker,  and  upon  the  toes. 

At  a  later  period,  the  tremor  continues  during  sleep ;  there  iis  in- 
creased weakness ;  the  body  is  bent  forward,  the  speech  becomes 
indistinct,  sw^allowing  difficult,  and  the  bowels  torpid.  At  last,  the 
urine  and  feces  pass  involuntarily,  and  delirium  and  coma  biiag  life 
to  a  close. 

Lead  Palsy. 

In  this  disease  the  muscles  of  the  forearm  are  palsied,  so  tfiat  the 
wrists  "  drop,"  as  it  is  said,  and  the  hands  hang  down  when  the  arms 
are  stretched  out.  It  is  caused  by  the  gradual  introduction  of  lead 
into  the  system.  It  is  a  disease,  therefore,  peculiar  to  painters, — 
particularly  those  who  use  carbotlate  of  lead,  or  white  lead,  as  it  is 
called.     It  is  generally  the  sequel  of  painter's  colic. 

Treatment.  —  A  sudden  and  severe  attack  of  palsy  .-equires  th«f 
same  treatmenr,  as  apoplexy.  When  the  bowels  are  obsrinately  con- 
stipated, they  must  be  purged  by  scammony  and  croton  oil  (31)  (32,) 
and  by  injectioiis  (246). 

When  all  the  symptoms  of  determination  of  blooa  to  the  head 
have  disappeart.'d,  and  the  disease  has  become  strictly  chronic,  ex- 
'citing  remedies  must  be'  employed,  as  frictions,  stimulating  liniments, 
blisters,  stimulating  baths,  cold  afl'usion,  and  electricity.  Among  the 
internal  remedies,  strychnine  has  the  best  reputation  (So)  (86).  The 
tincture  of  the  poison  oak  is  well  recommended  (284).  An  altera- 
tive (145)  should  likewise  be  used. 

Apply  counter-irritants  along  the  track  of  the  spine,  such  as  blis- 
ters, the  moxa,  the  compound  tar  plaster,  and  the  pitch  plaster. 

At  first  the  diet  should  be  light ;  but  after  the  more  active  symp- 
toms have  disap|)eared,  it  should  be  nutritious,  and  sometimes  stimu- 
lating.    Flannel  under-clothes  should  always  be  worn  next  the  skin. 


''I 
.'A 


DISEASES  OF  THE  BUAIN  AND  NERVES. 


165 


For  lead  palsy,  the  best  remcdiea  are  iodide  of  potasaiiun,  or  sul- 
phuret  of  potassium.  The  dose  of  either  of  these  is  from  three  to  ten 
grains,  three  times  a  day,  dissolved  in  water,  one  ounce  of  the  salt  to 
six  ounces  of  water,  and  taken  in  simple  syrup.  The  afteeted  limb 
should  also  be  soaked  an  hour  each  day  in  a  gallon  of  water,  with 
half  an  ounce  of  sulphuret  of  potassium  dissolved  in  it.        - 

Hydrophobia. — Rabies.  ' 

The  bite  of  the  mad  dog,  or  mad  wolf,  or  other  hydrophobic  ani- 
mal, is  the  most  dangerous  of  all  poisoned  wounds,  bec::;isc  it  is  apt 
to  be  followed  by  a  disease  for  which  there  is  no  certain  remedy. 
Fortunately,  the  human  subject  is  not  as  susceptible  to  the  effects  of 
the  poison  as  some  of  the  lower  animals ;  for  only  about  one-tenth 
of  those  bitten  are  attacked  by  hydrophobia. 

Syniptoiiis.  —  The  interval  between  the  bite  and  the  appearance  of 
the  disease,  varies  from  twelve  days  to  two  months.  The  wound 
heals  like  any  other  bite  of  a  similar  animal.  After  a  time,  the  sear 
begins  to  have  darting,  lancinating  pains,  which,  if  it  be  a  limb  that 
was  bitten,  run  up  towards  the  body.  Sometimes  it  feels  cold,  or 
stiff,  or  numb,  or  becomes  red,  swelled,  or  livid,  and  occasionally 
breaks  open,  and  discharges  matter.  The  patient  feels  a  strange 
anxiety,  is  depressed  in  spirit,  has  an  occasional  chill,  and  disturbed 
sleep,  and  spasrnotlic  twitches.  The  pulse  is  above  its  natural  state, 
both  in  quickne.ss  and  strength,  and  the  nervous  system  is  very  im- 
pressible. The  senses  are  all  more  acute  ;  trifling  noises  produce 
agitation,  and  the  eyes  are  so  disturbed  by  the  light  that  the  patient 
sometimes  hides  himself  in  a  dark  place.  The  appetite  is  lost.  This 
is  the  first  stage. 

Thirst  now  appears,  and  he  attempts  to  drink.  But  the  moment 
water  approaches  his  mouth,  a  spasmodic  shudder  comes  over  him  ; 
he  pushes  it  back  with  horror ;  the  awful  fact  of  his  condition  Hashes 
upon  him  ;  and  he  cries  out,  "  What  I  have  dreaded  has  come  upon 
me." 

Thenceforward  he  can  swallow  no  fluids;  complains  of  pain  and 
stiffness  about  his  neck  ;  is  thrown  into  convulsions  by  the  sight  of 
water,  or  even  the  sound  of  liquids  agitated  in  a  vessel,  or  by  a  breath 
of  air  blowing  upon  him,  by  a  bright  light,  or  the  glare  of  a  mirror. 
His  throat  is  full  of  a  viscid,  glairy  matter,  which  he  continually  iries 
to  clear  away.  Thus,  between  convulsions,  in  which  he  struggles, 
and  sometimes  strives  to  bite  his  attendants,  and  comparative  still- 
ness, during  which  he  suffers  great  depression  of  spirits,  he  passes 
three  or  four  days,  and  then  dies  either  in  a  spasm,  or  from  exhaus- 
tion. 

Treatment  —  Cut  off  the  bitteti  part,  or  apply  dry  cupping,  or  suc- 
tion, at  once.  Also  the  caustic  potash.  The  internal  remedies  here- 
tofore employed  have  had  little  success.  Perhaps  nothing  now  known 
promises  more  than  to  keep  the  patient,  for  a  long  time,  under  the 
influence  of  chloroform  or  ether.     The  tincture  of  scullcap,  in  two  or 


106 


DISKASKS  OF  TIIK  PUAIN  AND  NKIIVKS. 


three  tlrain  dowes,  will  'lliiy  tlio  nervous  agitation,  and  is  alway? 
worth  using.  It  has  been  proposed  to  clear  the  throat  of  the  tough 
mucus  by  cauterizing  it  with  a  strong  solution  of  nitrate  of  silver 
(219),  applied  with  a  shower  syringe.    The  remedy  is  worthy  of  a  trial. 

Some  of  the  Western  physicians  declare  the  red  chickweed,  or 
scarlet  pimpernell,  to  be  an  absolute  remedy  for  this  disease,  and  cite 
some  quite  remarkable  eases  of  its  success.  Four  ounces  of  this 
plant,  in  the  dried  state,  are  directed  to  be  boiled  in  two  quarts  of 
strong  beer  or  ale,  until  the  liquid  is  reduced  one  half.  The  liquid  is 
to  be  pressed  out  and  strained,  and  two  drams  of  laudanum  added  to 
it.  The  dose  for  a  grown  person  is  a  wine-glassful  every  morning 
for  three  mornings.  A  larger  dose  is  required  if  the  disease  have 
begun  to  show  itself;  and  if  the  case  be  fully  developed,  the  whole, 
may  be  taken  in  a  day.  The  wound  is  to  be  bathed  with  the  same 
decoction.  The  medicine,  it  is  said,  [)roduces  profuse  sweating.  It 
is  worth  a  trial. 

Considerable  has  been  said  of  late  of  a  remedy  used  in  some  parts 
of  Europe,  and  said  ro  be  eftectnal.  It  is  the  "golden  cenotides" 
{cetonia  aurata),  or  common  rose  brt^tlc,  found  in  large  quantities  on 
all  rose  trees.  A  similar  insect  is  said  to  iufest  the  geranium  plant. 
When  collected,  they  are  dried  and  powdered ;  and  given  in  this 
form,  relieve  excitement  (so  it  is  said)  of  the  brain  and  nerves,  and 
throw  the  patient  into  a  sound  sleep, 

Muscular  and  Nervous  Derangements  from  Wounds. 

In  some  persons,  a  very  small  local  injury  will  produce  violent  dis- 
turbance of  the  nervous  system.  Some  will  faint  and  be  thrown  into 
convulsions  and  vomiting  from  causes  scarcely  greater  than  the  prick 
of  a  needle  ;  and,  before  Morton  gave  the  world  the  boon  of  ether,  it 
was  not  very  uncommon  for  persons  to  die  under  the  knife  of  the 
surgeon.  One  of  the  most  serious  disturbances  from  wounds,  of  a 
nervous  and  muscular  character,  is 

Locked  Jaw. —  Tetanus. 

This  is  spasmodic  contraction,  with  rigidity,  or  stiffness,  of  the 
voluntary  musdes.  Sometimes  this  rigidity  is  partial,  at  other  times, 
universal  throughout  the  system. 

Tetanus  is  produced  by  two  causes,  exposure  to  cold  (idiopathic), 
and  bodily  injuries,  particularly  the  injury  of  a  nerve  (traumatic 
tetanus).  This  last  is  the  most  frequent,  —  perhaps  the  only  form  of 
the  complaint. 

The  Symptoms  are  long-continued,  violent  and  painful  contraction 
or  cramp  of  the  voluntary  muscles.  At  first  there  is  difficulty  and 
uneasiness  in  turning  the  head,  with  inability  to  open  the  mouth 
easily, — then  the  jaws  close  gradually,  but  with  great  firmness;  swal- 
lowing now  becomes  difficult,  and  a  pain,  starting  from  the  breast- 
bone, ])icrces  through  to  the  back,  —  probably  caused  by  cramp  of  the 


alway!« 
tough 
silver 
a  trial, 
eed,  or 
nd  cite 
of  this 
arts  of 
quid  is 
ded  to 
orning 
have 
whole, 
same 
g-     It 


of  the 


DISKASKS  OV  THK  UIIAIN  AND  NEllVES. 


167 


diaphragm  or  midriil!  The  cramps  now  extend  to  the  muscles  of  tiio 
body,  the  limbs,  the  face,  the  tongue,  etc.,  which  continue  in  a  state  of 
rigid  spasm,  —  being  swelled  and  liard  in  the  centre,  —  till  the  disease 
yields,  or  the  patient  dies.  At  times  the  abdominal  muscles  are  so 
tense  as  to  make  the  belly  as  hard  as  a  board.  Occasionally  the 
patient  is  drawn  backward  into  the  shape  of  a  hoop,  so  as  to  rest  on 
his  head  and  heels  (epistholonos) ;  at  other  times  he  is  drawn  forward 
in  the  shape  of  a  ball  (emprosthotonos).  All  the  contractions  ar<*  at- 
tended with  intense  pain.  It  is  the  racking  of  the  entire  body  with 
cramps  like  those  which  sometimes  attack  the  calf  of  the  leg.  So 
violent  are  the  contractions  that  the  teelli  are  sometimes  broken  by 
them,  and  the  tongue  is  often  badly  bitten.  In  the  mean  time,  the 
appearance  of  the  sufferer  is  frightful.  The  forehead  is  wrinkled,  the 
brow  knit,  the  eye-balls  motionless  and  staring,  the  nostrils  spread, 
the  corners  of  the  mouth  drawn  back,  the  set  teeth  exposed,  and  all 
the  features  fixed  in  a  ghastly  grin. 

Treatment — The  only  known  remedies  for  this  disease  are  chloro- 
form and  ether,  taken  either  into  the  stomach,  or  by  inhalation,  in 
(|uantities  sufficient  to  control  the  spasm,  and  to  be  pursued  as  long 
as  they  continue  to  occur.  The  costiveness  must  be  removed  by  one 
or  two  drops  of  croton  oil,  administered  in  a  spoonful  of  gruel. 

Epilepsy.— Epileptic  Fits. 

This  disease  has  been  sometimes  called  the  falling  sickness,  but 
generally  passes  under  the  more  vague  title  of  fits. 

Sjinptonis.  —  The  disease  is  characterized  by  a  temporary  loss  of 
consciousness,  strong  spasms,  and  intervals  between  the  tits.  The 
attack  is  sudden,  generally  without  warning,  and  attended  with  a  loud 
cry,  when  the  patient  falls  down,  is  senseless  and  convulsed,  strug- 
gles violently,  breathes  with  embarrassment,  has  a  turgid  and  livid 
face,  foams  lat  the  mouth,  bites  his  tongue,  has  a  choking  in  the  wind- 
pipe, and  app(!ars  to  be  at  the  point  of  death.  Presently,  in  from  five 
minutes  to  half  an  hour,  and  by  degrees,  these  symptoms  diminish, 
and  at  length  cease ;  and  the  patient  falls  into  an  apparent  sleep.  In 
a  short  time  more  he  recovers,  and  is  apparently  well.  These  attacks 
come  again  and  again,  and  at  irregular  intervals. 

This  is  the  worst  form  of  the  disease ;  there  is  another  class  of 
cases  in  which  the  symptoms  are  much  lighter,  —  there  being  no  tur- 
gescence  of  the  face,  no  foaming  at  the  mouth,  no  cry,  no  convul' 
sions ;  but  merely  a  sudden  and  brief  suspension  of  consciousness,  a 
fixed  gaze,  a  feeling  of  confusion,  or  a  totter,  from  all  of  which  the 
recovery  is  speedy. 

Causes.  —  These  are  numerous, —  as  worms,  disturbance  from  indi- 
gestible food  in  the  stomach  and  bowels,  difficult  teeth-cutting,  ner- 
vous irritation,  either  direct  or  by  sympathy,  sexual  excesses  and 
masturbation,  disease  or  injury  of  the  brain  or  spinal  marrow,  gall 
stones  in  the  excretory  duct  of  the  liver,  stone  or  gravel  in  the  kid- 


I 


M 


168 


DISEASES  OF  THE  BRAIN  AND  NKUVES. 


neys  and  bladder,  fright,  diHtresij  of  inind,  paHHion,  great  losa  of  bloo(f, 
and  iiiatiy  othersH. 

Treatment. —  But  little  can  be  done  during  the  fit,  except  to  protect 
the  patient  from  being  injured  by  the  violence  of  the  convulsions. 
To  do  this,  place  a  piece  of  leather,  cork,  or  other  BubHtancc  not  too 
hard,  between  the  buck  teeth  to  prevent  the  tongue  from  being  bitten. 
Remove  the  neckcloth,  and  unbutton  the  shirt  collar.  If  the  htomacli 
and  bowels  are  suspected  to  be  overloaded,  give  an  injection  (^6). 

The  treatment  during  the  intervals,  must  depend  on  the  cause  of 
the  disease.  If  worms  be  the  cause,  expel  them  ;  if  the  attficks  be 
excited  by  difficult  teething,  lance  the  gums ;  if  by  uterine  disturb- 
ances, search  out  the  nature,  and  give  the  treatment  recommended 
under  the  projjer  head ;  if  masturbation,  command  its  entire  discon- 
tinuance as  the  only  hojMi  of  relief;  if  the  complaint  arise  from  in- 
digestible food,  great  attention  must  be  given  to  the  diet  and  general 
health. 

In  all  cases,  indeed,  the  diet  should  be  carefully  regulated,  being 
light,  nutritious,  and  easy  of  digestion.  The  sleep  should  be  taken 
at  regular  hours,  and  daily  exercise  in  the  open  air  be  insisted  upon. 
The  bowels  must  be  kept  regular,  by  the  food,  if  possible ;  if  not,  by 
mild  laxatives.  Apply  along  the  spinal  column  195,  once  a  day, 
rubbing  it  well  in  ;  also,  now  and  then,  mustard  poultices. 

In  addition  to  these  remedies,  give  pills  of  iron  and  quinine  (72), 
one  after  each  meal,  —  also  oxide  of  zinc  (270),  which  is  one  of  our 
very  best  remedies.  Of  the  pills,  one  should  be  taken  three  times  a 
day. 

We  can  seldom  go  amiss  in  giving  medicine  calculated  to  relieve 
nervous  irritation,  and  to  build  up  the  general  system.  For  this  pur- 
pose, the  valerianate  of  quinine,  and  the  extract  of  black  coho.sh  (79) 
are  well  adapted.  Citrate  of  iron  and  strychnine  (316),  is  a  very 
valuable  remedy. 

It  is  said  that  a  black  silk  handkerchief  thrown  over  the  face  of  a 
person  in  a  fit,  will  immediately  bring  them  out  of  it.  It  is  an  ex- 
periment easily  tried;  and  having  seen  it  in  a  respectable  medical 
journal,  I  give  it  for  what  it  is  worth. 

Catalepsy.— Trance.— Ecstasy, 

Cataleptic  fits  are  simply  what  is  known  to  all  the  world  under 
the  name  of  trance ;  and  ecstasy  is  a  modification  of  the  same  ner- 
vous disorder.  It  is  a  state  in  which  the  mind  becomes  so  intensely 
absorbed  in  something  outside  of  its  earthly  tenement,  that  it  with- 
draws all  control  over  the  body,  and  all  apparent  connection  with  it, 
•  —  leaving  it  as  if  dead.  There  is  a  very  light  ticking  of  the  heart, 
just  perceptible  to  a  cultivated  ear,  but  the  breast  does  not  rise  and 
fall  with  breathing,  the  features  are  all  inexpressive  and  still,  the  eyes 
are  wide  open  and  motionless,  apparently  staring  after  the  departed 
intellect ;  and  the  body  and  limbs  are  entirely  passive,  —  remaining 
unmoved  where  they  are  placed  by  others,  however  tiresome  and 
uncomfortable  the  position.     In  a  wordi  a  person  in  catalepsy  is,  in 


)loo«|, 


(72), 


DISBASKS  OF  THE  BRAIN  AND  NEKVE8. 


1G9 


appearance,  like  a  marble  statue,  or  like  a  lintuau  ImmIv  suddenly 
turned  to  htone,  or,  like  Lot's  wife;,  to  a  pillar  ot"  salt.  There  id  u.i 
little  feeling,  or  thought,  or  consciousness,  as  if  tin;  1k)vv1  had  been  in» 
Btantaneously  broken  at  the  cistern,  and  tin;  apparent  deatli  were  real. 

It  is  a  peculiarity  in  this  disease  that  the  |)atient,  on  recovery  from 
a  fit,  takes  up  the  thread  of  conscious  life  just  where  it  was  broken  by 
th'-!  attack.  Thus,  if  she  were  lifting  a  cup  of  water  to  the  mouth, 
ehe  would  hold  it  steadily,  with  the  mouth  open,  till  the  return  of 
consciousness,  and  then  place  it  to  the  lips,  as  if  no  intt>rruption  hati 
occurred  ;  or,  if  conversing,  and  in  the  midst  of  a  sentence,  the  unfr 
ished  words  would  be  uttered  at  the  end  of  the  fit,  even  though  it 
bihould  last  many  days. 

Persons  in  a  cataleptic  fit  have  much  the  appearance  of  one  in  thr 
mesmeric  state  ;  and  the  statue-like  position  in  which  an  attack  iixes 
a  patient,  reminds  one  of  the  maimer  in  which,  the  psychologists,  so 
called,  will  arrest  a  man  under  their  influence,  and  make  him  immov- 
able, with  one  foot  raised  in  the  act  of  stepping. 

The  disease  attacks  females  much  more  often  than  males. 

The  premonitory  symptoms  are  much  like  those  of  epilepsy,  and 
the  treatment  should  be  about  the  same. 

Saint  Vitus's  Dance.  —  Chorea. 

This  disease  is  chicHy  confined  to  children  and  youth  between  the 
ages  of  eight  and  fourteen.     But  few  cases  occur  after  puberty. 

Symptoms.  —  The  complaint  affects  mostly  the  muscles  and  the 
limbs.  It  excites  curious  antics,  —  such  as  we  should  suppose  would 
occur  if  a  part  of  the  muscles  of  voluntary  motion  had  hatched  a 
mimic  rebellion,  broken  away  from  the  control  of  the  will,  and  in 
sheer  mischief  and  wantonness,  were  tripping  their  fellow  muscles, 
and  playing  tricks  with  the  patient.  A  few  of  the  muscles  of  the 
face  or  limbs  begin  their  mischievous  pranks  by  slight  twitches,  which, 
by  degrees,  become  more  energetic,  and  spread  to  other  parts.  The 
face  is  twisted  into  all  kinds  of  ridiculous  contortions,  as  if  the 
patient  were  making  mouths  at  somebody.  The  hands  and  arms  do 
not  remain  in  one  position  for  a  moment.  In  attempting  to  carry 
food  to  the  mouth,  the  hand  goes  part  way,  and  is  jerked  back,  starts 
again,  and  darts  to  one  side,  then  to  the  other,  then  mouthward 
again ;  and  each  movement  is  so  quick,  and  nervous,  and  darting,  and 
diddling,  that  ten  to  one  the  food  drops  into  the  lap.  If  the  attempt 
be  made  to  run  out  the  tongue,  it  is  snatched  back  with  the  quick- 
ness of  a  serpent's,  and  the  jaws  snap  together  like  a  fly-trap.  The 
lower  limbs  are  in  a  state  of  perpetual  diddle ;  the  feet  shuffle  with 
wonderful  diligence  upon  the  floor,  as  if  inspired  with  a  ceaseless 
desire  to  dance. 

It  is  supposed  by  some  that  the  disease  consists  in  a  partial  palsy 
of  a  part  of  the  muscles.  The  will  in  that  case  not  being  able  to 
control  the  palsied  muscles,  when  it  commands  the  others  to  move, 
their  action  is  not  balanced,  and  they  twitch  the  face  and  limbs  into 
all  the  capricious  and  fantastic  shapes  we  witness. 


i 


KL. 


170 


DI8KASK8  OV  TUK  BUAIN  AND  NKUVKS. 


\r 


Others,  niul  probably  with  more  truth,  hold  that  the  nont  of  the 
<liseii«e  it)  in  iht;  nTt'bfllum  or  little  bruin.  It  is  Hupposcd  to  be  one 
of  the  functionM  of  this  organ  to  preside  over  and  regulate  the  loco- 
motion,—  that  it  holds  the  olfice  of  chief  engineer,  and  that  its  duties 
are  to  keep  the  niuseles  in  subjection  to  the  will.  The  combined  and 
consenting  action  of  several  muscles  is  needed  for  every  movement. 
Jt  is  the  business  of  the  cerebellum  to  maintain  this  oneness  of  pur- 
pose and  action  — to  see  that  no  muscle  flinches  so  as  to  disturb  llio 
harmony  of  the  movement.  When  the  cerebellum  is  diseased,  all  is 
confusion, — just  as  the  locomotive  runs  from  the  track  ;vhen  the  en- 
gineer is  smitten  with  palsy. 

The  disease  is  not  dangerous,  but  when  it  continues  .  )r  many 
years,  it  is  apt  to  weaken  the  mind,  and  it  sometimes  very  nearly 
destroys  it. 

Canstit  —  Whatever  excites  and  weakens  the  nervous  system,  aa 
powerful  emotions  of  the  mind,  overworking  the  mind,  readmg  exeit- 
ing  )iovels,  eating  too  much  meat,  fright,  striking  in  of  eruptions,  self- 
pollution,  etc. 

Treatment.  —  In  the  first  place,  remove  all  causes  of  excitement. 
Take  the  patient  from  school,  and  require  some  sort  of  cheerful  out- 
door exercise,  daily.  Take  away  all  books,  and  be  careful  not  to  do 
anything  to  occasion  anger,  or  fear,  or  any  kind  of  injurious  excite- 
ment. 

In  the  second  place,  regulate  the  diet,  —  making  it  more  animal 
and  stimulating  if  it  has  been  too  low,  and  more  vegetable  and  cool- 
ing if  it  has  been  too  high. 

In  the  third  |)lace,  if  the  above  changes  have  not  been  sufficient  for 
the  purpose,  open  and  regulate  the  bowels  with  some  gentle  physic 
(30)  (34)  for  a  few  days. 

In  the  last  place,  build  up  the  nervous  system  with  oxide  of  zinc 
pills  (270),  three  a  day ;  or  iron  (73)  (80),  or  black  cohosh,  scullciij), 
etc.  (79),  or  the  compound  valerian  j)ill  (81).  Sulphate  of  zinc  (82) 
will  sometimes  succeed,  when  the  oxide  fails;  and  where  there  is 
scrofula,  the  iodide  of  zinc  is  to  be  used. 

To  these  remedies  should  be  added  the  shower-bath,  begining  with 
tepid  water,  and  making  it  a  little  colder  every  day.  If  the  shower- 
bath  frightens  the  patient,  or  is  not  otherwise  well  borne,  take  the 
sponge  bath. 

Chronic  Chorea. 

This  can  hardly  be  said  to  amount  to  a  disease.  It  consists  rather 
in  uncouth  tricks,  arising  from  some  slight  disorder  of  particular 
muscles,  and  grown  into  a  fixed  habit,  such  as  shaking  of  the  head 
every  three  to  twenty  seconds,  repeated  squinting  of  the  eyes  in  con- 
nection with  a  peculiar  knitting  of  the  eyebrows,  wrinkling  of  the 
nose,  shrugging  of  the  shoulders,  lifting  the  ears  up  and  down,  or 
even  moving  the  whole  scalp  back  and  forth.  These  movements  arc 
commonly  made  without  a  consciousness  of  it ;  and  generally  there 


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IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


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PhotDgraphic 

Sdences 

Corporation 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


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CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
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Canadian  Institute  for  Historical  Microreproductions  /  Instftut  Canadian  de  microreproductions  historiques 


..-^.t  ittnsST 


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DISEASES  OF  THE  BRAIN  AND  NERVES. 


171 


is  no  power  to  suspend  tliem  without  a  painful  oflTort  which  cannot 
be  easily  continued. 

No  medical  treatment  is  of  any  avail.  These  tricks  can  only  be 
corrected  by  great  watchfulness  and  etl'ort  on  the  part  of  the  person 
sutl'ering  from  them,  and  in  many  cases,  not  even  by  such  means. 

Cramps. 

Cramp  is  experienced  in  the  calves  of  the  legs,  the  thighs,  the 
stomach,  the  breast,  the  womb,  etc.  It  is  a  very  painful,  sudden,  and 
violent  contraction  of  one  or  more  muscles.  The  part  is  sometimes, 
as  the  phrase  is,  "drawn  up  into  knots."  When  it  attacks  the  stom- 
ach, it  is  a  very  dangerous  atiection.  Women  are  subject  to  it  about 
the  third  or  fourth  month  of  pregnancy. 

Caases.  —  Drinking  cold  water  when  very  hot  and  perspiring,  ex- 
posure to  dan.p  night  air,  debility,  indigestible  food,  and  excesses  in 
eating  and  drinking,  and  particularly  overstraining  the  muscles." 

Trentiiieiit. —  Moderate  the  excessive  labor  and  straining  of  the 
muscles  which  pioduce  the  cramps.  When  an  attack  occurs  in  the 
legs,  tie  a  cord  or  handkerchief  tight  around  the  leg  above  the  affected 
muscle.  This  will  generally  produce  instant  relief.  Also  rub  the 
part  with  spirits  of  camphor,  or  paregoric,  or  laudanum. 

When  it  occurs  in  the  stomach,  apply  warm  fomentations,  or  what 
is  better,  a  mustard  paste  (1G5).  Then  make  one  grain  of  morphine 
into  four  pills,  and  give  one.  If  this  does  not  bring  relief,  repeat  it 
in  half  an  hour.  The  bowels,  if  confined,  should  be  opened  with  an 
injection. 

Cramps  of  the  l;mbs  which  afflict  women  in  the  family  way  can 
only  be  mitigated,  not  cured,  till  after  confinement.  As  a  j)alliat:ve, 
high  cranberry  bark,  scullcap,  etc.  (87),  will  be  found  useful. 

Pain  of  the  Nerves. — Neuralgia. 

This  disease  affects  one  tissue  only,  —  the  nervous;  and  has  one 
symptom,  — pain. 

In  apoplexjj,  the  nerves,  rendered  powerless  and  senseless  by  an 
external  force,  are  like  a  man  under  a  bn  '•  of  earth  which  has  slid 
down  upon  him.  In  pa/sij,  they  arc  suc^cnly  bereft  of  feeling  and 
motion  by  a  bl  ng  scourge  within,  —  as  one  is  smitten  down  by  a 
pervasive  charge  Trom  a  magnetic  battery.  In  epilepsy,  the  nerves 
are  grasped  and  for  a  time  held  senseless  by  an  unseen  power,  in 
which  they  struggle,  as  a  man  strives  in  the  folds  of  the  anaconda. 
In  catalepsy,  they  are  suddenly  etifFened  into  senseless  strings,  for 
such  automatic  use  as  the  bystander  may,  for  the  time,  choose  to 
make  of  them.  In  chorea,  they  are  set  to  dancing  by  an  invisible 
exhilaration,  as  a  man  is  crazed  by  brandy. 

In  neuralgia,  the  nerves  are  neither  crushed,  nor  collapsed,  nor 
restrained  for  a  time,  nor  stiffened,  nor  exhilarated.  They  simply 
have  their  sense  of  feeling  intensely  exalted ;  they  are  filled  with  pain. 


172 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


The  pain  is  generally  of  a  peculiarly  darting,  piercing  character.  The 
patient  sometimes  calls  ic  tearing  pain.  It  comes  on  in  sudden  jiar- 
oxysms,  with  intervals  of  freedom  between.  The  attacks  are  some- 
times like  an  electric  shock,  and  are  so  agonizing  as  to  bring  a  tem- 
porary loss  of  reason.  Occasionally  there  is  great  tenderness  of  the 
parts  affected,  and  some  fulness  of  the  blood-vessels  in  the  neighbor- 
hood ;  but  generally  the  signs  of  inflammation  are  all  absent,  exccp. 
pain. 

Neuralgic  pains  occur  in  almost  every  part  of  the  system.     One  of 
the  most  familiar  forms  of  the  disease  is  known  under  the  name  of 


If^- 


Tic  Douloureux.  ' 

It  occurs  in  those  branches  of  the  fifth  pair  of  nerves,  which  go  to 
the  face.  (See  Fig.  92.)  Sometimes  one,  sometimes  all  of  the  three 
branches  are  affected,  but  more  often,  fio.  82. 

the  middle  branch  only.  When  the  up- 
per branch  is  the  seat  of  the  disease, 
the  pain  is  in  the  forehead,  the  brow, 
the  lid,  and  sometimes  the  ball  of  the 
eye.  The  eye  is  generally  closed  dur- 
ing the  pain,  and  the  skin  of  the  fore- 
head is  wrinkled.  When  the  affection 
is  in  the  middle  nerve,  the  pain  is  pre- 
ceded by  a  pricking  sensation  in  the 
cheek,  and  twitxjhing  of  the  lower  eye- 
lid. Soon  it  spreads  in  quick  and  pierc- 
ing pangs  over  the  cheek,  reaching  the 
lower  eye-lid,  the  sides  of  the  nostrils, 
and  the  upper-lip.  If  in  the  lower 
branch,  it  sends  its  lightning  shafts  to 
the  chin,  the  gums,  the  tongue,  and 
even  up  the  cheek  to  the  ear. 

Face-Aclie.  —  There  is  a  species  of  nervous  pain  called  face-adiv. 
which  does  not  quite  amount  to  tic  douloureux,  but  is  nevertheless 
very  afflictive.  It  occurs  principally  in  the  jaw,  which  seems  to  be 
filled  with  pain.  No  one  spot  seems  to  be  more  affected  than  an« 
other.  From  the  jaw  the  pain  oft-en  goes  to  the  whole  head,  but  it 
has  not  the  stabbing  intensity  which  generally  characterizes  neuralgia. 
It  often  proceeds  from  defective  teeth. 


Hemicrania. 

This  is  a  neuralgic  pain,  confined  to  one  side  of  the  head,  —  gen- 
erally the  brow  and  forehead.  Sickness  of  the  stomach  often  attends 
it,  and  in  many  cases,  it  is  periodical,  —  coming  on  at  a  certain  hour 
every  day,  and  lasting  a  given  time,  and  then  passing  away. 

It  may  be  caused  by  whatever  debilitates  the  system,  as  hysterics, 
Buckling  an  infant  too  long,  or  low  diet.     Li  fever  and  ague  districts, 


DISEASES  OF  THE  J3RAIN  AND  NERVES. 


173 


Iter.  The 
dden  par- 
ire  soino- 
ng  a  teni- 
ess  of  the 
neighbor- 
nt,  exc-('|)> 

One  of 
lame  of 


lich  go  to 
the  three 


it  is  frequently  produced  by  miasm, 
cannot  be  discovered. 


In  many  instances,  the  cause 


face-ac!it\ 
vertheh'ss 
ms  to  be 
than  an. 
ad,  but  it 
leuralgia. 


1.— 


gen- 


1  attends 
ain  hour 

ivsterics, 
districts, 


Sciatica. 

This  is  a  pain  beginning  at  the  hip,  and  following  the  course  of 
the  sciatic  nerve.  Occasionally  it  is  an  inflammatory  complaint ; 
sometimes  is  c"  mccted  with  an  affection  of  the  kidney;  but  fre- 
(juently  it  is  a  purely  neuralgic  or  nervous  pain  ;  and  I  have  therefore 
thought  it  best  to  place  it  here,  with  nervous  diseases. 

Beside  the  various  forms  of  neuralgia  now  noticed,  the  disease 
occurs,  —  sometimes  with  great  severity,  —  in  the  female  breast,  in 
t'.ie  womb,  in  the  stomach,  in  the  bowels,  in  the  thighs,  in  the  knee, 
and  even  in  the  feet.  In  many  of  these  cases,  the  disease  is  not  where 
the  pain  is  felt,  but  in  the  bradn  or  spinal  marrow,  and  consequently 
the  true  source  of  the  complaint  very  often  escapes  detection.  An 
excellent  Episcopal  clergyman  in  northern   New  York,  the  Rev.  M. 

B ,  with  whom  I  studied  Latin  and  Greek  preparatory  to  college, 

had  a  neuralgic  pain  in  the  knee  so  intense,  persistent  and  exhaustive, 
that  the  limb  had  to  be  cut  off  at  the  thigh  to  save  his  life. 

Treatmeilt.  —  This  must  be  as  diversified  as  the  causes  of  the  dis- 
ease. 

For  tic  douloureux,  and  some  other  forms,  give,  internally,  valeri- 
anate of  ammonia  (88) ;  also  89,  90,  91,  92,  93,  316. 

For  external  use  in  tic  douloureux,  and  other  neuralgic  affections, 
the  prescriptions  188,  196,  197,  198. 

For  the  face-ache,  above  mentioned,  muriate  of  ammonia  (134),  in 
half  dram  doses,  is  a  very  valuable  remedy. 

When  the  disease  is  caused  by  miasm,  and  has  a  periodic  character, 
like  ague,  it  must  be  treated  with  quinine  (67)  (79),  and  if  there  be  a 
low  state  of  the  blood,  iron  (72)  (93)  must  be  given  at  the  same 
time. 

The  shower  bath,  exercise  in  the  open  air,  and  whatever  else  will 
build  up  the  general  health,  must  be  used  according  to  circumstances. 

Dera'^gement  of  Mind.— Insanity. 

Most  writers  on  this  disease  have  attempted  a  de/inition  of  it.  I 
have  never  seen  one  which  suited  me.  Here  is  mine.  Insanity  is  a 
wrench  of  man's  nature,  which  sets  his  intellectual  and  moral  faculties 
aivry  in  their  relations  with  the  external  loorld. 

In  a  state  of  mental  and  moral  health,  he  looks  straight  at  the  out- 
ward world,  and  sees  it  ns  it  is;  insanity  gives  him  an  angular  con- 
nection with  it,  and  he  sees  it  as  it  is  not;  its  objects  have  all  changed 
their  relative  places ;  objects  at  the  right  in  the  panorama  of  life  have 
moved, to  the  centre,  or  gone  quite  over  to  the  loft ;  while  things  at 
the  top  have  gone  to  the  bottom,  and  those  in  the  lowest  places  have 
taken  the  highest.  With  the  thoroughly  insane,  the  loorld  has  ffotie 
back  to  chaos. 


•tr,\ 


'i' 


174 


DISEASES  OF  THE  BTIAIN  AND  NERVES. 


h 


f"-.. 


These  peraoiis  have  their  sensibility  very  much  altered  and  per- 
verted. Errors  of  the  senses  and  illusions  cheat  them.  In  many 
cases,  they  cannot  read  because  the  letters  are  mingled  in  a  confused 
mass.  They  often  do  not  recognize  their  freinds,  and  regard  them  as 
strangers  or  enemies. 

They  become  awkward  in  the  mechanical  use  of  their  hands,  and 
their  touch  loses  the  power  to  correct  the  errors  of  the  other  sense.-*. 
Hence  they  are  cheated  in  regard  to  the  size,  form,  and  thickness  of 
bodies. 

They  are  haunted,  at  times,  with  smells  which  have  no  existence, 
and  they  hoar  voices  distinctly  speaking  to  them  from  clouds,  or  from 
trees ;  and  these  voices  have  the  familiar  tones  of  a  friend,  relative,  or 
enemy. 

The  insane  lose  the  power  of  comparing  ideas.  They  associate 
things  the  most  unlike,  and  often  in  a  ridiculous  way. 

They  also  lose  the  control  of  themselves,  and  come  under  the 
dominion  of  their  passions ;  and  then  they  will  do  acts  which  they 
themselves  disapprove.  One  of  strict  integrity,  of  unblemished  mor- 
als, and  of  excellent  standing,  becomes  insane,  and  immediately  steals 
what  he  does  not  want,  makes  infamous  proposals,  and  indecent  ges- 
tures, and  is  in  every  respect  the  opposite  of  his  past  self. 

The  insane  often  become  averse  to  those  who  were  previously 
among  the  most  dear  to  them.  For  acts  of  kindness,  they  repay 
abuse.  They  fly  from  their  best  friends.  This  is  the  result  of  their 
fear  and  jealousy ;  for  they  are  very  cowardly  and  jealous.  This  alien- 
ation from  friends  is  almost  a  characteristic  of  insanity,  and  is  one  of 
its  saddest  features.  The  moral  affections  are  always  disordered, 
perverted,  or  annihilated  in  insanity.  So  much  is  this  a  leading  fea- 
ture of  the  disease,  that  it  is  only  when  the  insane  begin  to  recover 
their  moral  affections,  when  they  begin  to  wish  to  see  their  children 
and  friends,  to  fold  them  once  more  in  their  arms,  and  to  enter  the 
family  circle  and  renew  its  joys,  that  we  can  count  upon  any  certain 
signs  of  a  cure. 

The  insane  have  a  thousand  strong  fancies  in  regard  to  themselves. 
One  thinks  himself  inspired  of  God,  and  charged  with  the  conversion 
of  the  world ;  while  another,  equally  sincere,  believes  the  devil  has 
entered  into  him,  and  that  the  pains  of  hell  are  already  taking  hold 
of  him,  and  he  curses  God,  himself,  and  the  universe.  Still  another 
is  the  "  monarch  of  all  he  surveys,"  and  much  more  ;  he  governs  the 
world,  and  directs  the  stars.  One  has  all  knowledge,  and  affects  to 
teach  the  wisest.  Another  is  proud,  and  withdraws  from  his  fellows, 
tidding  them  not  to  come  into  his  presence  without  proper  acts  of 
homage,  —  calling  himself,  it  may  be,  a  king. 

There  are  five  kinds  of  insanity.  I  will  speak  of  each  of  them 
briefly. 


Melancholy. — Lypemania. 


Tins  is  char3<*terized  by  moroseness,  fear,  and  prolonged  sadness. 
The  melanchoi;  ;  person  is  lean  and  slender,  with  black  hair,  and  a 


and  per- 

In  many 

confused 

i  them  as 

ands,  and 
lit  senses, 
ckness  of 

existence, 
S  or  from 
ilative,  or 

associate 

inder  the 
hich  they 
'hed  mor- 
ely  steals 
cent  ges- 

)reviously 
icy  repay 
t  of  their 
'his  alien- 
is  one  of 
isordered, 
iding  fea- 
o  recover 
r  children 
enter  the 
ly  certain 

ernselves. 
onversion 
devil  has 
fing  hold 
11  another 
i^erns  the 
affects  to 
3  fellows, 
r  acts  of 

of  them 


sadness, 
ir,  and  a 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


175 


pale  and  sallow  countenance.  His  skin  is  brown  or  blackish,  and 
dry  and  scaly.  His  physiognomy  has  a  fixed  appearance,  the  muscles 
of  the  face  are  drawn  tight,  the  eyes  are  motionless,  and  directed  to 
one  point,  the  look  is  askance  and  suspicious,  and  the  general  expres- 
sion is  one  of  sadness,  fear,  and  terror.  He  desires  to  pass  his  days 
in  solitude  and  idleness.  He  walks  as  if  aiming  to  shun  some  dan- 
ger.    His  eye  and  ear  are  on  the  watch  for  evil. 

These  persons  do  not  sleep  much.  They  are  kept  awake  by  fear, 
jealousy,  and  hallucinations.  If  their  eyes  close,  they  see  phantoms 
which  terrify  them. 

Their  secretions  are  disordered.  The  urine  is  either  abundant  and 
clear,  or  scanty  and  muddy.  They  sometimes  retain  their  urine  for 
diiys.  One  patient  did  not  dare  to  make  water  lest  he  should  drown 
the  world,  but  was  finally  persuaded  lo  it  by  the  assurance  that  he 
would  extinguish  a  fire  which  was  devouring  a  city. 

Insanity  on  One  Subject. — Monomania. 

Tms  is  a  chronic  affection  of  the  brain,  not  attended  by  fever,  and 
clmraottMizcd  by  a  derangement  of  the  intellect,  the  affections,  or  the 
will,  upon  one  subject  only.  The  patient  seizes  upon  a  false  princi- 
ple, and  draws  from  it  injurious  conclusions,  which  modify  and 
eli:mge  his  whole  life  and  character.  In  other  cases  the  intellect  is 
sound,  but  the  alVeetions  and  disposition  being  perverted,  their  acts 
are  strange  and  inconsistent.  These  they  attempt  to  justify  by  plau- 
sible reasoning. 

Mania.     . 

This  is  also  a  chronic  affection  of  the  brain,  generally  without 
fever.  The  countenance  of  the  maniac  is  sometimes  fiushed,  at  other 
times  pale.  The  hair  is  crisped  ;  the  eyes  injected,  shining  and  hag- 
gard. Maniacs  dislike  the  light,  and  certain  colors  horrify  them. 
Their  ears  are  sometimes  very  red,  and  are  disturbed  by  a  tingling, 
and  a  rumbling  sound.  Noise  excites  and  disturbs  them.  They  suf- 
fer from  false  sensations,  illusions  and  hallucinations ;  and  their  ideas 
come  with  great  rapidity,  and  are  confused  and  without  order.  Their 
affections  are  in  a  state  of  turmoil,  and  their  judgments  are  all  erro- 
neous. 

Unlike  the  monomaniac,  their  delirium  extends  to  all  subjects. 
Their  entire  intellect,  affections  and  will,  are  a  chaotic  wreck. 

Dementia. 

Here  is  another  chronic  affection  of  the  brain,  without  fever,  in 
which  the  sensibility,  the  intellect,  and  the  will,  are  all  weakened. 
Demented  persons  liave  not  the  power  to  concentrate  their  minds  on 
anything,  and  can  form  no  correct  notions  of  rbjects.  Their  ideas 
float  after  each  other  without  connection  or  meaning.  They  sj>eak 
without  any  consciousness  of  what  they  are  saying. 


K,  t 


Many  of  them  have  lost  their  memory,  or,  like  old  persona,  they 
remember  nothing  recent,  —  forgetting  in  a  moment  what  is  just  said 
or  done. 

The  demented  have  neither  desires  nor  aversions ;  neither  hatred 
nor  love.  To  those  once  most  dear  to  them,  they  are  totally  indiffer- 
ent. They  meet  friends  long  absent  without  emotion,  and  part  from 
their  dearest  ones  without  a  pang.  The  eveiits  of  life  passing  around 
them,  awaken  in  them  no  inttirest,  because  they  can  connect  them- 
selves neither  with  the  past  nor  the  future ;  they  have  no  remen> 
brances,  nor  hopes.  Their  brain  is  inactive  ;  it  furnishes  no  ideas,  or 
sensations.  They  are  no  longer  active,  but  passive  beings  ;  they 
ilcfcr mine' nothing,  but  yield  themselves  to  the  will  of  others. 

They  have  a  pale  face,  a  dull  eye,  moistened  with  tears,  an  uncer- 
tain look,  and  a  physiognomy  without  expression.  They  sleep  pro- 
foundly, and  for  a  long  time,  and  have  a  voracious  appetite. 


- 


^;' 


Idiocy.  ..      _  '  " 

Idiocy  is  the  condition  in  which  the  intellectual  faculties  have 
never  been  manifested.  We  are  not  to  infer  disease  from  it,  any  more 
than  we  infer  it  in  the  lower  animals  from  the  absence  of  intellect. 

In  idiocy  there  is  no  mind,  because  the  brain  is  not  large  enough 
to  be  the  organ  of  intelligence.  It  always  dates  back,  therefore,  to 
the  beginning  of  life.  Everything  about  the  idiot  betrays  a  defective 
organisation.  The  demented  person,  the  monomaniac,  etc.,  once  had 
intelligence  ;  the  idiot,  never.  They,  in  many  cases,  may  be  cured ; 
he  is  hopelessly  incurable.  They  had  blessings  which  have  been 
taken  from  them ;  to  him,  none  were  ever  given.  They  were  once 
the  pride  and  hope  of  their  friends  ;  he,  from  his  birth,  was  the  smit- 
ten and  blasted  one  of  his  family.  He  never  reaches  an  advanced 
age,  —  rarely  living  beyond  thirty  years. 

These  remarks  are  sufficient  to  show  the  difference  between  idiocy, 
and  other  forms  of  mental  derangement.  In  the  other  forms  of  in- 
sanity there  are  brains  enough,  but  they  are  diseased;  in  this  there  is 
no  disease ;  the  smallness  of  the  brain  is  the  primal  and  fatal  defect 

This  form  of  mental  derangement  is  caused  by  a  defective  develop- 
ment of  the  brain.  That  the  other  forms  are  produced  by  disease  of 
the  brain,  there  can  be  no  doubt. 

Some  have  supposed  insanity  to  be  a  mental  disorder  merely,  hav- 
ing nothing  to  do  with  the  body.  They  might  as  well  suppose  the 
delirium  of  fever  to  be  a  disease  of  the  mind  only. 

Insanity  is  an  unsoundness  of  the  brain  and  nerves  wh'ch  proceed 
from  it,  in  every  instance.  At  first  it  is  probably  only  excitement  of 
the  brain  ;  but  this,  long  continued,  becomes  a  chronic  inflammation. 
The  brain  and  nerves  of  an  insane  person  are  undoubtedly  sore,  and 
hence  the  painful  thoughts  and  feelings  which  afflict  them.  Whec 
tlic  soreness  is  much  increased,  they  are  violent  and  furious ;  whta 
it  subsides,  they  are  calm.  In  consequence  of  this  inflammation 
and  soreness  of  the  brain,  an  insane  person  can  no  more  think,  oi 
reason,  or  will,  or  feel  correctly,  than  a  person  with  an  inflamed 


stomach  can  digest  food  well,  or  than  one  with  inflamed  eyes  can 
see  well. 

C'ciUHes  of  Insanity.  —  Hereditary  predisposition ;  painful  subiccts 
of  thought  or  feeling  long  revolved  in  the  mind ;  injured  feelings 
which  cannot  be  resented,  mortified  pride,  perplexity  in  businesp ; 
disappointed  affection  or  an'bition  ;  great  political,  religious,  or  social 
excitements ;  sudden  and  heavy  strokes  of  misfortune  in  the  loss  of 
property  and  friends;  and  in  general,  whatever  worries  the  mind  foe 
a  long  time,  and  creat^^a  a  deep  distress,  may  be  a  cause  of  insanity. 

But  one  of  the  moat  prolific  causes,  and  worthy  of  special  mention, 
is  masturbation,  or  self-pollution,  —  a  vice  contracted  by  thousand;, 
of  young  people,  both  male  and  female. 

Beside  the  above,  I  may  mention  several  physical  causes,  as  coji- 
vulsions  of  the  mother  during  gestation,  epilepsy,  monthly  disorders 
of  women,  blows  upon  the  head,  fevers,  loss  of  sleep,  syphilis,  exces- 
sive use  of  mercury,-worms  in  the  bowels,  and  apoplexy. 

Chances  of  Cure.  —  Idiotism  is  never  cured. 

Melancholy  and  monomania  are  cured  when  recent,  and  do  not 
depend  upon  organic  disease. 

Dementia  is  sometimes,  though  seldom,  cured. 

Chronic  insanity,  of  long  standing,  is  not  easily  cured. 

Insanity  which  has  been  produced  by  moral  causes,  acting  sud- 
denly, are  generally  curable  ;  if  the  causes  have  acted  slowly  and 
long,  the  cure  is  more  doubtful. 

Excessive  study  causes  insanity  which  is  hard  to  cure. 

If  caused  or  continued  by  religious  ideas,  or  by  pride,  it  is  not  often 
cured. 

Insanity  caused  and  maintained  by  masturbation,  is  cured  with 
great  difficulty. 

Treatment. —  The  treatment  of  the  insane  is  now  almost  confined, 
as  it  should  be,  to  public  hospitals.  In  these  institutions,  all  the 
means  are  provided  which  humanity  has  been  able  to  devise,  to  lift 
from  these  unfortunate  beings  the  terrible  shadow  which  is  upon 
them.  Here  they  have  safety,  comfort,  recreation,  friendly  guardians, 
rest,  and  medicine. 

They  have  safety  from  the  annoyances  which  well-meaning  but 
mistaken  friends  at  home  almost  always  commit  in  contradicting,  and 
n»asoning  with,  persuading,  and  threatening  them ;  for  only  in  these 
humane  institutions  has  it  been  well  learned  that  to  do  so  is  no  wiser 
than  to  persuade,  scold,  or  threaten  a  neuralgic  pain  in  the  face,  an 
inflammation  in  i  e  stomach,  or  a  felon  upon  the  finger.  They  are 
safe,  too,  from  the  impertinent  scrutiny  of  neighbors,  the  hootings  of 
unthinking  boys  in  the  streets,  and  especially  from  the  causes,  what- 
ever they  are,  which  have  produced  the  disease.  And  so  far,  this  is 
just  the  treatment  they  want,  —  no  contradiction,  no  impertinent 
scrutiny  from  neighbors,  no  abuse  in  the  streets,  and  a  withdrawal  of 
the  causes  which  have  produced  the  disease. 

In  these  institutions,  to  i,  they  have  comforts.     They  have  clean 

23 


f  i 


nn 


178 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


roomn,  ralleriea,  lodges,  bathing-roomfi,  yards  and  gardens  for  cxerciHe 
and  walking,  safe,  quiet,  well-aired  bed-rooms,  and  clean  and  com- 
fortable beds ;  cheerful  dining  rooms,  and  plain,  wholesome,  and 
nutritious  food.     And  this,  likewise,  is  the  treatment  they  require. 

They  have  recreation,  —  dances,  cards,  back-gammon,  chequers, 
chess,  billiards,  nine-pins,  walking  parties,  riding  partit  s,  gardening, 
and  an  indulgence  in  those  arts  of  painting,  music,  ciiawing,  uiid 
architecture,  for  which  they  may  have  a  taste.  And  such  recreations 
are  powerful  instruments  m  the  cure  of  fU  disorders  of  the  nervous 
system. 

Here,  too,  they  have  friendly  guardians,  who  have  long  studied 
their  complaints,  and  have  imbued  their  souls  with  a  sympathy  which 
goes  down  into  the  depths  of  their  suiTerings,  and  allies  itself  with 
all  their  sorrows  ;  —  men  and  women  who  are  willing  to  act  the  part 
of  guardian  angels ;  to  be  their  friends  ;  who  know  how  to  gain  their 
confidence ;  and  who  use  the  influence  acquired  by  love,  in  leading 
them  back  towards  health  and  happiness.  And  this,  too,  in  curing 
the  insane,  is  of  great  consequence,  for  none  can  do  them  good  till 
they  have  their  confidence,  and  this  can  be  gained  only  by  love  and 
wisdom. 

In  these  insane  asylums,  they  find  rest.  When  the  brain  is  hot 
from  inflammation,  and  they  are  raving  from  delirium,  they  are  here 
withdrawn  from  the  noisy  crowd,  and  shielded  from  the  rude  shocks 
of  the  world.  If  need  be,  they  are  placed  in  solitary  rooms,  where 
silence  spreads  its  soothing  stillness  through  their  excited  brains.  And 
it  is  of  the  greatest  importance  that  the  sore  and  torn  feelings  should 
rest ;  for  rest  allays  excitement,  and  brings  sleep ;  and  without  a  proper 
amount  of  sleep,  recovery  is  not  possible. 

Finally,  in  these  institutions,  they  receive  the  best  medical  treat- 
ment, "they  have  warm  and  cold  bathing,  judiciously  administered  ; 
they  have  simple  cathartics  when  the  bowels  are  bound,  as  salts,  cas- 
tor oil,  and  magnesia  ;  tonics  for  debility,  such  as  quinine,  iron,  quas- 
sia, columbo,  and  chamomile ;  and  quieting  medicines  for  their  ex- 
citement, such  as  opium,  morphin?,  cicuta,  hyoscyamus,  belladonna, 
stramonum,  scuUcap,  and  valerian.  Prescription  74  is  a  combination 
much  used.  Here,  too,  broth,  gruel,  and  milk,  are  administered  by 
the  forcing  pump  to  such  at  -ake  a  fancy  not  to  eat,  —  an  expedient 
which  has  saved  many  lives.  Fruits  of  all  kinds,  as  strawberries, 
cherries,  currants,  plums,  apples,  peaches,  and  grapes,  are  allowed 
freely.  Cold  water,  sweetened  or  otherwise,  is  the  drink.  To  these 
things  are  added  lively  conversation,  and  whatever  will  divert  the 
mind  from  ieflection,  and  internal  imaginings  and  revery. 

Thus  I  have  indicated,  very  briefly,  the  treatment  which  the  insane 
receive  in  public  institutions.  That  the  chances  of  recovery  in  these 
humane  retreats  is  much  greater  than  at  home,  does  not  admit  of  a 
doubt.  When  it  is  not  convenient  to  send  an  insane  person  to  a 
hospital,  the  treatment  should  be  as  near  like  the  one  here  sketched 
as  circumstances  will  permit 


DI8KA8ES  OF  THE  BUAIN  AND  NERVES. 


179 


exercise 
nd  coin- 
me,  and 
luire. 
.'hequera, 
irdening, 
'ing,  and 
creations 
;  nervous 

r  studied 
;hy  which 
self  with 
t  the  part 
»ain  their 
11  leading 
in  curing 

?;ood  till 
ove  and 

lin  is  hot 
y  are  here 
de  shocks 
ms,  where 
tins.  And 
igs  should 
it  a  proper 

'ical  treat- 

niatered ; 

salts,  cas- 

iron,  quas- 

their  ex- 

Uadonna, 

mbination 

istered  by 

expedient 

•awberries, 

allowed 

To  these 

divert  the 

the  insane 
ry  in  these 
admit  of  a 
erson  to  a 

e  sketched 


Hypochondria. 

The  common  names  of  this  disease  are  low  spirits,  spleen,  vapors, 
hypo,  and  the  blues.  It  produces  constant  fear,  anxiety,  and  gloom. 
Business,  pleasures,  the  acquisition  of  knowledge,  and  all  the  useful 
pursuits  of  life,  become  insi|)id,  tasteless,  and  even  irksome  to  the 
hypochondriac.  His  mind  is  full  of  the  belief  that  sonujthing  dread- 
ful is  about  to  befall  him.  He  is  either  going  to  be  sick,  or  to  die  r 
lose  his  property  or  friends.  He  has  no  mind  to  engage  in  any  busi- 
ness, nor  does  he  wish  to  go  anywhere,  or  to  see  anybody.  Night 
and  day  his  spirits  are  down  to  zero,  and  his  heart  has  a  load  too 
heavy  to  bear.  He  is  wholly  occupied  with  his  troubles,  and  his  feel- 
insjs.  He  thinks  he  has  various  diseases,  and  wears  out  his  friends 
by  talking  of  his  sufl'erings.  He  feels  of  his  pulse  often,  looks  at  his 
tongue  in  the  glass,  and  several  times  a  day  asks  a  friend  if  he  does 
not  look  pale  or  sick. 

The  external  senses  manifest  symptoms  of  derangement  as  well  as 
the  thoughts,  feelings,  emotions,  and  passions.  There  are  roarings  in 
the  ears,  like  a  waterfall,  or  the  noise  of  a  distant  carriage.  Floating 
black  specks,  or  bright  sparks,  are  seen  before  the  eyes.  These  indi- 
cate a  slight  fulness  of  the  blood  vessels,  and  perhaps,  in  some  in- 
stances, sparks  of  electricity  passing  to  or  from  the  eye,  and  are  in  no 
proper  sense  subjects  for  the  alarm  they  cause.  At  one  time  the 
person  will  feel  as  large  as  a  barrel,  at  other  times  not  larger  than  a 
whip-stock ;  the  head  will  feel  light  or  heavy,  large  or  small.  The 
skin  will  twitch  in  different  parts,  or  feel  numb,  or  have  the  sensation 
of  spiders  crawling  on  it  The  smell  and  taste  become  perverted ; 
the  hypochondriac  will  smell  odors  and  flavors,  at  times,  where  there 
are  none. 

These  errors  of  the  senses  are  all  owing  to  some  slight  disorder  of 
the  organs  of  sense ;  and  they  are  no  more  wonderful  than  that  the 
mind  should  perceive  personal  danger,  poverty,  and  death  itself,  when 
none  of  these  things  are  impending. 

These  persons  are  subject  to  fainting  turns,  when  the  breathing  will 
appear  to  stop,  the  body  become  cold,  the  face  pale  ;  there  will  be 
distress  in  the  region  of  the  heart,  which  will  apparently  stop  beating, 
and  the  person  will  feel  as  if  dying.  At  the  same  time  the  mind  will 
remain  clear.  These  nervous  spells  are  alarming,  but  pass  ofl'  with- 
out danger. 

These  persons  become  changed  in  their  moral  dispositions.  They 
are  jealous,  take  a  joke  as  an  affront,  and  feel  the  greatest  distress  at 
any  apparent  lack  of  attention  or  neglect  on  the  part  of  friends. 
They  put  the  worst  construction  upon  the  actions  of  friends.  They 
are  irritable,  fretful,  peevish,  and  fickle. 

The  complaint  is  distressing,  but  does  not  appear  to  shorten  human 
life. 

The  seat  of  the  disease  is  in  the  brain  and  nerves.  It  is  caused  by 
anxiety,  care,  disappointment,  working  the  brain  too  hard,  diseases  of 


i' 


W:. 


V    ' 


: 


I' 


1. 


I    V 


ISO 


DI8KARR8  OF  THE  BRAIN  AND  NRRVES. 


Ilie  liver  hikI  Htuinacli,  contiveness,  ucdontury  habitu,  excessive  venen'a) 
iii(lulgi<iu:c,  and  inaHturbatioii. 

Treutnieiit,  —  This  diaease  in  inoro  easily  prevented  than  cnred.  It 
would  be  ulinost  entirely  prevented  in  this  eountry  if  in  childhood  we 
were  all  taught  to  be  contented  with  humble  competence,  to  love 
active  labor,  and  to  think  it  honorable,  instead  of  struggling  after 
wealth,  and  falling  into  unhappineMS  when  it  does  not  come. 

ItciiiPdieH,  —  Of  all  the  remedies  for  this  complaint,  that  which  is 
most  iuiportant  is  active  employment  out  of  doors.  The  human 
body  was  made  for  motio.-i.  Without  it  the  blood  cannot  be  dis- 
tributed to  the  several  or/^ans.  The  senses,  —  the  eye,  the  ear,  the 
touc^h,  —  should  be  much  in  communion  with  ntiture.  In  this  way 
they  are  strengthened.  Nature  is  their  great  physician.  Man  is  a 
creature  of  sensation  ;  and  if  too  much  occupied  with  feelings, 
liioughts,  and  deep  reflections,  the  nerves  will  be  irritated,  and  begin 
to  give  deceptive  sensations.  A  very  nervous  man  should  lly  to  some 
active  occupation,  if  he  would  be  rid  of  suffering. 

The  open,  fresh  air  is  very  important  to  restore  the  system  to 
soundness. ' 

Temperance,  both  in  eating  and  drinking,  will  do  much  for  this 
class  of  patients,  yet  they  are  the  very  persons  who  eat  largely,  and 
they  often  fly  to  the  excessive  use  of  stimulants  to  drive  away  their 
sorrow.     By  so  doing,  they  aggravate  the  disease. 

Alliasenients  are  very  important  for  hypochondriacs.  Lively  com- 
pany, cheerful  aud  witty  conversation,  with  mirth  and  laughter,  lively 
songs  and  instrumental  irmsic,  arc  all  desirable  ;  and  so  are  gunning, 
fishing,  iding,  billiard-playing,  and  travelling. 

Never  allow  these  patients  to  be  alone,  and  to  have  time  to  brood 
over  their  misery.  See  that  they  go  early  to  bed,  and  rise  betimes  in 
the  morning.  The  warm  bath,  the  cold  shower,  or  sponge  bath,  with 
brisk  friction,  are  not  on  any  account  to  be  omitted.  The  diet  should 
be  light,  nutritious,  and  generous  ;  but  fats,  acids,  licjuors,  and  cofTee, 
must  be  forbidden. 

But  little  medicine  will  be  required.  If  there  be  costiveness,  let  the 
cracked  wheat  be  eaten;  if  this  do  not  answer,  a  liltle  rhubarb  and 
bicarbonate  of  potassa  (35),  or  lepteudrin,  podophyllin,  etc.  (36),  may 
be  given  as  required  by  the  symptoms.  A  teaspoonful  of  calcined 
inagnesia  once  a  day,  or  the  infusion  of  thoroughwort,  drank  cold, 
will  often  answer  an  excellent  purpose.  A  bowl  of  warm  mothei-- 
wort  tea,  with  a  teaspoonful  of  spirits  of  camphor  in  it,  will  do  well 
in  fits  of  fainting  when  there  is  a  sensation  of  dying.  A  teaspoonful 
of  sulphuric  ether  may  be  given  at  the  same  time.  If  there  be  debil- 
ity, tonics  are  sometimes  useful  (50)  (49)  (54)  (55). 

Hiccough. — Singultus. 

This  is  a  sudden,  jerking  spasm  of  the  midriff,  occurring  every  few 
moments  in  bad  cases,  causing  the  air  to  be  driven  out  of  the  lungs 


veiierrnl 

ured.  It 
lliood  we 
t<j  love 
me;  after 


,  -1 


•t 


vliich  is 
human 
be  (Hs- 


p.  far,  tlie 
thia  way 
Vlan  in  a 
feelings, 
11(1  begin 

y  to  Hoin(! 

lysteni   to 

h  for  this 
rgcly,  and 
way  their 

ively  com- 
iter,  lively 
;  gunning, 

1  to  brood 
betimcH  in 
bath,  with 
liet  should 
md  coffee, 

ess,  let  the 
ubarb  and 
(36),  may 
)f  calcined 
rank  cold, 
m  mother- 
fill  do  well 
eaapoonfal 
e  be  debil- 


[  every  few 
f  the  lungs 


DISEASES  OF  THE  BUAIN  AND  NBUVKS. 


181 


with  such  BuddennesB  an  to  produce  a  noinc  »omething  like  the  invol- 
untary yel|)  of  a  pr<ppy.  It  is  generally  cauHcd  by  acidity  of  the 
stomach,  which  irritttes  the  nerves  distributt^d  to  iti*  neighborhood, 
and  is  not  difficult  to  remove ;  but  wuen  it  occurs  towards  the  close 
of  some  acute  and  grave  disease,  it  is  Hoinetimes  a  sign  that  dissolu- 
tion is  at  hand. 

Treutnifilt.  —  Startle  the  person  suffering,  by  exciting  surprise,  or 
fear,  or  anger ;  or,  let  a  few  small  draughts  of  cold  wati'r  b<^  taken  in 
(juick  BucccHsion  ;  or,  let  the  bnnith  be  held  as  long  as  possible.  If 
the  stomach  is  s(mr,  take  a  teaspoonful  of  bicarbonate  of  soda,  di.s- 
solved  in  half  a  tumblerful  of  cold  water.  To  expel  wind  from  the 
stomach,  if  it  be  pn'scnt,  take  some  warm  aromatic-essence  of  pep- 
permint, ether,  or  compound  spirits  of  lavender.  But  one  of  the 
most  effectual  remedies,  is  heavif  jrressure  made  upon  "'e  collar  bones. 
It  is  simple,  and  very  effectual. 

Painting. — Si/ncope. 

Fainting  is  preceded  by  a  distress  about  the  heart,  a  swimming  of 
the  head,  sometimes  sickness  at  the  stomach,  coldness  of  the  hands 
and  feet,  and  a  loss  of  sight,  or  a  sense  of  thing's  growing  dark.  The 
breathing  diminishes,  the  pulse  becomes  small,  the  face  deadly  pale, 
and  the  patient  wilts  down,  and  becomes  more  or  less  unconscious  of 
what  is  passing  around. 

"Whatever  causes  debility,  particularly  of  the  nervous  system,  vvill 
predis|X)se  to  fuintiiig.  Persons  much  weakened  by  disease,  faint 
easily,  —  especially  when  they  attempt  to  stand  still.  When  on  their 
feet,  such  persons  should  keep  moving.  Fainting  is  sometimes  in- 
duced by  sudden  surprizes  and  emotions,  by  violent  pains,  by  the 
sight  of  human  blood,  and  by  irritation  of  the  coats  of  the  stomach 
by  indigestible  food. 

1'rrntiiieilt.  —  Lay  the  patient  upon  the  back,  with  the  head  low ; 
let  fresh  air  into  the  room  instantly,  and  apply  gentle  friction. 
Sprinkle  a  little  cold  water  upon  the  face,  and  hold  spirits  of  cam- 
phor, ether,  hartshorn,  or  vinegar  to  the  nose,  —  rubbing  a  little  of 
the  spirits  of  camphor  upon  the  forehead,  and  about  the  nostrils.  As 
soon  as  the  patient  can  swallow,  give  a  teaspoonful  of  com|X)und 
spirits  of  lavender,  with  ten  drops  of  water  of  ammonia  in  it. 

Persons  sutiject  to  fainting  should  not  go  into  crowded  assemblies 
where  the  air  is  bad  ;  neither  should  they  wear  tight  dresses,  or  allow 
themselves  to  get  excited.  Cold  bathing,  a  weH-regulated  diet,  and 
TCgetable  ttnics,  will  do  much  to  break  up  the  habit 

D*  -^inesa  of  the  YLqz.^.— Vertigo. 

This  affection  makes  objects  which  are  stationary  appear  as  if 
moving,  or,  as  the  phrase  is,  "  turning  round."  When  seized  with  it, 
one  will  have  a  sensation  as  if  falling,  and  objects  about  hi;n  will 
seem  to  be  in  motion. 


Hi!:!: 


w 

■■J 


f' ' 


K' 


^ 


nr 


t 


IH'2 


DISEASKS  OF  TIIK  BRAIN  AND  NKUVES. 


It  ia  caused  by  irritation  of  the  nerves  of  the  stomach  in  dyspepsia, 
by  long  application  of  the  iriind,  by  a  weakened  nervous  system,  by 
hysterics,  and  by  a  fuhiess  of  the  blood-vessels  of  the  head.  When  it 
proceeds  from  most  of  these  causes,  it  is  not  dangerous ;  but  when 
caused  by  impending  apoplexy,  it  is  a  symptom  of  very  serious  im- 
port. 

Treatment. —  Find  out  the  cause  and  remove  that,  and  the  dizzi- 
ness will  disappear.  If  it  come  from  dyspepsia,  eat  lightly;  if  from 
costiveness,  open  the  bowels  either  by  coarse  food,  by  daily  cold 
water  injections,  or  by  some  gentle  physic.  Avoid  coffee,  ardent 
spirits,  and  late  suppers,  and  take  much  exercise.  Keep  the  feet 
warm,  and  the  head  cool. 

Disturbed  Sleep.— Nightmare. — Incubus. 

In  this  complaint  the  sleep  is  disturbed  generally  by  some  frightful 
image.  Whatever  of  an  alarming  cliiiracter  is  presented  to  the  mind 
in  sleep,  causes  fear,  or  some  other  puiiiful  emotion,  the  same  as  when 
awake.  And  when  the  attempt  is  made  to  resist,  or  to  flee  from  the 
danger,  it  is  ineffectual,  because  the  muscles  are  locked  fast  in  sleep. 
The  fear  being  increased  by  the  inability  to  escape,  the  sleeper  makes 
all  sorts  of  horrible  noises,  indicating  distress  of  mind.  The  danger 
seen  is  as  real  to  the  sleeper  as  if  he  were  awake,  and  he  trie's  to  do 
just  what  he  would  if  awake.  Sometimes  the  sensation  is  that  some 
heavy  weight,  or  perhaps  some  horrible  monster,  is  upon  the  breast, 
nearly  pressing  the  breath  out  of  the  body. 

At  times,  the  power  of  motion  is  not  absent,  and  then  disturbed 
dreams  may  cause  one  to  talk,  or  to  rise  and  walk,  or  run.  Children 
will  laugh,  or  cry,  or  scream,  which  shows  that  their  minds  are  agi- 
tated by  different  passions.  Persons  who  idulge  gloomy  and  troub- 
lous thoughts  in  their  waking  hours,  are  apt  to  be  disturbed  with 
sleep-walking,  sleep-talking,  and  frightful  dreams,  as  of  falling  down 
precipices,  during  the  hours  for  repose. 

There  is  nothing  very  wonderful  about  these  disturbances  of  sleep. 
It  is  only  necessary  that  there  should  be  an  unusual  sensitiveness 
of  the  brain,  or  that  a  hearty  supper,  eaten  late,  should  irritate  the 
nerves  of  the  stomach,  and  that  distressing  thoughts  should  be  dwelt 
upon  during  the  day  and  evening,  in  order  to  produce  all  the  walk- 
ing, talking,  dreaming  of  hobgoblins,  shipw  recks,  fires,  and  polar  bears, 
which  distress  so  many  unfortunate  sleepers. 

In  night-walking  there  is  simply  a  little  more  wakefulness  than  in 
night-talking,  and  in  this  latter,  more  than  when  one  falls  from  a  high 
place,  and  in  this  perhaps  slightly  more  than  in  real  incubus,  when 
one  is  in  the  greatest  peril,  but  cannot  move  at  all. 


Trentmeiit.  —  Wh 


en 


sleeping  persons  groan,  or 


make 


any 


noise 


indicating  nightmare,  shake  them,  and  they  will  come  out  of  it  at 
once.  As  these  troubles  are  often  caused  by  a  weakened  state  of 
the  nerves,  much  out-door  exercise  should  be  taken.  The  diet  should 
Im'  simple,  and   well  regulated.     The  suppers  should  be  light,  and 


DISEASKS  OV  THE  BRAIN  AND  NERVES. 


183 


never  taken  late.  The  evening  should  be  spent  in  some  pleasant 
amusement,  which  will  drive  away  care ;  and  the  last  hours  of  wake- 
fulness be  occupied  with  pleasant  reflections.  One  afHicted  with 
nightmare  should  not  lie  upon  the  back,  nor  with  the  hands  over  the 
head.  Acidity  of  the  stomach,  and  costiveness,  if  they  exist,  should 
be  removed  by  the  neutralizing  mixture. 

Headaches. 

These  are  not  always  caused  by  disorders  of  the  brain  and  nerres, 
but  they  frequently  are,  and  this  seems  the  proper  place  to  speak  of 
them. 

It  is  unwise  ever  to  neglect  headaches.  They  are  sources  of  great 
suffering,  and  often  lead  to  serious  derangements  of  the  health  In 
childhood  they  have  a  more  serious  meaning  than  in  adult  life.  They 
often  indicate  the  approach  of  scarlet  fever,  or  measles,  or  of  other 
diseases. 

Headaches  are  more  common  among  the  civilized  than  the  uncivil- 
ized ;  more  frequent  among  females  than  among  males ;  among  those 
of  sensitive  feeling  than  among  the  more  obtuse ;  among  those  who 
think  much  than  among  those  who  tl  ink  little  ;  among  the  sedentary 
than  among  the  active. 

Causes  of  Headaches.  —  They  are  dependent  on  various  causes,  as 
derangement  of  the  circulating  system,  of  the  digestive  organs,  of  the 
nervous  system,  etc.  Among  those  dependent  on  disturbance  of  the 
circulation,  are 

Plethoric  Headaches.  —  These  are  dependent  on  a  general  fulness 
of  blood  They  are  of  two  kinds.  One  is  occasional,  and  lasts:  but 
a  few  hours.  The  other  lasts  for  days  or  weeks.  It  occurs  most 
often  in  the  night  or  morning.  Persons  whose  occupations  require 
stooping  have  it  most  A  little  dizziness  is  generally  felt  on  rising 
up  from  a  stooping  posture.  It  is  brought  on  by  the  ba..  ^ir  of 
crowded  rooms,  and  is  attended  by  costive  bowels,  short  breath,  and 
a  white  furred  tongue. 

The  persistent  headache  is  accompanied  by  a  sense  of  fulness,  and 
sometimes  of  throbbing  over  the  brows  and  temples,  with  a  sensation 
of  dizziness,  and  of  mist  before  the  eyes.  The  sufferer  fears  exertion, 
and  is  constantly  looking  for  a  rush  of  blood  to  the  head.  Nature 
sometimes  relieves  this  form  of  headache  by  a  diarrhoea,  or  by  bleed- 
ing from  the  nose. 

There  is  another  form  of  plethoric  headache,  difTering  slightly  from 
the  above,  in  which  there  is  too  much  blood,  and  it  is  made  too  fast, 
but  it  does  not  circulate  so  rapidly.  The  muscles  are  not  very  firm, 
and  the  heart  does  not  propel  the  blood  with  much  force.  This  form 
of  headache  is  connected  with  congestion. 

Headaches  of  Indigestion.  —  These  are  caused  either  by  taking  im- 
proper articles  of  food,  or  by  eating  too  much  of  those  which  are 
proper.     The  sensation  in  the  head  is  not  always  a  pain,  but  tfome- 


if 


.  ,1 
,  ( i 


184 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


i:'-^^' 


times  only  a  dull  weight,  attended  by  languor  and  disinclination  for 
exertion ;  a  tongue  white  in  the  centre,  and  pale  red  at  the  tip  and 
edges;  cold  and  numb  fingers;  slight  nausea;  languid  and  feeble 
pulse ;  dim  and  indistinct  sight ;  eyes  aching  when  employed ;  and 
difficulty  in  fixing  the  attention. 

Sick  Headache.  —  This  has  received  its  name  from  the  constant 
nausea  or  sickness  at  the  stomach  which  attends  the  pain  in  the 
head. 

This  headache  is  apt  to  begin  in  the  morning,  on  waking  from  a 
deep  sleep,  or  after  sleeping  in  a  close  room,  and  when  some  irregu- 
larity of  diet  has  been  committed  on  the  day  before,  or  for  several 
previous  days.  At  first  there  is  a  distressingly  oppressive  feeling  in 
the  heaci,  which  gradually  merges  into  a  severe,  heavy  pain  in  the 
temples,  frequently  attended  by  a  sense  of  fulness  and  tenderness  in 
one  eye,  and  extending  across  the  forehead.  There  is  a  clammy,  un- 
pleasant taste  in  the  mouth,  an  offensive  breath,  and  the  tongue 
covered  with  a  yellowish-white  fur.  The  sufferer  desires  to  be  alone, 
and  in  the  dark.  The  hands  and  feet  are  cold  and  moist,  and  the 
pulse  feeble. 

Accompanying  these  symptoms,  there  is  a  depressing  sickness  at 
the  stomach,  v^hich  is  increased  by  sitting  up,  or  moving  about  After 
a  time,  vomiting  comes,  and  relief  is  obtained. 

Bilious  lleadaclie.  —  This  is  most  common  in  summer  and  autumn. 
.It  afflicts  persons  of  dark  complexion,  with  black  hair  and  melancholy 
dispositions.  There  are  two  kinds  ;  one  is  due  to  an  accumulation  of 
bile  in  the  syiitem ;  the  other  to  a  large  secretion  of  bile. 

In  the  first  variety  the  skin  is  dingy  and  sallow,  the  spirits  de- 
pressed, the  bowels  costive,  and  there  is  wind  in  the  stomach,  with  a 
dull,  aching  pain  on  the  right  shoulder.  The  pain  i&  in  the  forehead, 
eyebrows,  and  eyelids,  and  the  "  white  of  the  sye  "  is  a  little  yellow- 
ish. The  tongue  has  a  brown  fur,  and  is  cracked  in  the  centre. 
There  is  a  bitter  taste  in  the  mouth  on  waking  in  the  morning,  after 
restless  nights,  ai.d  frightful  dreams. 

In  the  second  variety,  which  is  due  to  an  "  overflow  of  bile,"  the 
symptoms  are  much  like  those  of  the  first  kind,  but  t'  j  pain  is  not  so 
continuous.  In  addition  to  the  symptoms  named,  there  is  a  throb- 
bing, rending  pain  in  the  head,  the  skin  is  hot  and  the  face  flushed, 
the  limbs  are  sore,  and  there  is  a  luminous  Iialo  or  ring  around  objects 
looked  at,  and  a  feeling  of  giddiness. 

IVervous  Headaches.  —  These  are  more  common  among  females 
than  males.  They  occur  most  frequently  among  persons  of  high 
susceptibility,  who  are  easily  elevated,  and  as  easily  depressed.  They 
are  often  connected  with  indigestion. 

The  pain  is  usually  acute  and  darting,  and  is  made  worse  by  light, 
with  a  feeling  as  if  the  temples  were  being  "  pressed  together,"  and  a 
"  swimminess  "  in  the  head.  There  is  sometimes  a  sense  of  sinking, 
with  a  dread  of  falling,  and  great  despondency  and  restlessness.  The 
bowels  are  generally  costive,  and  the  sight  dim.     The  pain  comes 


tion  for 
tip  and 
I  feeble 
id ;  and 

constant 
in  the 

from  a 
irregn- 
several 

eling  in 
in  the 

mess  in 


tongue 


=11 


DISEASES  OF  THE  BllAIN  AND  NERVES. 


185 


on  most  commonly  in  the  morning,  lasts  through  the  day,  and  abates 
in  the  evening. 

nysteiiclleadache.  —  There  is  a  nervous  headache  dependent  on 
the  hysterical  condition.  It  is  generally  confined  to  one  small  spot, 
frequently  over  the  eyebrow,  and  is  sometimes  compared  to  a  wedge 
->T  nail  driven  into  the  skull. 

Headache  from  Exhaustion. —  Still  another  species  of  nervous  head- 
ache arises  ft  .  extreme  exhaustion,  produced  by  great  loss  of  blootl, 
by  diarrhoea,  or  by  over-suckling.  The  pain  is  generally  on  the  top 
of  the  skull,  and  is  often  compared  to  the  beating  of  a  small  hammer 
on  the  head. 

Brow  Aj^iC'  --  This  is  intermittent  in  its  character,  and  is  brought 
on  by  exposure  to  cold  and  moisture  in  damp  and  marshy  districts ; 
and  in  this  respect  is  much  like  ague. 

Meg^rims.  —  This  is  most  frequent  among  females.  It  is  often  de- 
p»endent  on  the  same  causes  as  Brow  Ague,  and  is  also  produced  by 
long  and  exhausting  v^atching  over  sick  children,  distress  of  mind, 
and  indigestion. 

In  both  the  above  forms,  the  pain  is  intermittent,  seldom  lasting 
long,  but  being  of  a  sharp,  piercing  character,  like  that  of  tic  doulou- 
reux. The  pam  of  Megrims,  usually  begins  at  the  inner  angle  of  the 
eye,  and  extends  towards  the  nose  ;  the  parts  being  red  and  sore,  and 
the  eye-ball  tender.  In  Brow  Ague,  pain  and  great  tenderness  cover 
an  entire  half  of  the  head,  compaicd  by  the  patient,  sometimes,  to 
"  an  opening  and  shutting  of  the  skull."  It  begins  with  a  creeping 
sensation  over  the  scalp.  >  .  ■' 

Rheumatic  Headaches.  —  These  generally  affect  persons  who  have 
been  subject  to  rheumatism,  and  are  often  brought  on  by  uncovering 
the  head  when  sweating.  The  pain  is  usually  in  the  brow,  the  tem- 
ples, or  the  back  of  the  head,  and  is  dull  and  uching,  —  rather  an 
intense  soreness  than  a  real  pain ;  and  the  paini'al  part  is  exces- 
sively tender  upon  pressure.  The  skin  is  moist,  but  mt  hotter  than 
natural. 

Treatment  —  In  considering  the  treatment,  I  will  take  up  the  same 
order  in  which  I  have  spoken  of  the  different  forms  of  headaciie. 

,  Pletlioric  Headaclies.  —  Not  much  medicine  should  be  taken  for 
these,  if  it  can  be  avoided.  A  diuretic  (131)  may  be  taken  twice  a 
day,  and  an  occasional  dose  of  gentle  physic  at  night,  followed  by  (7) 
in  the  morning.     This  will  generally  give  great  relief. 

Meat  should  be  taken  but  once  a  day,  and  the  whole  diet  should 
be  spare,  the  appetite  never  being  fully  satisfied.  All  spirituous 
drinks,  including  distilled  and  fermented,  should  be  let  alone,  and 
coffee  likewise. 

Much  exercise  should  be  taken  in  the  open  air.  The  hair  should 
be  kept  short,  and  the  head  elevated  during  sleep.  Bleeding  at  th« 
nose,  when  it  occurs,  must  not  be  too  suddenly  stopped. 


ili 


186 


DISKASES  OF  THE  BRAIN  AND  NEKVES. 


Conipestive  Headaclies.  —  The  exercise,  diet,  mode  of  sleeping,  etc., 
should  be  the  same  as  in  plethoric  headaches.  In  this  complaint,  th(>re 
is  too  much  blood  in  the  head,  and  it  inclines  to  stagnate.  The  feet 
and  hands  are  cold ;  and  gloves  and  stockings  of  wool,  ahd  other  bad 
conductors  of  heat  from  the  body,  must  be  worn. 

Occasionally  a  little  gentle  physic  (319)  is  desirable  to  induce  the 
bowels  to  act  every  djiy.  If  there  is  great  debility,  iron  (71)  (74)  (75) 
(320)  will  be  required. 

Heaviaclie  of  Indigestion.  —  If  the  pain  come  immediately  after  a 
meal,  and  can  be  traced  to  something  eaten,  an  emetic  (2)  may  be 
taken,  if  the  person  be  tolerably  strong.  If  the  pain  come  on  some 
hours  after  eating,  take  rhubarb  and  magnesia  (28)  (14),  or  fluid 
magnesia.  "When  the  system  is  debilitated,  take  a  warm  draught 
(322)  in  the  morning  after  a  light  breakfast,  or  twice  a  day,  a  bitter 
with  an  alkfli  (323).  If  the  stomach  be  very  irritable,  bismuth,  at 
meal  times  (324)  (326).  "When  it  occurs  after  a  debauch,  take  recipe 
325. 

Sicli  Headache.  —  When  it  results  from  food  taken,  a  draught  of 
warm  chamomile  tea,  or  a  little  weak  brandy-and-water,  will  generally 
give  relief.  If  the  sickness  continue,  soda  and  water,  with  a  little 
ginger  may  do  well,  or  a  mustard  poultice  upon  the  stomach  (165) 
may  be  required.  As  soon  as  it  can  be  kept  on  the  stomach,  a 
dose  of  physic  r;26)  must  be  taken  ;  and  if  relief  does  not  come  after 
the  operation  ol  his,  give  a  bitter  and  an  aromatic  (327).  The  patient 
must  have  perfet  '•est.  If  there  be  great  lack  of  tone  in  the  system, 
the  mineral  acids  ^    .'8)  (329)  wlil  be  excellent 

The  diet  must  be  carefully  regulated,  as  in  plethoric  and  congestive 
headaches.  >, 

Bilions  Headaches.  —  These  are  generally  connected,  more  or  less, 
with  some  affection  of  the  liver. 

During  an  attack,  if  the  suffering  be  great,  attended  by  nausea, 
give  an  emetic  (2).  In  milder  cases,  give  recipe  (321).  If  there  be 
costiveness,  give  recipe  (330)  at  night,  and  (7)  in  the  morning.  • 

A  few  doses  of  podophyllin,  leptandrin,  etc.  (34)  (36)  (39),  to  re- 
lieve the  liver  when  the  bile  does  not  flow  fast  enough,  will  diminish 
the  frequency  and  force  of  the  attack.  The  fluid  extract  of  dandelion, 
taken  for  some  time,  often  does  good  service. 

The  diet  should  be  light,  and  chiefly  vegetable,  and  exercise  in  the 
open  air  must  not  be  omitted.  The  daily  sponge  bath,  with  friction, 
is  excellent. 

Nenoiis  Headaclies.  —  The  first  thing  to  be  done  is  to  relieve  the 
pain,  and  this  may  generally  be  accomplished  either  by  preparation 
(331),  or  (332),  or  (333),  or  (88),  or  (93),  or  two  or  three  drops  of 
tincture  of  nux  vomica  in  a  spoonful  of  water,  taken  three  times  a 
day. 

In  simple  nervous  headache,  diet  is  of  the  greatest  importance  ;  in 
hysterical  cases,  exercise ;  in  headaches  from  exhaustion,  tonics  (81) 
(79)  (63)  (73)  (64)  (61)  (60). 


eping,  etc., 

laint,  there 

The  feet 

I  other  bad 

induce  the 
)  (74)  (75) 


ely  after  a 
2)  may  be 
on  some 
),  or  Hnid 
m  draught 
ay,  a  bitter 
)i»muth,  at 
taiie  recipe 

draught  of 
II  generally 
ith  a  little 
nach  (165) 
stomach,  a 
come  after 
Che  patient 
the  system, 

congestive 

ore  or  less, 

by  nausea, 
If  there  be 
ing.  ■ 

(89),  to  re- 
11  diminish 
'  dandelion, 

rcise  in  the 
th  friction, 


relieve  the 
sreparation 
e  drops  of 
ee  times  a 

)rtance ;  in 
tonics  (81) 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


197 


Rheumatic  Headaches. —  Tike  a  light  diet,  with  but  little  animal 
food.  Wear  warm  clothing,  and  avoid  exposure  to  wet  feet  and 
dampness  generally,  and  go  to  a  mild  climate,  if  convenient. 

When  the  local  pain  is  ^eat,  apply  hot  fomentat' jus,  or  a  stimu- 
lating liniment  (334),  or  a  mustard  poultice,  to  the  back  of  the  neck. 
In  the  beginning  of  the  treatment^  a  little  physic  at  night  (335)  la 
useful. 

Before  closing  this  chapter  on  headaches,  let  me  enter  a  respectful 
protest  against  the  indiscriminate  use  of  the  thousand  and  one  reme- 
dies advertised  to  cure  headaches ;  for  in  a  great  majority  of  cases  it 
is  merely  a  syniptom  of  some  other  disease ;  instance :  Indigestion, 
Fever,  Bright's  Disease,  Softening  of  the  Brain,  Diseased  Livec.  etc. ; 
&nd  the  use  of  thetie  remedies  serves  rather  to  increase  than  •esseii 
the  difficulty. 


''  .*    i-. 


r 


,     DISEASES   OF  THE  THROAT. 


The  diseases  which  seat  themselves  in  the  throat,  and  in  the  great 
cavity  of  the  chest,  have  occupied  a  large  share  of  my  attention  for 
the  last  ten  years.  My  practice  in  these  complaints  has  been  large, — 
being  drawn  from  every  part  of  the  United  States,  and  the  British 
Provinces.  No  class  of  diseases  from  which  men  suffer  are  more  nu- 
merous than  these,  and  none  have  so  generally  baffled  tiie  skill  of  the 
profession.  For  this  reason,  I  wish  to  present  here  a  brief,  practical, 
and  common-sense  view  of  these  complaints,  which  shall  be  of  r^al 
value  to  the  thousands  of  families,  who,  I  trust,  will  consult  these 
pages.  .  -• 

Increase  ofThroat  Diseases. —  A  striking  increase  in  the  number 
of  throat  diseases  has  been  witnessed  within  the  last  few  years.  A 
person  suffering  from  any  of  them  will  find,  on  speaking  of  his  com- 
plaint, that  a  number  of  his  neighbors  are  afflicted  with  troubles  of  a 
similar  kind.  I  have  thought  that  in  some  of  their  forms  these  dis- 
eases have  fastened  upon  the  throats  of  not  less  than  half  our  |M)pu- 
lation.  And  when  it  is  considered  that  they  are  the  natural,  and 
if  unmolested,  the  certain  harbingers  of  lung  disease,  it  is  wise  to 
make  a  note  of  the  above  fact.  As  I  shall  dcscrit>e  them  in  the  nasal 
cavities,  the  pharynx,  the  fauces,  etc.,  they  all  have  a  natural  proclivity 
downwards.  From  these  upper  cavities  they  pass,  by  one  short  step, 
into  the  larynx,  —  the  cavity  where  the  voice  is  formed,  —  and  then, 
by  another  equally  short  and  easy  stage,  into  the  body  of  the  wind- 
pipe. It  is  a  singular  fact  that  their  progress  is  always  from  the 
upper  breathing  passages  downward,  and  never  from  the  lower  pas- 
sages upward.  They  afford  a  parallel  to  the  order  of  progression  in 
the  moral  world,  in  which  evil  tendencies  are  toward  a  lower  depth. 

A  Mistake  Corrected. — Before  describing  the  several  diseases  which 
belong  to  this  family,  I  wish  to  correct  the  mistake  which  so  generally 
classes  them  all  under  the  term  Bronchitis. 

They  all  consist  in  a  simple  inflammation,  acute  or  chronic,  either 
of  the  mucous  membrane  lining  the  several  cavities  to  be  spoken  of, 
or  of  the  small  glands  or  follicles  connected  with  that  membrane;  and 
each  disease  takes  its  name  from  its  particulai  location.  Thus,  the 
inflammation  of  the  membrane  lining  the  upper  part  of  the  throat,  or 
pharynx,  h  called  Pharyngitis.     Inflammation  in  the  top  of  the  wind- 


ifn^sa.! 


DISEASES  OF  THE  THROAT. 


189 


the  great 
itition  for 
II  large,— 
le  British 
more  im- 
kill  of  the 
practical, 
be  of  rial 
suit  these 

number 
years.  A 
"  his  com- 
ibles  of  a 
these  dis- 
>ur  popu- 
turai,  and 
3  wise  to 
the  nasal 

proclivity 
liort  step, 
ind  then, 
the  wiiid- 
from  the 
)\V('r  pas- 
i!ssion  in 
depth. 

es  which 
jenerally 

ic,  either 
>oken  of, 
^ne;  and 
'bus,  the 
'iroat,  or 
le  wind- 


pipe, or  larynx,  is  Laryngitis.  In  the  windpipe,  or  trachea,  it  ia  Tra- 
iliilis.  In  the  bror.chial  tubes,  it  is  Bronchitis.  As  the  bronchial 
tubes  exist  nowhere  except  in  the  lungs,  below  the  division  of  the 
windpipe,  there  can  be  no  Bronchitis  in  the  throat  Nevertheless,  it 
is  the  same  disease  with  Laryngitis  and  Pharyngitis,  and  differs  from 
them  only  in  being  in  a  more  dangerous  place. 

As  the  windpipe  descends  into  the  chest,  it  divides  below  the  top 
of  the  breast  bone  into  two  branches,  one  going  into  the  right,  the 
other  into  the  left  lung.  These  branches  divide  and  subdivide  very 
...inuteiy,  and  send  their  ramifications  into  every  part  of  the  pulmon- 
ary tissue.     Thus  situated,  Meckel  has  compared  the  windpipe  to  a 

Fio.  88. 


»         > 


hollow  tree  with  the  top  turned  downward,  —  the  larynx  and  trachea 
representing  the  trunk,  and  the  bronchial  tubes,  with  their  innumera- 
ble subdivisions,  the  branches  and  twigs.     (Fig.  82.) 

If  the  reader  will  now  understand  that  the  trunk  and  bruncLcs  of 
this  bronchial  tree  are  hollow  throughout,  and  lined  with  a  delicate 
and  smooth  mucous  membrane,  and  that  the  diseases  to  be  described 
are  inflammations  either  upon  this  membrane  or  the  small  glands 
connected  with  it,  causing  swelling,  redness,  unhealthy  discharges, 
roughness,  etc.,  he  will  have  a  good  general  idea  of  them. 


Nasal  Oatarrh. 

I  TAKE  these  diseases  in  the  order  of  their  location, 
consists  in  inflammation,  which  begins  behind  and  r> 
veil  of  the  palate,  and  extends  upward  from  thence  . 


•^Ef 


Nasal  Catarrh 
little  above  the 
.,  the  nose.     It 


190 


DISEASES  OF  THE  THROAT. 


is  an  exceedingly  trcubleBome  complaint,  and  afllicta  great  numben. 
It  passes  nndcr  the  name  of  Catarrh  in  the  Head. 

The  inflammation  iH  not  coniined  to  the  nasal  cavities.  It  extends 
frequently  to  the  air  cavities,  called  antrums  and  sinuses,  which  cover 
a  considerable  portion  of  the  face,  and  extend  to  the  lower  part  of  the 
forehead.  Persons  sometimes  feel  as  if  their  whole  face  were  involved 
in  the  disease,  and  were  almost  in  a  state  of  rottenness,  —  so  great  is 
the  amount  of  matter  discharged  from  the  head.  Such  free  discharges 
cannot  be  wondered  at  when  we  reflect  that  all  the  air  cavities  in  tlie 
face  are  lined  with  the  same  mucous  membrane  which  lines  the  nose, 
and  that  they  all  communicate  with  the  nasal  cavities. 

The  *■  horn  ail,"  among  cattle,  is  a  similar  inflammation  of  the 
inner  surface  of  horns;  and  the  "horse  distemper"  is  an  inflamma- 
tion of  the  air  cavities  in  the  head  of  the  horse,  and  is  much  the 
same  disease  with  our  catarrh  in  the  head. 

The  catarrh  often  creates  a  perpetual  desire  to  swallow,  and  gives 
the  feeling,  as  patients  express  it,  "  a«  (/"  something'  were  sticking  in  the 
upper  part  of  the  throat." 

When  the  inflammation  has  existed  a  long  time,  and  ulceration  has 
taken  place,  puriform  matter  is  secreted,  and  drops  down  into  the 
throat,  much  to  the  discomfort  of  the  patient.  Indeed,  this  is  one  of 
the  most  distressing  features  of  the  complaint,  as  this  matter  often 
descends  into  the  stomach  in  large  quantities,  causing  frequent  vom- 
iting, and  a  general  derangement  of  the  health.  Many  times  the 
sufferer  can  only  breathe  with  the  mouth  open.  Upon  rising  in  the 
morning  a  great  effort  is  required  to  clear  the  head  and  the  extreme 
upper  part  of  the  throat.  There  is  occasionally  a  feeling  of  pressure 
and  tightness  across  the  upper  part  of  the  nose  ;  and  the  base  of  the 
brain  sometimes  suffers  in  such  a  way  as  to  induce  headache,  vertigo, 
and  confusion.  The  smell  is  frequently  destroyed,  and  sometimes 
the  taste.  The  inflammation  sometimes  gets  into  the  eustachian 
tubes,  the  mouths  of  which  are  behind  and  a  little  above  the  veil  of 
the  palate,  and  extends  up  the  lining  membrane  to  the  drum  of  the 
ear,  causing  pain  or  deafness,  and  occasionally  both.  In  addition  to 
this  catalogue  of  evils,  there  is  often  added  inflammation  and  elon- 
gation of  the  uvula  or  soft  palate. 

Treatment.  —  The  following  is  a  fair  illustration  of  my  mode  of 
treatment : 

On  the  12th  of  December,  1852,  Mr. ,  of  this  city,  came  under 

treatment  for  a  bad  case  of  catarrh  in  the  head,  complicated  with 
follicular  disease  of  the  pharynx,  or  upper  part  of  the  throat.  In 
addition  to  nearly  all  the  symptoms  mentioned  above,  he  had  a  stench 
from  the  nose  exceedingly  offensive  to  all  about  him.  So  much  had 
the  disease  worn  upon  him  that  he  had  become  bilious,  sallow,  de- 
jected, and  low  in  strength  and  flesh.  When  it  is  said  that  to  all 
this  were  added  a  cough  and  loss  of  appetite,  with  insidious  ap- 
proaches of  hectic,  it  will  not  be  surprising  that  his  friends  saw  the 
most  serious  results  impending,  even  though  assured  by  me  that  tht* 
disease  had  not  yet  taken  firm  hold  of  his  lungs.     The  first  thing 


It  extends 

llch    COVtT 

Jart  of  the 
!  involved 
|o  great  i« 
liHcharges 
lies  in  tliu 
I  the  nose, 

J>n  of  the 

}nuc'h  the 

lid  gives 
in^  in  the 


ation  has 
into  the 
is  one  of 
fter  often 
ent  vom- 
imes  the 
ig  in  the 
extreme 
pressure 
ise  of  the 
;,  vertigo, 
ometimes 
ustachian 
fie  veil  of 
m  of  the 
dition  to 
and  elon- 


tnode  of 

ne  under 
ted  with 
oat.     h\ 
a  stench 
uch  had 
low,  de- 
Lt  to  all 
ous  ap- 
!aw  the 
that  the 
it  thing 


DISKA8B8  or  THE  THROAT. 


191 


done  for  him  was  to  rut  off  the  uvula.  Five  days  after,  I  began  to 
bathe  the  whole  nasal  cavity,  three  times  a  week,  with  a  shower 
syringe,  by  pushing  the  smooth  bulb  up  behind  the  veil  of  the  palate, 
and  throwing  instantaneously  a  most  delicate  shower  of  medieuted 
fluid  up  both  sides  of  the  septum.  The  upper  part  of  the  throat  was 
likewise  bathed  by  the  use  of  a  shower  syringe  made  expressly  fi<r 
that  part,  and  the  larynx,  or  place  where  the  voice  is  formed,  by  a 
lung,  bent  instrument  made  to  reach  this  part  of  me  throat.  The 
solution  used  consisted  of  liiif  a  drum  of  crystals  of  nitrate  of  silver 
dissolved  in  one  ounce  of  -loft  water. 

The  nitrate  of  silver  powd(!r  was  inhtited  once  a  day  witli  the  powder 
inhaler.  In  this  way  the  nasal  cavities  and  throat  were  kept  cleansed, 
and  the  articles  used  gradually  subdued  the  inflammation,  setting  up 
a  new  and  healthful  action  in  place  of  the  disea.<«ed  one.  The  stom- 
ach was  relieved  of  the  offensive  matter  which  had  daily  and  nightly 
gone  down  into  it,  and  the  system  of  the  poisonous  effects  of  its  absorp- 
tion. The  great  danger  which  threatened  the  lungs,  and  whi  would 
soon  have  been  realized  in  their  destruction,  passed  away.  The  skin 
gradually  assumed  its  proper  color;  the  appetite,  flesh,  spirits,  and 
strength  came  back,  and  Mr.  B.  has  been  since  in  the  enjoyment 
of  good  health,  pursuing  his  business  cheerfully. 

When  the  above  tr«;atment  fails,  as  it  does  occasionally,  I  am  in 
the  habit  of  changing  the  solution,  using,  sometimes,  a  weak  solution 
of  acid  nitrate  of  mercury,  twenty  drops  to  an  ounce  of  water.  In 
other  cases,  a  solution  of  sulphate  of  zinc  serves  a  good  purpose.  A 
dilution  of  the  tincture  of  arnica  flowers  is  a  preparation  of  some 
value  in  these  cases.  There  are  other  preparations,  too  numerous  to 
mention,  which  I  am  in  the  habit  of  using.  I  will  add,  that  the 
nitrate  of  silver  powder,  snuffed  once  a  day,  a  piuch  at  a  time,  is  far 
more  successful  than  any  other  muff  ever  made. 

Inflammation  of  the  Pharynx. — Pharyngitis. 

This  is  an  inflammation  of  the  upper  and  buck  part  of  the  throat, 
or  all  that  |)art  which  can  be  seen  wnen  the  mouth  is  stretched  opcru 
It  causes  a  redness  of  the  mucous  membrane  lining  the  part,  which 
is  deep  in  proportion  to  the  intensity  of  the  inflammation.  This 
complaint  is  generally  connected  with  the  one  I  am  about  to  describe ; 
and  since  the  treatment  is  the  same,  the  reader  is  referred  to  what 
next  follows. 

Clergymen's  Sore  Throat. — Follicular  Pharyngitis. 

This  disorder  made  its  appearance  in  this  country  in  1830,  and  the 
attention  of  the  profession  was  first  drawn  to  it,  as  a  distinct  disease, 
in  1832.  Some  have  supposed  its  origin  to  have  had  a  hidden  con- 
nection with  the  epidemic  influenza,  which  spread  over  the  civilized 
woi  Id  in  1830,  and  affected  all  classes  of  persons ;  but  this  is  only 
conjecture.  In  its  early  developments  it  attracted  notice  chiefly  by 
its  visitations  upon  the  throats  of  the  clergy.     Hence  its  popular 


\f 


m' 


193 


D1SEABE8  OF  THE  THROAT. 


name  of  ClergymetCs  Sore  Throat.  It  was  soon  found,  howevor,  to 
attack  all  clasaea  of  persons  indiscriminately,  whether  engaged  in  any 
calling  which  required  a  public  exercise  of  the  voice  or  otherwiue.  It 
was  noticed  more  by  public  speakers  and  singern,  on  account  of  the 
greater  inconvenience  it  gave  them. 

The  diacase  conuists  in  a  chronic  inflammation  of  the  mucous  foi- 
iielcH,  or  glands  connected  with  the  mucous  membrane  which  linf-« 
the  throat  and  windpipe.  The  office  of  these  little  glund.s  is  to  secrets 
a  fluid  to  lubricate  the  air  passages.  When  inlhuned,  they  spread  an 
acrid,  irritating  fluid  over  surrounding  parts,  which  excites  inlhiunnu- 
tion  in  them.  Hence  a  general  inflammation  of  the  upper  part  of  the 
throat,  or  pharyngitis,  usually  attends  the  follicular  disease,  and  \ 
shall  speak  of  the  two  together.  This  inflammation  of  the  glands 
and  the  membrane,  being  neglected,  as  it  generally  is,  lingers  on  from 
month  to  month,  or  from  year  to  year,  making  in  some  cases  slow 
progress,  in  others  more  rapid,  —  made  a  little  worse  and  its  step 
slightly  quickened  by  every  fresh  cold,  and  finally  results  in  ulcera- 
tion. The  expectoration  thenceforward  becomes  puriform,  and  finally 
undistinguishable  from  that  of  consumption,  with  all  the  symp- 
toms of  which  the  patient  finally  dies.  Indeed,  before  its  nature  was 
understood  by  the  profession,  it  was  considered  the  most  fatal  form 
of  consumption,  because  it  could  be  aflected  only  in  a  very  small 
degree,  if  at  all,  by  medicines  taken  into  the  general  system. 

Inflammation  of  Mucous  Membrane  and  Glands  of  Larynx. 

Follicular  Laryngitis. 

A  FEW  strong  and  beautifully  formed  cartilages  unite  to  form  a 
curious  and  convenient  box  or  cavity  at  the  top  of  the  windpipe, 
called  the  larynx.  Across  this  enclosure  are  stretched  two  remark- 
able cords,  called  the  vocal  ligaments.  They  are  from  half  to  three 
(juarters  of  an  inch  in  length,  and  arc  rendered  more  or  less  tense  by 
the  small  muscles  with  which  they  are  connected.  Just  above  these 
cords  are  two  t^vities,  which,  with  the  ligaments,  act  an  important 
part  in  the  formation  of  the  voice.  Here  is  produced  the  somul,  which 
is  modified  and  articulated  by  the  tongue,  the  lips,  and  the  nasal  cav- 
ities. 

When  disease  reaches  this  cavity,  and  the  fluid  secreted  to  lubricate 
these  cords  becomes  acrid,  the  voice,  from  this  and  other  causes,  is 
made  hoarse ;  and  when,  at  length,  these  ligaments  are  altered  in 
structure  by  inflammation  and  ulceration,  the  voice  suffers  a  gradual 
extinction.  I  have  treated  a  large  number  suffering  entire  loss  of 
voice,  and  am  happy  to  say  it  has  been  generally  restored,  where  the 
lungs  have  not  been  involved  in  the  disease.  There  is  often  also  a 
little  sensitiveness,  or  even  soreness,  in  some  cases,  in  the  region  of 
the  larynx,  which  may  be  felt  by  pressing  upon  that  prominence  in 
front  of  the  throat,  called  Adam's  apple. 


nwever,  to 
j<h1  in  aiiv 
irwlse.  it 
uiit  of  the 

iiicoua  foi- 

liich  liiu-n 

to  socrt'ta 

sprrad  an 

iiiMiiiriiim- 

irt  of  Hu> 

,  unci    I 

glands 

rs  on  from 

I  sea  t*lo\v 

its  step 

in  ulcera- 

md  finally 

he    symp- 

ftture  was 

fatal  form 

fery  small 


Laxynx. 


to  form  a 
windpipe, 

0  remark- 
f  to  three 
s  tense  by 
ove  these 
important 
/«/,  which 
jusal  cav- 

lubricafe 
causes,  is 
iltered  in 

1  gradual 
3  loss  of 
vhere  the 
en  also  a 
egion  of 
inence  in 


DISEASES  OF  THE  THROAT. 


193 


Inflammation  in  the  Windpipe. — Trachitij. 

This  complaint  and  the  one  preceding  it  ddfer  only  in  their  locality 
from  those  described  in  the  upper  cavities;  and  thf-y  are  more  alarm- 
ing, because  two  remcvcs  nearer  the  citadel  of  life.  Happily,  we  know 
that  the  seat  of  thtse  diseases  may  be  easily  reached,  and  we  have  a 
shower  syringe,  constructed  by  me  in  1849,  so  arranged  as  to  pour 
the  remedial  agent  directly  upon  them,  without  any  lacerating  dis-' 
turbanco  of  the  parts. 

SyinptoillS.  —  The  approach  of  these  disorders  is  often  so  insidious 
as  hardly  to  attract  notice,  —  sometimes  for  months,  or  even  years, 
giving  no  other  evidence  of  their  presence  than  the  annoyance  of 
something  in  the  throat  to  be  swallowed  or  hawked  up, —  an  in- 
creased secretion  of  nmcus,  and  a  sense  of  wearisomeness  and  loss 
of  power  in  the  throat,  after  public  speaking,  singing,  or  reading 
aloud.  At  length,  upon  the  taking  of  a  strvere  cold,  the  prevalence 
(if  an  epidemic  inliuenza,  or  of  an  unexplained  tt'iulcncy  of  disease 
to  the  air  pa.ssages  and  lungs,  the  throat  of  the  patient  suddenly 
l»ecotnea  sore,  its  secretions  are  increased  and  rendered  more  viscid, 
the  voice  grows  hoarse,  the  difficulty  of  speaking  is  aggravated,  and 
what  was  only  an  annoyance,  becomes  an  allliction,  and  a  source  of 
alarm  and  danger.  These  diseases  clearly  belong  to  the  family  of 
consumption,  and  need  early  attention. 

Causes.  —  It  is  amusing  to  reflect  upon  the  theories  which  writers 
were  in  the  habit  of  constructing,  a  few  years  since,  to  account  for 
the  throat  affection  among  the  clergy.  It  was  attributed  by  some  to 
■peaking  too  often,  by  others  to  speaking  too  loud.  One  class  of 
writers  thought  it  arose  from  high,  stiff  neck-stocks ;  another,  from  a 
strain  of  voice  on  the  Sabbath  to  which  it  was  not  accustomed  on 
other  days. 

The  cause  lies  deeper  than  any  of  these  trifli.ig  things.  As  it  con- 
cerns ministers,  it  nmy  generally  be  expressed  in  two  words,  —  labor, 
anxiety. 

The  clerical  order  are  placed  just  where  they  feel  the  force  of  the 
high-pressure  movements  of  the  age.  They  are  the  only  class  of 
recognized  instructors  of  adult  men,  and  are  obliged  to  make  great 
exertions  to  meet  the  wants  of  their  position.  The  extremely  trying 
circumstances  in  which  they  are  often  placed,  too,  in  these  exciting 
dmes,  by  questions  which  arise  and  threaten  to  rupture  and  destroy 
their  parishes,  weigh  heavily  upon  their  spirits,  and  greatly  depress 
the  vital  powers.  And  when  we  add  to  this  the  fickle  state  of  the 
public  mind,  and  the  shifting,  fugitive  character  of  a  clergyman's 
dwelling  place,  and  the  consequent  liability  tx>  poverty  and  want  to 
which  himself  and  family  are  exposed,  we  have  a  list  of  depressing 
causes  powerfully  predisposing  to  any  form  of  disease  which  may 
prevail. 

It  will  be  pardoned  me,  I  think,  if  I  suggest  here,  that  the  nature 
of  a  clergyman's  calling  is  of  so  serious  a  character,  that  he  some- 

25 


194 


U18KAHE8  or  THE  TUKUAT. 


titncH  carrion  hiniHolf  with  too  much  HcdatcnRsn,  keeps  himself  too 
much  braced  up,  <ind  doeH  not  allow  himself  hours  enough  of  that 
cheerful,  light-hearted  abandon,  which  is  esncntial  to  the  health  of 
every  sedentary  man  of  mental  liabitH.  The  hard-thinking  and  hard- 
working mininter,  who  will  retain  his  health,  and  save  his  throat,  muHt 
have  some  moments,  at  least,  when  the  weighty  responsibilities  of  his 
oiKce  are  lifted  up  from  I: is  soul,  and  he  becomes,  for  the  hour,  the 
jocund,  playful  boy  of  earlier  days.  How  far  he  can  consistently 
relax  anA  let  hi       "'   ' 


/, 


himself  down,  or  in  my  view  of  the  matti^r,  raise  him- 
self  up  to  tVd  simplicity  and  mirth  of  childhood,  he  alone  can  be  thf 
judf^e.     As  a  physician,  I  prescribe ;  as  a  miiiister,  lie  must  decide 
low  far  my  prescription  can  be  followed. 

Reading  Seinnous.  —  There  is  one  practice,  which,  though  it  has 
not  much  to  do  with  inducing  this  disease,  does  frcijuently  aggravate 
it  when  once  e  tablished ;  I  mean  the  habit  of  reading  sertnons  from 
manuscripts, —  e^peciully  when  it  is  done  in  a  sort  of  mechanical 
way.  Every  person  who  has  suffered  from  throat  ail,  has  doubtless 
noticed  that  to  read  aloud,  for  half  an  hour,  from  a  book,  o<;casions 
more  fatigue  and  irritativ>n  in  the  throat  than  extem;x)raneoud  speak- 
ing, in  the  same  tones,  for  one  or  two  hours.  The  reason  is,  that  in 
the  latter  ease  the  mind  conceives  the  thought  in  season  for  the 
organs  of  speech  to  fall  into  a  natural  attitude,  and  utter  it  with  ease. 
The  two  work  harmoniously  together,  —  the  instruments  of  articula- 
tion following  the  mind,  and  easily  and  naturally  uttering  its  concep- 
tions. "Whereas  in  the  case  of  reading,  the  mind  itself  is,  at  least 
partially,  ignorant  of  what  is  coming  until  it  is  just  upon  it,  so  that 
the  organs  of  sjieech,  being  warned  of  what  is  to  be  done  only  at 
the  moment  their  service  is  required,  do  their  work  under  a  perpetual 
surprise  and  constraint.  The  difference  is,  in  some  respects,  like  that 
between  walking  freely  at  large,  without  regard  to  where  the  feet  are 
put  down,  and  being  obliged  to  step  exactly  in  the  footprints  of  some 
traveller  who  has  gone  before.  In  the  latter  case,  the  muscles  tire 
much  sooner,  because  they  work  in  fetters. 

I  have  thus  spoken  particularly  of  the  clergy,  though  it  is  not  by 
any  means  they  only,  but  all  classes  of  people  who  are  afflicted  with 
this  dangerous  malady.  ,  , 

These  diseases  often  begin  with  a  cold.  But  colds  are  seldom 
taken  except  when  the  nervous  system  is  depressed,  so  that  they  are, 
in  fact,  to  be  traced  back  to  the  same  cause  which  I  have  assigned  to 
catarrhal  or  throat  complaints  themselves. 

Tkese  Complaints  Worse  at  Night — It  is  worthy  of  note,  that  all 
these  complaints,  and  many  others,  are  worse  during  the  night.  This 
is  easily  explained  wnen  we  remember  that  the  atmosphere  haa  the 
least  amount  of  electricity  in  i"  at  three  o'clock  in  the  mor.iing, 
and  that  the  first  minimum  at'nospheric  pressure,  which  happens 
twice  a  day,  occurs  not  far  from  the  same  hour.  From  three  to  four 
in  the  morning,  therefore,  the  nerve-power  sinks  to  its  loivest  ebb ;  "  nd 
those  diseases  which  owe  their  existpiu-c  to  anxiety,  overwork,  etc., 
suffer,  at  this  time,  their  greatest  daily  Jij^gravation.     Death  occurs. 


DISEASES  OF  THE  THROAT. 


ig.*; 


itriBrlf  too 
gh  of  that 

iH'lllth    of 

uiul  hard- 
iroat,  must 
til's  of  his 
hour,  the 
iiiHiHttMitly 
raise  him- 
an  be  th(! 
uat  decide 


igh  it  has 
aggravate 
10II9  from 
lechanical 
doubtleas 
occasions 
(US  speak- 
is,  that  in 
in  for  the 
with  ease, 
f  articuia- 
ts  concep- 
a,  at  least 
it,  so  that 
e  only  at 
perpetual 
;  like  that 
le  feet  are 
8  of  some 
iscles  tire 

is  not  by 
ictcd  with 

re  seldom 
t  they  are, 
isigned  to 

e,  that  all 
[ht  This 
re  ha:*  the 

moMing, 

happens 

ee  to  four 

ebb;  -nd 
kvork,  etc., 
th  occurs. 


too,  more  often  during  these  hours,  than  in  any  other  portion  of  the 
twenty-four. 

TrfUtinent.  —  Some  years  ago  these  disenses  were  thought  to  be 
incurable  ;  and  by  all  trie  appliances  of  medical  art  then  known,  they 
were  so.  But  time  ha.s  brought  u  sucircssful  method  of  treatment,  a.s 
well  as  a  cleorer  knowledge  of  their  nature. 

This  treatment  consists  in  what  is  called  topical  medication,  or  the 
applying  of  the  medicine  directly  to  the  dlseaHed  part.  The  <nedici« 
nai  agent  more  extensively  used  than  any  other  is  a  solution  of 
crystals  of  nitrate  of  silver.  This  substance  is  not,  however,  adaptel 
to  erer^  case,  —  other  articles  succeeding  better  in  some  instances. 
Modern  chemistry  has  given  us  a  variety  of  agents  from  which  llie 
Hkilful  physician  may  select  a  substitute,  should  the  nitrate  of  silver 
fail. 

The  operation  of  applying  this  and  other  substances  co  the  air 
passages,  is  a  delicate  one,  re(|uiring  tact  and  experience.  Surgeons 
had  supposed  it  an  anatomical  impossibility  to  introduce  an  inst.  u- 
ment  into  the  larynx ;  but  this  has  been  practically  demonstrated  co 
be  a  great  mistake. 

Instn^  nents.  —  The  instrument  devised  and  used  by  Dr.  Horace 
Green  is  a  piece  of  whalebone,  bent  at  one  end,  to  which  is  attached 
a  small,  round  piece  of  sponge.  This,  dipped  in  the  solution,  is  dex- 
terously intrixluced  into  the  laryngeal  cavity,  and  applied  directly  to 
the  diseased  part. 

I  formerly  used  this  instrument  myself,  and  am  happy  to  know, 
that  notwithstanding  its  defects,  it  was  generally  successfnl.  Yet 
where  the  larynx  was  highly  inflamed,  with  a  swollen  and  ulcerated 
condition  of  the  epiglottis  and  lips  of  the  glottis,  I  am  sure  I  some- 
times had  the  lingular  powers  of  the  nitrate  of  silver  put  at  defi"!^ce 
by  an  irritation  evidently  produced  by  the  sponge  of  the  probang. 
Upon  its  introduction,  in  such  cases,  the  parts  contract  upon  and 
cling  to  it,  and  suffer  aggravat-ed  irritation,  almost  laceration,  upon 
ita  withdrawal,  however  carefully  effected. 

Laryngeal  Shower  Syringfe.  —  Such  defects  ir-  the  probang  led  me 
to  contrive  an  instrument,  which  I  call  a  Laryv^eal  S/ioiver  Syringe. 
It  is  in  thfj  form  of  a  syringe,  the  barrel  and  pis; on  of  which  are  made 
of  glass,  silver,  or  gold,  as  may  be  desired.  To  this  is  attached  a 
small  tube,  made  of  silver  or  gold,  long  enough  to  reach  and  enter 
the  throat,  and  bent  like  a  probang,  with  a  ghbe  or  bulb  at  the  end, 
from  a  quarter  to  a  third  of  an  inch  in  diameter,  pierced  with  very 
minute  holes,  which  cover  a  zone  around  the  centre  about  one-third 
of  an  inch  in  breadth. 

This  silver  bulb  I  daily  introduce  into  highly  inflamed  and  u'cor- 
ated  larynges,  generally  without  any  knowledge  of  ita  priaent  on 
the  part  o/  the  patient,  until  the  contained  solution  is  discharged. 
The  instrument,  being  charged,  is  carried  to  the  proper  place,  when  a 
delicately  quick  pressure  upon  the  piston  causes  very  fine  streams  to 
flow  through  the  holes  in  the  form  of  a  delicate  shower,  and  all  sides 
of  the  walls  of  the  larynr  are  instantaneously  bathed. 


■■3  ^ 


m 


"inK  ?J"»  ""itTtrT!5»  ;-*wx-:«iTy  •irjiumni'i 


;3', 


How  Introduced.  —  The  introduction  of  this  instrament  into  the 
larynx  is  easy.  Upon  the  approach  of  any  foreign  substance,  the 
ejiifrlottis  instinctively  drops  down  upon  the  entrance  to  the  larynx, 
guarding  it  against  improper  intrusions.  It  has  been  found,  however, 
that  when  the  root  of  the  tongue  is  firmly  depressed,  this  cartilage 
cannot  obey  its  instinct,  but  stands  erect,  its  upper  edge  generally 
rising  into  view.  Availing  himself  of  this,  the  surgeon  has  only  to 
dejxess  the  tongue  with  a  spatula,  bent  at  right  angles,  so  that  the 
left  hand  holding  it  may  drop  below  the  chin  out  of  the  way,  and  as 
Uie  epiglottis  rises  to  view,  slip  the  ball  of  the  instrument  over  its 
■;>per  edge,  and  then  with  x  quiclr  yet  gentle  motion,  carry  it  down- 
nurd  and  forioard,  and  the  entrance  is  made.  I  have  often  admired 
the  faithfulness  of  this  epiglottic  sentinel,  who,  when  overborne  by 
8U])erior  force,  stands  bolt  upright,  and  compels  us  to  enter  the  sacred 
temple  of  speech  directly  over  his  head! 

••haryugeal  Shower  Syringe.  —  For  washing  the  upper  part  of  the 
th.oat,  I  construct  the  instrument  with  a  straig-ht  tube,  with  holes 
over  the  outer  end  of  the  globe,  and  extending  to  the  centre.  This 
washes  instantaneously  the  fauces  and  pharynx,  but  does  not  throw 
the  solution  back  upon  the  tongue.  Its  main  advantage  over  the 
j)robang  is,  that  it  bathes  every  part  of  the  fauces  and  pharynx  in- 
stantaneously, and  does  not  subject  the  patient  to  the  coughing  and 
gagging  which  follow  the  slower  and  rougher  process  of  drawing  the 
sponge  from  side  to  side  across  the  cavity  of  the  throat  ' 

Xasal  Shower  Syringe. —  Inflammations  in  the  back  passages  to  the 
nose,  called  catarrh  in  the  head,  have  been  almost  inaccessible  by  any 
reliable  healing  agent,  and  consequently  ihcurable.  The  probang 
could  only  reach  a  short  distance,  and  occasioned  great  suffering.  I 
have  had  a  syringe  constructed  with  the  tube  bent  at  an  angle  of 
forty-five  degrees,  and  the  globe,  very  small,  pierced  with  a  few  fine 
holes  at  the  upper  end.  Carrying  this  globe  up  behind  the  velum 
palati,  with  a  single  injection  I  wash  both  passages  clear  through.  I 
have  had  the  pleasure  of  curing  a  large  number  of  bad  cases,  of  many 
years'  standing,  to  the  surprise  and  delight  of  the  patients. 

About  nineteen  twentieths  of  the  physicians  who  have  examined 
fhese  instruments,  and  so  far  as  my  knowledge  extends,  all  who  have 
used  them,  thinl:  them  much  better  than  the  probang.  As  to  patients, 
I  have  yet  to  see  one  who  will  allow  the  sponge  to  be  used  after  try- 
ing both. 

r 

Have  Superseded  tlie  Probang.  —  In  my  own  practice  the  syringes 
have  superseded  the  probang  altogether.  My  reasons  may  be  briefly 
stated.  I  have  already  said  there  is  less  irritation  produced.  A  piece 
of  sponge  drawn  over  an  inflamed  surface,  especially  when  clung  to 
by  the  irritated  and  quivering  parts,  must  necessarily,  in  some  cases 
at  least,  aggravate  the  sympto».ii.  of  disease.  To  this  consideration 
add  thj  comfort  of  the  patient  during  the  operation.  It  is  so  quickly 
and  delicately  done  with  the  syringe,  that  it  is  scarcely  known  when 
the  act  is  performed.     The  straight  syringe  does  not  touch  the  throat 


i!ia;\inrr' 


into  the 
ance,  the 
e  larynx, 
however, 
cartilage 
generally 
3  only  to 
that  the 
ly,  and  as 
over  ita 
f  it  down- 
ad  mi  rod 
borne  by 
\ii  sacred 


art  of  the 
vith  holes 
tre.  This 
lot  throw 
!  over  the 
larynx  in- 
ghing  and 
ivving  the 

igea  to  the 
)le  by  any 
5  probang 
ffering.  I 
I  angle  of 
a  few  fine 
the  velum 
irough.  I 
3,  of  many 

examined 
who  have 

0  patients, 

1  after  try- 


B  synnges 
be  briefly 
.  A  piece 
n  clung  to 
9me  cases 
isideration 
so  quickly 
)wn  when 
the  throat 


DISEASES  OF  THE  THROAT. 


197 


at  all.  On  touching  the  probang  to  the  throat,  the  nitrate  of  silver 
unites  with  the  mucus  upon  the  surface,  instantly  covering  the  sponge 
with  an  albuminous  pellicle,  something  like  that  which  lines  the  shell 
of  an  egg,  preventing,  in  a  degree,  the  further  pressing  out  of  the 
solution,  and  rendering  its  contacts  with  other  parts  of  the  surface 
comparatively  powerless.  For  this  reason,  the  sponge  pushed  down 
into  an  ulcerated  bronchus,  as  Dr.  Green  recommends,  must  be 
utterly  valueless  as  a  remedial  agent.  Mopping,  as  it  does  in  it» 
whole  course,  a  larynx  and  trachea,  lined  in  some  cases  with  puriform 
matter,  and  generally  with  mucus,  every  inch  of  its  descent  doubles 
the  gravity  of  this  objection.  Let  it  be  considered,  too,  that  in  apply- 
ing  the  remedy  to  an  ulcerated  larynx,  the  sponge  cauterizes  the 
healthy  parts  above,  in  its  descent,  and  thus  unfits  itself  for  doing 
much  for  the  diseased  part ;  whereas  the  syringe  retains  its  solution 
till  it  reaches  the  affected  place,  and  then  pours  a  clean  shower  di* 
rectly  upon  it,  and  upon  no  other  part. 

Considering  these  manifest  advantages  of  the  syringes,  I  am  sur- 
prised that  any  physician  should  still  use  the  probang,  —  especially  as 
one  of  these  instruments,  the  Nasal  Syringe,  accomplishes  an  object 
which  the  probang  cannot  effect  at  all,  not  even  in  a  rough  way.  I 
have  wondered,  too,  how  any  parent  can  allow  a  ■;hild,  suffering  with 
croup,  to  be  tormented  by  having  a  sponge  pushed  down  its  throat, 
when  a  syringe  would  give  it  so  much  less  pain. 

I  will  mention  briefly  one  or  two  cases  of  croup  and  diphtheria,  se- 
lected from  a  great  number  treated  by  me  for  the  last  few  years,  where 
the  syringes  were  successfully  used,  after  several  attempts  to  use  the 
probang  had  been  made,  and  failed,  and  where  the  pain  caused  by 
using  was  so  small,  and  the  relief  so  instantaneous  and  complete,  that 
the  patients  were  anxious  for  my  return  to  use  it  again. 

On  the  25th  of  November  last,  I  was  called  to  see  a  little  boy  of 
Mr.  E.,  five  years  old,  who  had  had  an  attack  of  membraneous  croup 
some  days  previous ;  and  when  I  saw  him  the  voice  had  sunk  to  a 
whisper,  and  the  cough  was  entirely  muffled,  so  that  I  had  no  doubt 
of  the  fatal  tei'nination  of  the  case,  and  expressed  my  opinion  to  that 
effect  to  the  astonished  parents.  The  probang  had  been  used  by  the 
physcian  in  attendance,  which  had  caused  so  much  suffering  that  foi 
the  two  days  previous  the  parents  had  prohibited  its  use.  It  had  iio 
doubt  increased  the  irritation,  besides  nearly  causing  strangulation. 

It  was,  therefore,  with  great  reluctance  that  they  consented  to  et 
me  nse  the  syringe,  which  I  did,  to  the  great  relief  of  the  little  buf- 
ferer,  and  to  the  entire  satisfaction  of  the  parents. 

The  strength  of  the  solution  of  the  crystals  of  the  nitrate  of  silver 
used  was  20  grains  to  the  outice  of  water,  which  I  injected  freely, 
once  in  three  hours  for  the  first  day,  and  then  two  or  three  times  a 
day  for  two  or  three  days.     His  recovery  was  rapid  and  complete. 

1  will  now  mention  the  case  of  a  young  woman,  with  diphtheria, 
where  the  syringe  was  used  with  success. 

On  the  evening  of  the  10th  of  September  last,  I  was  called  to  see 
Miss  T.,  of  this  city,  who  had  an  attack  of  diphtheria  the  day  p.evi- 
nns.     Found  her  in  bed,  very  much  prostrated,  breathing  with  gi  ;at 


|i> 


•If 


198 


DISEASES  OF  TIIK  TIIllOAT. 


1\ 


difficulty,  and  uttering  at  every  inspiration  a  croupai  sound,  which  at 
times  was  followed  by  a  short  convulsive  cough.  The  face  was 
(lushed,  pulse  124,  small  and  feeble,  and  she  complained  constantly  of 
a  (lensc  of  suilbcation  and  of  great  distress  in  the  laryngeal  rejjibn. 

On  inspecting  the  throat,  the  fauces  and  the  pharyngeal,  membrane 
as  far  down  as  it  could  be  seen,  presented  the  appearance  of  a  high 
degree  of  inflammation.  One  of  the  tonsils  was  nearly  covered  with 
the  diphtheretic  membrane,  and  the  upper  and  back  part  of  the  throat 
were  thickly  studded  with  small  white  or  cream-colored  spots. 

The  physician  in  attendance  had  tried  first,  a  swab,  or  mop  as  she 
termed  it,  and  then  the  probang,  which  gave  her  so  much  pain  that  he 
wa»  obliged  to  give  it  up.  He  then  gave  up  the  case  as  hopeless.  At 
my  earnest  solicitation  she  cc  lented  to  the  use  of  the  syringe.  With 
a  solution  of  the  crystals  of  the  nitrate  of  silver,  of  the  strength  of 
60  grains  to  the  ounce  of  water,  I  injected  freely  the  fauces  and  the 
upper  part  of  the  cavity  of  the  larynx.  For  a  few  moments  the  diffi- 
culty of  breathing  and  feeling  of  strangulation  was  increased,  but 
very  soon  a  large  amount  of  viscid,  ropy  mucus  was  discharged.  In 
'.he  course  of  half  an  hour  after  the  use  of  the  syringe,  the  symptoms 
nad  improved,  the  respiratio;i  was  less  laborious,  so  that  in  a  short 
time  the  patient  obtained  some  sleep.  I  was  afterward  called,  as  she 
thought  herself  worse,  but  found  that  an  application  of  the  caudtic 
.vith  a  syringe  was  all  that  was  required.  There  was  no  further 
trouble  with  the  "ise. 

Several  partieL  in  this  country  have  got  up  imitations  of  these 
syringes,  and  have  made  them- 
selves liable  for  damages  under 
the  patent ;  but  they  are  persons 
of  little  or  no  responsibility,  and 
I  have  not  as  yet  brought  the 
law  to  bear  ujwn  them.  Those 
who  purchase  and  use  these  imi- 
tations, should  bear  in  mind  that 
they  are  also  liable  for  damages, 
as  they  lie  in  a  case; 


FlO.84. 


[Patented  December  6,  1853.] 


Figure  84  represents  these  syringes 


Mode  of  Using.  —  The  glass  barrel  and  piston  of  my  instruments 
are  delicate,  but  they  need  not  be  broken.  I  handle  them  with  the 
same  ease  that  I  do  a  spoon  in  feeding  myself,  and  jiot  in  a  very  dis- 
similar way.  The  last  three  fingers  are  placed  on  the  under  side  of  the 
barrel,  with  the  thumb  on  the  upper  side,  —  the  index  finger  being 
poised  over  the  end  of  the  piston,  ready  to  drive  it  home  at  the  propei 
instant  The  motion  of  the  piston  should  be  quick,  so  as  to  cause 
the  streams  to  leap  out  in  jets ;  yet  delicate,  that  they  may  not  im- 
pinge with  too  much  force  upon  the  diseased  surfaces. 

They  should  be  rinsed  with  water  immediately  after  being  used 
But  even  with  this  precaution,  a  small  residuum  of  the  nitrate  re- 
mains and  crystallizes,  and  after  a  time  partially  closes  the  holes. 
They  must  then  be  picked  out  with  the  point  of  a  needle. 

When  the  silver  tube  becomes  detached  from  the  glass,  it  may  be 
fastened  on  with  common  sealing  wax ;  first  melting  the  wax  and 


itif«i  ^  it 


which  at 
face  was 
taiitly  of 
I  region, 
embrane 
high 


a 


e. 


;red  with 
he  throat 

3. 

)p  as  flhe 
n  that  he 

less.   At 
With 

ngth  of 

and  the 
the  diflB- 
ised,  but 
ged.  In 
^mptoma 

a  short 
(i,  as  she 
5  caudtic 

further 

of  these 


'•J 


syringes 


trument* 
with  the 
very  dis- 
de  of  the 
er  being 
e  propel 
fo  cause 
•  not  im- 

ig  used 
trate  re- 
le  holes. 

may  be 
/ax  and 


niSEASF:S  OF  THE  THItOAT. 


199 


sticking  it  around  tiie  glass ;  then  heating  t;he  silver  over  a  lamp,  and 
pressing  it  on.  .'     ' 

Amount  of  Solution  to  be  Used.  —  The  amount  of  solution  to  be 
used  should  be  small.  Half  a  dram  is  enough.  The  piston  of  the 
syringe  need  be  drawn  up  only  from  an  eighth  to  a  third  of  an 
inch.  Strangling  is  not  often  produced  by  these  operations ;  but  to 
make  its  prevention  still  more  sure,  let  the  patient  be  directed  to  fill 
the  lungs  with  a  long  inspiration  while  the  operator  is  depressing  tha 
tongue. 

Strength  iutlon. —  The  strength  of  the  solution  in  ordinary 

cases  of  ch;  folliculitis,  etc.,  should  generally  be  about  forty  grains 
of  the  crystals  of  the  nitrate  of  silver  to  the  ounce  of  water.  But 
in  all  acute  diseases  of  the  air  passages,  it  should  be  considerably 
stronger,  —  varying  from  one  to  two  drams.  A  preparation  of  this 
strength  is  powerfully  antiphlogistic  and  sedative.  In  those  cases  of 
chronic  disease,  where  the  inflammation  is  of  a  low  grade,  and  the 
mucous  membrane  is  in  a  relaxed,  atonic  condition,  looking  either 
sodden  and  pale,  or  of  a  dark  color,  like  the  cut  surface  of  beef,  some 
days  exposed  to  the  air  (as  is  often  the  case  in  throats  of  literary  dys- 
peptics), then  a  solution  of  fifteen  to  thirty  grains  to  the  ounce,  is 
sufficient.  This  strength  acts  as  a  stimulant,  and  is  well  suited  to 
throats  in  such  condition,  but  would  be  injuriotts  in  high  grades  of 
inflammation.  Catarrh  in  the  head  generally  requires  only  about  this 
strength.  I  am  sorry  to  say,  the  topical  mode  of  treating  throat  affec- 
tions has  been  in  some  places  injured,  in  the  public  estimation,  by  a 
lack  of  knowledge  and  judgment  on  the  part  of  the  operator,  in  choosi- 
ing  the  strength  of  his  solution. 

To  determine  the  proper  frequency  of  the  operation,  also  requires 
judgment  and  experience.  In  an  ordinary  case  of  chronic  disease, 
the  treatment  may  begin  by  showering  the  throat  once  a  day  for  a 
week.  Then  the  operation  should  be  repeated  three  times  a  week, 
for  a  shorter  or  longer  period  ;  then  twice  a  week,  and  at  last  once  a 
week. 

Attendant  Diseases. — Among  the  persons  I  am  treating  for  diseases 
of  the  air  passages,  many  are  dyspeptic  and  suffer  with  depression  of 
spirits.  So  often  does  this  symptom  present  itself,  that  I  regard  it  as 
almost  one  of  the  peculiarities  of  throat  disease.  Persons  thus  de- 
pressed generally  have  the  dark  and  dingy  look  of  the  face  which 
indicates  functional  derangement  of  the  liver.  They  are  often  ema- 
ciated, nervous,  hypochondriacal,  irritable  in  temper,  and  are  ex- 
hausted by  aa  excessive  secretion  of  urea.  The  urine  of  such  per- 
sons is  always  acid,  and  loaded  with  crystals  of  oxalate  of  lime. 

An  expla"iiation  of  this  fact  has  been  attempted,  by  supposing  that 
the  oxydation  of  carbon  (of  which  these  persons  have  a  superabun- 
dance), imperfectly  accomplished  in  inflamed  respiratory  organs,  is 
vicariously  effected  in  the  capillaries  of  the  kidneys,  —  oxalic  acid 
(C2.  02.)  instead  of  carbonic  acid  (C.  02.)  being  the  result 

The  crystals  of  oxalate  of  lime  are  octahedral  in  form,  and,  in  the 
field  of  a  good  microscope,  are  beautiful  objects  for  inspection. 


iy-aji.:^:i 


200 


DISEASES  OF  THE  THROAT. 


Lawyers,  clergymen,  statesmen,  and,  in  general,  those  who  labor 
hard  mentally,  witti  but  little  bodily  exercise,  and  who  have  a  great 
weight  of  care  resting  on  them,  are  the  persons  who  suffer  most  from 
this  complication.  Generally,  the  inflammation  in  the  throat  is  of  a 
low  grade,  and  must  not  be  treated  with  a  very  strong  solution  of 
nitrate  of  silver. 

Of  course  when  these  attendant  diseases  exist,  something  more  is 
needed  than  the  local  treatment.  For  the  troubles  just  described,  the 
treatment  for  hypochondria  and  dyspepsia  will  be  proper. 

Elongation  of  the  Uvula. 

The  uvula  is  the  small  teat-like  or  pendulous  organ  which  hanga 
down  from  the  palatine  arch,  just  over  the  root  of  the  tongue.  It  is 
very  apt  to  get  inflamed,  and  its  parts  becoming  relaxed,  it  stretches 
out  lengthwise,  so  that  its  lower  extrem-  j.,g  ^ 

ity  sometimes  rests  upon  the  tongue. 
(Fig.  85.)  When  this  happens,  it  naps 
about,  backward  and  forward,  and  to 
the  right  and  left,  —  touching  the  throat 
at  various  points,  and  by  the  tickling 
sensation  produced,  exciting  a  most  in- 
cessant, uncontrollable,  and  rsicking 
cough.  Some  of  the  most  distressing 
coughs  I  have  ever  heard,  have  been 
produced  and  kept  up  by  this  cause 
alone.  Miny  a  fatal  consumption  has 
begun  in  this  way.  When  long  in- 
flamed, it  often  gets  much  out  of  shape, 
being  sometimes  bent  nearly  double. 

Treatment — Insome  cases,  the  uvula, 
thus  elongated,  may  be  reduced  back  to 
its  natural  size,  by  an  astringent  gargle, 
composed  of  an  infusion  of  white-oak 
bark,  with  a  little  alum  dissolved  in  it 
(232) ;  but  it  will  generally  stretch  out 
again  and  again,  upon  the  appearance 
of  any  fresh  cold,  and,  therefore,  the 
only  certain  cure  is  to  cut  it  off. 

-To  do  this,  take  hold  of  it  with  a  pair 
of  common  forceps,  and  having  stretched 
it  down  a  little,  clip  it  off  above  the 
forceps,  with  a  pair  of  curved  scissors. 
Nearly  the  whole  of  it  should  generally  be  removed.  To  take  off  a 
part  only,  leaves  a  stump,  which  is  often  more  objectionable  than  the 
whole  organ.  Its  removal  never  injures  the  speech  in  the  least.  In 
many  cases  of  nasal  catarrh,  this  organ  is  a  sort  of  diseased  centre, 
from  which  the  inflammatory  action  spreads  upward  into  the  nasal 
cavities,  and  no  medicine  or  power  on  earth  can  effect  a  cure  uutil 
thiit  offending  member  is  snipped  off.     ' 


DISEASES  OF  THE  THROAT. 


201 


vho  labor 
I'e  a  great 
nost  from 
>at  is  of  a 
)lution  of 

ig  more  is 
ribed,  the 


ich  hangs 

rue.     It.  Is 

stretches 


ike  off  a 
than  the 
iast.  In 
1  centre, 
^e  nasal 
ire  until 


Acute  Inflammation  of  the  Tonsils. —  Tonsilitis. 

The  tonsils  are  chiefly  a  collection  or  mass  of  small  mucous  folli- 
cles or  glands.  They  secrete  a  portion  of  the  fluid  which  keeps  the 
throat  moist. 

There  is  a  class  of  persons  who  suffer  about  every  winter,  some- 
times oftener,  with  an  attack  of  acute  inflammation  of  these  glands, 
which  causes  great  suftering  for  several  days.  The  trouble  begins 
with  a  slight  soreness  and  swelling  in  these  glands,  which  gradually 
increase  until  the  mouth  can  scarcely  be  opened,  and  the  act  of  swal- 
lowing is  attended  with  indescribable  suftering.  At  length,  in  from 
four  to  ten  days,  an  abscess  forms  and  breaks  in  one  or  both  glands, 
which  produces  immediate  relief. 

Treatment.  —  The  inflammation  may  sometimes  be  cut  short  by 
thrusting  a  lancet  into  the  tonsils,  and  bleeding  them  freely,  and  thcMi 
steaming  them  by  the  inhalation,  by  means  of  an  old  teapot,  of  the 
steam  of  mullein  leaves  and  hot  water.  But  the  only  cure  is  to  be 
found  by  cutting  ofl*  the  tonsils,  after  the  inflammation  has  subsided. 
This  will  put  an  end  to  the  attacks  at  once. 

Tonsils  v;hich  are  subjn  :  to  these  periodical  attacks  of  acute  inflam- 
mation are  always  more  difficult  tlian  others  to  operate  upon,  as  they 
are  almost  invariably  bound  down  very  tight  to  the  throat,  and  cannot 
be  raised  up  for  convenient  excision. 

Chronic  Inflammation  of  the  Tonsils. 

In  many  of  the  fallicular  diseases  of  the  throat,  these  glands  are 
affected  by  a  chronic  inflammation,  and  are  found  enlarged,  and 
sometimes  very  much  hardened.  In  such  cases  they  secrete  a  thin, 
unhealthy,  irritating,  fluid,  which  is  spread  over  the  throat,  increasing 
and  perpetuating  its  disease.  Much  of  this  secretion,  finds  its  way 
into  the  stomach,  and  thence  into  the  circulation. 

In  the  thioats  of  many  young  persons  and  children,  these  glands 
are  permanently  so  large,  as  nearly  to  fill  the  fauces.  The  respiration 
of  many  children  thus  afllicted,  is  difficult,  and  when  asleep  they  can 
only  breathe  with  the  mouth  open.  The  defective  breathing  of  such 
children  often  occasions  contraction  of  the  chest,  and  thus  lays  the 
foundation  for  consumption.  From  these  diseased  parts,  the  inflam-> 
matiou  often  spreads  upwards,  into  the  posterior  nares,  and  many 
times  enters  the  eustachin  tubes,  causing  deafness  or  pain  in  the  ears. 
Such  children  often  breathe  as  though  they  had  a  bad  cold  in  the  head. 
Their  health  and  safety  require  an  immediate  attention  to  this  state 
of  things. 

Treatment. —  It  is  customary  to  attempt  to  reduce  enlarged  tonsils 
by  astringent  gargles,  by  repeated  applications  of  a  solution  of  nitrate 
of  silver,  and  by  other  remedies,  and  particularly  by  brushing  them 
over  with  the  tincture  of  iodine.  As  a  general  thing,  these  applica- 
tions are  useless,  ending  in  disappointment     As  with  the  elongated 


202 


DISEASES  OF  THE  THROAT. 


uvula,  the  remedy  is  found  only  in  excision.  Cut  them  off.  The 
throat  seldom  geta  well  until  they  are  removed.  The  speedinesa  of 
the  recovery  after  the  removal  ia  often  surprising. 

Improved  Tonsil  Instrninent.  —  For  the  excision  of  theae  glands,  I 
found  the  same  lack  of  instruments  as  for  making  topical  applications 
to  the  throat.  The  only  one  which  had  any  claima  to  regard,  was 
the  guillotine  instrument.  It  had,  however,  no  facilitiea  for  drawing 
the  tonsil  forward.  Generally,  all  that  could  be  done  with  it,  was,  to 
trim  the  gland,  which  did  little  good,  for  it  became  again  enlarged. 
I  have  prepared  an  entirely  original  instrument,  with  which  the  extir- 
pation of  these  glands  is  easy  and  expeditious.  It  has  two  cutting 
blades  in  the  shape  of  crescents,  pio.  so. 

which,     when     open,     leave     a  [Patented  Janmiyn,  ism] 

proper  space  for  drawing  the 
tonsil  between  them.  Two  pol- 
ished guards  which  I  formerly 
had  made  of  steel,  but  now  of 
German  silver,  protect  the  upper 
and  the  under  surfaces  of  the 
crescentic  blades,  and  running  back,  are  fastened  by  the  common 
rivet,  which  holds  together  the  shanks,  so  that,  when  open,  the  blades 
are  concealed  under  the  guards.  The  tenaculum  rests  upon  the  rivet, 
as  upon  a  fulcrum,  and,  dipping  between  the  blades,  takes  hold  of  the 
tonsil,  and  draws  it  up  for  excision.  Cutting,  as  these  blades  do,  the 
entire  circumference  of  the  gland  first,  and  at  the  same  instant,  and 
the  central  portion  last,  the  operation  can  never  fail.  The  entire  ton- 
sil, even  when  much  hardened,  is  swept  off  with  a  cleanness  and  ease, 
which,  at  the  first  trial,  surprises  the  operator  not  less  that  the  patient. 
The  pain  of  removing  these  glands  is  so  trifling,  as  scarcely  to  be 
thought  of ;  and  the  pretence  that  evil  consequences  follow  their  re- 
moval, is  the  offspring  of  great  ignorance  of  the  whole  subject. 

To  operate  easily,  take  the  instrument'  in  the  right  or  left  hand,  ac- 
cording to  the  side  to  be  operated  upon ;  take  the  forceps  in  the  other 
hand,  and  running  them  through  the  open  blades,  into  the  mouth  of 
the  patient,  take  firm  hold  of  the  tonsil ;  then  slide  the  instrument 
down  over  the  forceps,  and  lifting  the  gland  up  between  the  blades, 
cut  it  quickly  off". 

I  am  aware  that  a  few  irregular  practitioners,  who  stand  outside 
the  profession  that  they  may  act  without  responsibility,  have  declared 
that  mischievous  results  follow  this  operation  upon  the  tonsils.  Their 
reasons  for  so  declaring  are  manifest.  They  have  never  performed 
the  operation,  and  have  not  the  skill  to  do  it  if  they  would.  They 
expect,  too,  that  those  nervous  persons  who  dread  the  operation,  will, 
when  told  by  a  physician  that  it  is  necessary,  strive  to  evade  it  by 
seeking  their  advice.  Such  practitioners  are  shrewd,  but  neither 
honest  nor  wise.  They  defeat  their  own  purpose  in  the  end.  I  have 
again  and  again  had  patients  leave  me  when  this  operation  was 
urged  upon  them,  and  finally  return  and  submit  to  it,  after  nearly 
losing  their  lives  in  the  hands  of  dishonest  quacks.     A  few  of  these 


«<t  iW. 


off.     The 
sediness  of 


le  glands,  I 
pplicationa 
egard,  wns 

or  drawing 
it,  was,  to 

n  enlarged. 
1  the  extir- 

wo  cutting 

854] 


IB  common 

the  blades 
»n  the  rivet, 

hold  of  the 
ides  do,  the 
nstant,  and 

entire  ton- 
!s  and  ease, 
the  patient, 
ircely  to  be 
w  their  re- 
)ject, 

ft  hand,  ac- 
in  the  other 
e  mouth  of 
instrument 

the  blades. 

nd  outside 
ve  declared 
sils.    Their 

1)erformed 
d.  They 
•ation,  will, 
svade  it  by 
)ut  neither 
id.  I  have 
ration  was 
fter  nearly 
w  of  these 


DISEASES  OF  THE  THROAT. 


QO'6 


practitioners  have  taken  the  same  course  in  regjird  to  the  use  of  ni- 
trate of  silver,  and  for  similar  reasons. 

Curability  of  Tlirottt  Di.Hetlse.s. —  I  have  dwelt  somewhat  u|)on  the 
preceding  form.s  of  throat  disease,  not  so  much  because  they  have 
b«'en  a  speciality  with  me  for  the  last  ten  yean<,  as  because  they  pre- 
vail to  a  fearful  extent,  and  are,  in  thousands  of  cases,  but  the  lirst 
stages  of  fatal  disease  of  the  lungs. 

If  not  connected  with  lung  disease  in  the  be^nninff,  my  experience 
in  treating  them  enables  me  to  say,  emp'^'atically,  they  are  generally 
turablfi. 

But  patients  often  put  the  question  to  me,  —  "  If  cured,  will  I  ever 
!iave  the  complaint  again  ?"  My  answer  is,  —  "Unless  I  can  plant 
in  your  constitution  a  better  protection  than  your  Maker  put  there  at 
your  creation,  you  will  of  course  be  liable  to  a  second  attack."  But 
then,  where  the  lungs  have  been  entirely  free  from  disease,  I  have 
never  yet  seen  a  case  of  simple  throat  complaint  relapse  and  become 
dangerous  after  proper  treatment  with  the  syringes.  Let  not  those, 
therefore,  who  have  been  benefited,  but  not  entirely  cured  by  this 
treatment,  undervalue  what  has  been  done  for  them.  Even  in  such 
cases,  the  advantage  derived  to  them  amounts  to  just  the  value  they 
attach  to  —  the  contintuince  of  life. 

Dxng^ers  of  Ik'ltiy.  —  In  closing  these  remarks,  let  me  warn  the 
reader  against  tlie  dangers  of  delay.  Many  of  those  who  finally  seek 
my  services  in  these  complaints,  first  try  all  nostrums,  and  tamper 
with  their  disease  till  the  case  is  either  critical  or  ho|K'less.  loo 
many  wait  till  they  are  near  enough  to  the  engulfing  whirlpool  to 
hear  it  roar,  before  they  seek  in  any  practicable  way  to  escape  its 
dangers. 

Scarce  a  day  passes  but  cases  come  into  my  hands  which  at  first 
were  only  a  slight  inflammation  of  the  pharynx,  and  might  have  been 
cured  in  a  few  days,  but  which,  from  long  neglect,  has  gradually  crept 
down  the  windpipe,  spread  over  the  widely  distributed  mucous  lining 
of  tile  bronchial  tubes,  and  thus  become  curable  only  in  a  partial  de- 
gree, and  after  long  and  tedious  treatment  Hundreds  of  persons  in 
this  city,  and  thousands  in  New  England,  are  now  suffering  from 
slight  attacks  of  this  sort,  who  might  be  rid  of  the  affliction  in  a  week 
or  a  fortnight,  but  who  will  either  carelessly  give  it  no  attention  at 
all,  or  resort  to  useless  nostrums,  until  it  has  run  through  its  primary 
stages  and  invaded  the  constitution,  and  will  finally  die  of  some  of 
the  forms  of  pulmonary  disease. 

Cases  Treated. 


In  July,  1852,  Professor 


of  W ,  Mass.,  a  distinguished 


teacher  and  composer  of  music,  called  on  me  to  obtain  relief  from 
laryngitis  and  tracheitis,  from  both  of  which  he  was  suffering,  in  con- 
nection with  bronchial  and  pulmonary  irritation.  A  year  previous  to 
this,  his  health  had  suffered  a  general  break-down  from  these  com- 
plaints.    He  had  soreness  in  the  larynx  and  trachea ;  a  severe  cough 


204 


DISEASES  OF  THE  THROAT. 


and  large  expectoration ;  he  had  hoarseness,  with  inability  to  ning ; 
night  sweats;  emaciation;  general  debility  and  lowness  of  spirits; 
in  short,  the  whole  catalogue  of  symptoms  which  indicate  impending 
bronchial  consumption.  By  advice  of  physicians  and  friepds,  he  went 
to  Europe  and  travelled  extensively.  Finding  no  relief,  he  pushed  on 
to  Africa.  On  reaching  Cairo,  his  disease  showed  the  first  abate- 
ment.  Remaining  here  a  few  weeks,  he  found  himself,  as  he  thouglit, 
about  well.  But  on  reaching  Europe,  upon  his  way  home,  his  congl^ 
with  all  his  other  bad  symptoms,  returned,  and  after  a  year's  weary 
search  for  health,  he  came  to  the  wharf  at  Boston  in  about  the  siime 
condition  as  when  he  left.  It  was  at  this  moment,  that,  disheartened, 
and  expecting  to  die,  he  picked  up  the  Evening  Traveller,  the  first 
paper  that  met  his  eye,  and  saw  an  article  on  throat  diseases,  which 
brought  him  to  my  office.  Fortunately,  before  his  departure  for 
Europe,  Mr. had  bought  a  farm  in  W .  I  gave  him  an  In- 
strument, with  the  proper  medicines  to  inhale,  and  directed  him  to 
work  every  day  on  his  farm,  to  *he  extent  of  his  physical  ability,  and 
to  come  to  me  three  times  a  veek  to  have  the  larynx  and  windpipe 
showered  with  a  solution  of  nitrate  of  silver.  These  directions,  with 
others  relating  to  his  general  health,  he  followed  to  the  letter.  It  is 
enough  to  say,  that  all  his  bad  symptoms  gradually  subsided,  and 
upon  the  approach  of  the  following  winter  he  found  himself  nearly 
recovered.  In  accordance  with  my  advice,  however,  he  abstained 
from  professional  labor  until  the  following  spring,  since  which  time 
he  has  pursued  his  calling  diligently. 

In  1853,  Mr. ,  a  merchant  of  this  city,  came  to  me  with  two 

enormously  enlarged  and  hardened  tonsils,  with  which  he  had  been 
afHicted  for  a  long  time.  One  of  the  glands  had  been  operated  on  five 
times,  the  other  eleven  times,  by  one  of  our  best  surgeons.  But  tli«! 
old  guillotine  instrument  used  was  not  large  enough  to  permit  either 
gland  to  be  drawn  into  it,  and  only  small  pieces  could  be  shaved  oil'. 
The  consequence  was,  that  they  were  made  no  smaller  by  the  opera- 
tions ;  and  being  often  cut,  they  were  hardened  by  it,  and  had  taken 
a  very  obstinate  form  of  disease,  so  much  so,  that  the  patient,  though 
naturally  a  strong  man,  was  seriously  threatened  with  pulmonary  dis- 
ease. He  had  travelled  much  during  the  preceding  summer,  but  w;is 
in  no  way  improved  by  it.  I  had  a  large  instrument  made  expressly 
for  the  purpose,  through  which  the  glands  could  be  easily  drawn,  and 
cut  them  both  through  the  centre,  or  root,  removing  one  half.  A 
solution  of  nitrate  of  silver,  fifty  grains  to  the  ounce,  was  applied  to 
the  throat  three  times  a  week,  for  about  a  month,  at  the  end  of  which 
time,  the  patient  was  dismissed  well,  and  has  remained  so  to  the 
present  time. 

In  February,  1852,  another  merchant  of  this  city,  Mr.  J.  A , 

came  under  treatment  for  a  well-marlied  case  of  follicular  disease, 
with  nasal  catarrh  and  bronchitis.  Indeed,  the  lungs  were  on  the 
point  of  becoming  a  prey,  as  a  fine  rattle  was  plainly  distinguishable 
at  the  top  on  both  sides,  and  blood  was  raised  at  various  times. 


DISEASES  OF  THE  THROAT. 


205 


y  to  Ping; 
of  8pirit« ; 
mptMiding 
8,  he  w«'nt 
puHhed  on 
ir8t  abate- 
je  thonght, 
hia  congf^ 
ar's  wciiry 
t.  the  name 
heartened, 
',  the  lir«t 
.>*es,  which 
irture  for 
him  an  in- 
d   hint;  to 
bility,  and 
I  windpipe 
tiont»,  with 
tter.     It  is 
sided,  and 
self  nearly 
abstained 
irhich  time 


f  with  two 
had  been 
itedon  five 
.     But  tli<> 
rmit  either 
shaved  oii! 
the  opera- 
had  taken 
nt,  though 
lonary  dis- 
r,  but  was 
expres!>|y 
rawn,  and 
!  half.     A 
applied  to 
i  of  which 
so  to  the 


J.  A , 

r  disease, 
re  on  the 
iguishable 


The  uvdtli  Ifitt  being  excised,  the  whole  throat  and  nasal  cavities 
were  showered  from  two  to  three  times  a  week,  for  two  or  three 
months,  every  bathing  bringing  away,  during  the  first  part  of  the 
treatment^  enormous  quantities  of  tenacious,  ropy  mucus.  To  this 
treatment,  with  inhalation,  and  constitutional  remedies,  the  disease 
yielded  slowly  but  surely,  and  Mr.  A.  has  a  good  prospect  of  pursuing 
his  profession  in  comfort  to  old  age. 

In  February,  1857,  I  was  inquired  of  respecting  the  prudence  of 
ntulertaking  to  get  a  young  man  to  Boston  from  one  of  the  northern 
towns  of  New  Hampshire,  who  was  supposed  to  be  rapidly  sinking 
ill  consumption.  After  hearing  the  case  described,  I  decided  it  to  be 
n  sifc  undertaking.  Though  feeble,  he  came  safely  in  two  days, 
lie  had  the  most  incessant,  tearing,  and  destructive!  cough,  I  ever 
heard.  The  moment  I  heard  its  peculiar  sound,  I  suspected  the 
source  of  the  trouble  ;  and,  seating  him  in  a  chair,  I  opened  his 
mouth,  and  found  tlu;  uvula  enlarged  to  a  si/e,  and  stretched  down  to 
a  length,  which  I  had  never  witnessed  before.  It  was  lying  down 
upon  the  tongue,  as  in  cut  85,  which  is  a  good  representation  of  it 
Without  giving  hinj  any  notice,  I  took  the  forceps  and  scissors,  and 
cut  it  off,  the  whole  of  it  I  told  him  to  go  to  his  hotel,  and  come 
to  me  the  next  morning.  He  entered  my  office  the  next  day,  cheer- 
ful and  laughing,  saying  he  had  not  coughed  any  all  night,  and  had 
slept  well,  —  a  thing  he  had  not  done  for  several  months.  In  two 
weeks,  he  could  walk  three  miles,  and  I  sent  him  home  well.  But 
for  tlie  operation,  he  would  have  died  within  six  weeks. 

I  would  be  glad  to  add  a  great  number  of  caties  to  the  above  ;  but 
these  are  all  for  which  I  have  room. 

\       -   •' 

A  Cold.— Influenza. 

A  SLIGHT  attack  of  the  disease  about  to  be  described,  affecting  only 
here  and  there  a  person,  and  lasting  only  for  a  fevv  days,  is  called 
a  cold.  When  it  affects  a  large  part  of  the  community  at  the  same 
time,  lasting  many  days,  or  even  weeks,  it  is  then  an  epidemic,  and 
passes  under  the  name  of  influenza.  In  this  latter  form,  it  sometimes 
spreads  over  a  whole  country,  and  has  at  times,  as  in  1832,  extended 
to  nearly  the  whole  civilized  world.  It  often  shows  marked  severity 
in  its  progress,  and  leaves  serious  results  behind. 

Symptoms.  —  A  tingling,  with  dryness,  and  a  sense  of  fulness  in 
the  mucous  membrane  of  the  nose,  are  among  the  first  indications  of 
an  attack  of  fhis  complaint  Sneezing  is  a  common  symptom.  Soon, 
pain  is  felt  in  the  forehead,  and  breathing  through  the  nose  becomes 
difficult  The  eyes  are  red  and  watery,  the  throat  is  sore ;  there  is  a 
dry  ccugh,  hoarseness,  thirst,  general  lassitude,  chills,  and  a  desire  to 
get  near  the  fire.  The  mucous  membrane  of  the  nose,  throat,  wind- 
pipe, Hud  breathing  tubes,  is  inflamed,  red,  swollen,  and  sometimes 
painful. 

In  a  short  time,  water  begins  to  run  from  the  nose  and  eyes,  and 


2G6 


DISEASES  OF  THE  THROAT. 


the  cough  becomes  a  little  more  moist  There  is  also  a  slight  dis- 
charge from  the  throat  and  tubes,  which  gradually  increases,  and,  at 
lcngt[ ,  a8  the  disease  declines,  and  becomes  less  acute,  the  expectora- 
tion is  thick  and  yellow. 

Aching  of  the  back  and  limbs,  thirst,  loss  of  appetite,  flashes  of 
heat,  anu  chills  whenever  the  patient  is  exposed  to  air  a  little  cooler 
than  he  is  accustomed  to,  are  almost  constant  attendants  upon  thu 
disease. 

Causes.  —  It  is  not  always  easy  to  say  what  the  causes  of  this  com- 
plaint are.  Frequently,  it  can  be  traced  to  an  improper  exposure  to 
cold  or  dampness ;  but  in  a  great  majority  of  cases,  especially  wIkmi 
it  takes  the  form  of  influenza,  the  causes  are  not  obvious.  Tlicy 
probably  exist  in  some  peculiar  states  of  the  atmosphere,  and  iu  u 
depression  of  the  nervous  system. 

The  influence  upon  disease  of  the  differerlt  degrees  of  density  in 
the  air  which  surrounds  us,  and  of  other  circumstances  affecting  it, 
have  not  been  much  studied.  Some- valuable  facts  will  be  drawn 
from  this  source  before  many  years.  The  putting  upon  the  body,  or 
taking  from  it,  several  tons  of  pressure  every  timi?  the  barometer  rises 
or  falls,  must  have,  of  itself,  no  small  influence  upon  its  health.  The 
comparatively  new  science  of  Physical  Geography,  by  spreading  be- 
fore us  its  interesting  facts  in  regard  to  temperature,  storms,  atmos- 
pheric currents,  etc.,  is  opening  the  way  for  the  physician  to  learn  a 
great  deal  more  about  the  causes  of  disease  than  he  now  knows. 

Treatment.  —  In  mild  cases,  only  the  most  simple  treatment  is  re- 
quired,—  such  as  remaining  in  the  house  for  a  few  days,  soaking  the 
feet  in  warm  ;vater,  taking  a  gentle  sweat,  drinking  warm  infusions 
of  flax-seed,  mullein,  slippery  elm,  or  warm  lemonade,  and  taking 
only  a  spare  vegetable  diet.  K  the  bowels  be  costive,  some  gentle 
physic  (34)  (41)  may  be  used.  A  laxative  drink  (132)  v'Hl  likewise 
be  usef'il. 

When  the  attack  is  more  severe,  sweating  must  be  induced  by  de- 
cisive measures.  This  may  be  effected  by  the  spirit  vapor  bath,  or 
by  putting  the  patieat  in  bed,  putting  bottles  of  hot  water  to  the  feet 
and  sides,  and  administering  warm  drinks,  and  the  compound  tinc- 
ture of  Virginia  snake  root.  Five  drops  every  hour  of  the  tincture 
of  veratrum  viride,  will  often  cause  very  free  perspiration,  and  will 
reduce  the  inflammation  upon  the  mucous  surface. 

An  emetic  is  sometimes  very  useful.  To  produce  vomiting,  use 
the  powder  of  ipecac,  ten  to  twenty  grains,  or  the  compound  tincture 
of  lob'-lia. 

It  soothes  the  inflamed  mucous  surfaces  very  much  to  inhale  the 
vapor  from  half  a  pint  of  hot  water,  with  five  drops  of  tincture  of 
veratrum  viride,  or  the  same  amount  of  the  tincture  of  aconite  root. 

If  the  cough  is  severe,  use  the  preparations  recommended  under 
bronchitis  and  consumption. 

In  the  latter  stages  of  the  disease,  if  there  be  debility,  —  as  there 
generally  is,  —  quinia,  iron,  nux  vomica,  etc.  (75),  should  be  taken  ;  or, 
to  support  the  nervous  system,  the  extracts  of  scuUcap,  and  boneset. 


slight  (lis. 
es,  and,  at 
expuctora- 

flashcH  of 
ttle  cooler 
upon  the 

this  coni- 

poHuro  to 

ialiy  whf'ii 

U8.     Th.y 

and  iu  a 

density  in 
fleeting  it, 

be  drawn 
le  body,  or 
neter  Tineti 
ilth.  The 
fading  be- 
ns, atinos- 
to  learn  a 
aows. 

ment  is  re- 
)aking  the 

I  infusions 
nd  taking 
me  gentle 

II  likewise 

ced  by  de- 
Jr  bath,  or 
to  the  feet 
3und  tinc- 
le  tincture 
I,  and  will 

liting,  use 
d  tincturo 

inhale  the 
incture  of 
lite  root, 
led  under 

—  as  there 
taken  ;  or, 
1  boneset. 


D1SKASE8  OF  TUK  THROAT. 


207 


and  the  sulphate  of  qninia  (81)  will  be  fonnd  useful.     At  this  stage 
of  the  complaint,  the  diet  should  be  more  liberal  and  nourishing. 

The  patient  should  not  venture  into  the  open  air,  until  the  unplcas- 
ant  senHC  of  chilliness,  peculiar  to  the  disease,  ceases  to  be  produced 
by  exposure. 

Acute  Inflammation  of  the  Epiglottis. 

This  is  the  disease  by  whieh  our  country  lost  its  most  loved  and 
dintinguiHhed  citizen,  George  Washington.  This  complaint  was  n«)t 
understood  at  the  time  of  his  dealh,  —  the  intelligent  physicians  who 
attended  him,  supposing  it  to  be  inHammation  of  the  winupi|)e.  From 
their  very  clear  description  of  the  symptoms,  we  now  know  it  to  have 
been  an  acute  inflammation  of  the  epiglottis  and  glottis. 

From  the  rapid  inflammation  of  the  epiglottis,  water  is  eflused  into 
this  cartilage,  bo  as  to  puiT  it  up,  and  prevent  it  from  shutting  down 
in  the  a'^t  of  swallowing.  The  lips  of  the  glottis  are  swollen  from  the 
same  cause,  and  brought  so  near  to  each  other  that  air  passes  through 
to  the  lungs  with  great  difficulty,  and  unless  relief  is  soon  obtained, 
the  patient  is  strangled. 

Symptoms.  —  The  disease  begins  with  a  severe  chill,  accompanied 
with  some  pain,  and  a  sense  of  stricture  or  tightness  in  the  upper 
and  fore  part  of  the  throat.  There  is  cough,  with  difficult  and  somt*- 
times  painful  swallowing.  These  symptoms  are  soon  followed  bv 
quick  and  laborious  breathing.  Speaking  aloud  is  from  the  first  difli- 
eult,  and  soon  becomes  impossible.  As  the  complaint  runs  its  rapid 
course,  the  breathing  grows  more  difficult,  and  death  soon  results 
from  Qomplete  strangulation. 

Treatment  —  Apply  immediately  to  the  parts,  a  strong  solution  of 
nitrate  of  silver.  The  solution  should  be  of  the  strength  of  ninety 
to  one  hundred  and  twenty  grains  to  the  ounce  of  soft  water.  It 
should  be  applied  every  hour  or  two  till  the  feeling  of  suflbcation  sub- 
sides, and  should  '/e  done  with  the  kryngeal  shower  syringe,  though 
if  this  is  not  at  nand,  the  sponge  probang  may  be  used. 

While  this  local  treatment  is  being  employed,  liberal  doses,  from 
five  to  twenty  drops  of  tincture  of  veratrum  viride  should  be  given 
every  hour,  wa+^ching  the  effect,  and  discontinuing  when  the  pulse 
sinks  too  low. 

Hot  fomentations  applied  externally,  and  filling  the  room  with 
(team,  as  recommended  in  cases  of  croup,  would  be  useful. 

Mumps. — Parotitis. 

This  disease  appears  most  often  among  children ;  but  as  it  is  not 
confined  to  them,  I  have  not  placed  it  among  their  complaints. 

Symptoms. —  It  begins  with  soreness  and  stiffiiess  in  the  side  of  the 
neck.  Soon  a  swelling  of  the  parotid  gland  takes  place,  which  is 
painful,  and  continues  to  increase  for  four  or  five  days,  sometimes 


V  ■ 


•'f^H 


-i-ii  v*SaS»J*)K=iS»i*Aj6 


fC 


308 


DISEASES  OF  THE  THROAT. 


becoming  very  large,  and  making  it  difficult  to  Bwallow,  or  open  the 
mouth  to  receive  food.  After  tlie  fourth  or  fifth  day  the  swelling 
HubHides,  and  disappeani  in  from  seven  to  ten  daya. 

Both  glands  generally  HWell  about  the  same  time,  but  sometimes 
the  swelling  appears  in  one  only  after  it  has  ouhsidcd  in  the  other, 
and  occasionally  the  swelling  is  wholly  confined  to  one  side. 

When  the  swelling  is  great,  there  is  heat,  and  sometimes  fevcj-,  with 
dry  skin,  (|uick  pulse,  furred  tongue,  constipated  bowels,  and  scanty 
UM(1  high-colored  urine. 

The  affection  is  sometimes  translated,  as  we  say  ;  that  is,  in  fe- 
males, the  breasts  swell,  and  in  males,  the  testicles  become  swollen 
and  painful.  This  accident  generally  happens  in  eonseciueiice  of  tak- 
ing cold  from  some  imprudence. 

The  disease  is  contagious ;  that  is,  it  ia  communicated  from  i>nc 
perwon  to  another. 

Treatment. —  In  mild  cases,  very  little  treatment  is  required.  Keep- 
ing the  face  and  neck  warm,  avoiding  exposure  to  cold  and  damp, 
drinking  warm  infusions  of  balm,  spearmint,  or  sage,  and  taking  oc- 
casionally, if  there  be  some  severity  of  symptoms,  four  to  six  grains 
of  Dover's  powder ;  or  the  compound  powder  of  jalap,  if  there  be 
costiveness,  is  about  ali  that  is  required.  Th(.  diet  should  consist  of 
rye  hasty  pudding,  or  brown  bread  and  sweetened  water. 

If  the  case  be  severe,  and  other  glands  swell,  physic  must  be  freely 
'a«cd,  leeches  must  be  applied,  ana  cooling  lotions,  or  poultices. 
Sw«mting  must  also  be  induced  by  the  compound  tincture  of  Ver- 
ginia  snake  root,  or  by  a  vapor  bath. 


>»  ; 


jr  opfln  the 
e  Hwc'lling 

sometimea 
the  other, 

fi'vei-,  with 
iikI  Hcuiity 

t  i«,  ill  fe- 
iw  swollen 
life  of  tak- 

froin  one 

t:(l.  Keep- 
aiid  damp, 
taking  oc- 
uix  grains 
if  there  be 
conaict  of 

t  be  freely 
poultices, 
ire  of  Ver- 


♦     «    .    •   ! 


•    .vut;' 


.•.*t  .■; 


DISEASES   OF  THE  CHEST. 


.  .        Oonsumption.—  Phthisis.  ^         - 

At  the  head  of  the  diHcasea  of  our  climate  stands  Consumption,-- 
at  their  head  both  as  it  reH|x;ct8  prevalence  and  fatality.  Small  pox, 
yellow  fever,  and  cholera,  are  terrible  in  their  visitations ;  but  what 
are  all  their  aggregated  blaughtcrH  compared  with  the  ceaseless,  silent 
march  of  this  fell  disease,  which  steals  away  in  their  fresh  prime  the 
brightest  and  the  best  ? 

Boston,  from  its  population  of  160,000,  loses  by  consumption  about 
fifteen  per  week,  sixty-five  \tet  month,  or  about  seven  hundred  and 
eighty  per  annum.  An  equal  mortality  from  any  disease  not  often 
among  v  i,  would  send  our  citizens  in  terror  to  the  country,  and  cause 
the  stoutest  hearts  to  feel  that  "  in  the  midst  of  life  we  are  in  death." 
Massachusetts  loses  about  6000  per  annum  ;  New  England,  not  less 
than  20,000  ;  and  wim  the  State  of  New  York  added,  the  victims  of 
this  single  disease  swell  to  40,000  a  year !  What  an  army  !  Picked 
from  the  choicest!  All  sundered  from  life  untimely,  and  leaving 
more  blight  and  sorrow  behind  than  would  perhaps  twice  or  thrire 
the  number  whom  any  othei  pestilence  would  have  selected.  The 
magnitude  of  the  evil  places  the  question  of  the  remedy  before  all 
others  that  pertain  to  the  healing  art 

jWethods  of  Examininji^  the  Chest  —  Before  speaking  further  of  con- 
sumption, I  propose  to  do  what  has  never  been  done,  namely,  to 
instruct  the  general  reader,  very  briefly,  in  the  method  of  examining 
the  chest  to  learn  the  existenct;  of  disease.  Perhaps  this  will  be  con- 
sidered a  departure,  in  some  slight  degree,  from  my  purpose  to  nia.'.o 
this  entire  book  intelligible  to  the  general  reader.  If  so,  my  reply  is. 
that  there  are  many  school  teachers,  mechanics,  masters  of  vessels, 
and  farmers,  who  have  inquiring  minds,  and  sagacity  enough  to  leani 
the  physical  signs  of  chest  diseai-e,  and  to  make  them,  in  many  cases, 
practically  useful ;  and  that  even  readers  of  little  reflection  cannot 
fail  to  comprehend  a  portion  of  my  explanations. 

Position  of  tlie  Patient.  —  In  performing  percussion  upon  the  front 
of  the  chest,  the  patient  should  be  required  to  sit  in  a  square  posi*^ion, 
with  the  arms  hooked  over  the  corners  of  the  back  of  the  chair,  and 
the  head  thrown  a  little  back. 

27 


210 


DISEASES  OF  THE  CflXST. 


Instniment  with  which  to  Thmnp.  —  The  index  and  middle  fineers 
of  the  right  hand  are  to  be  brought  together,  into  a  line,  and  used  aa 
the  percussing  instrument  The  blow  given  with  these  is  to  be  smart 
and  quick,  rattier  than  heavy. 

Mediam  to  Thump  Upon.  —  Either  the  index  or  middle  finger  of 
the  left  hand  is  to  be  pressed  firmly  upon  the  surface  of  the  chest  to 
be  percussed  or  struck,  and  thus  used  as  a  pleximiter. 

Anscultatioil.  —  Listening  for  the  purpose  of  hearing  within  the 
chest  the  sounds  produced  by  breathing,  talking,  coughing,  etc.,  is 
called  auscultation. 

Iiistniiiients  with  wliich  to  Listen.  —  The  naked  ear  is  generally 
(  oiK-*idared  best  for  hearing  low  and  delicate  sounds  ;  but  for  hearing 
laud  and  rough  ones,  it  is  not  so  good  as  the  stethoscope,  repre- 
Hciited  by  Fig.  87.  A.  still  better  instrument  is  the  double-eared  steth- 
oscope, Fig.  88.  It  magnifies  the  sounds  very  mucli,  and  is  apt  to 
confuse  an  examiner  not  accustomed  to  it ;  but  when  the  ear  is  once 
familiar  with  it,  the  aid  it  aftbrds  is  very  valuable. 


FiQ.  87 


Fio.  88. 


The  examiner  should  pass  firom  side  to  side,  continually  comparing- 
the  sounds  upon  one  side,  with  chose  upon  the  othen 

The  patient  must  be  calm,  and  the  examiner  in  no  hurry. 

Healtliy  Sounds.  —  To  become  skilful  either  in  percussion  or  aus- 
cultation, the  examiner's  ear  must  first  be  trained  to  healthy  sounds. 

These  are  best  heard  in  the  child,  in  whom  they  are  louder  than  in 
the  adutt. 

In  describing  the  healthy  sounds  in  the  different  regions  of  the 
chest,  I  sha'I  refer  the  reader  constantly  to  Figs.  89  and  90. 

Clavicular  Region.  —  This,  in  Fig.  89,  is  represented  by  1, 1.  Upon 
thumping  upon  the  collar-bones,  the  sound  given  out  at  the  breast- 
bone ei^  should  be  very  clear ;  less  clear  in  the  middle  ;  and  dull  at 
the  shoulder  end. 


Ik 


mSRASES  OF  THE  CHEST. 


3H 


ile  fineers 
1  usea  as 
be  smart 


finger  of 
le  chest  to 


vithin  the 
ig,  etc.,  is 

generally 
or  hearing 
)pe,  repre- 
ared  steth- 

is  apt  to 
;ar  is  once 


comparing- 


3n  or  au8- 
!iy  sounds. 
Icr  than  in 

tns  of  the 


1.  Upon 
he  breast- 
nd  dull  at 


SabdaTiaB  BCfkMH*  —  Thii*  is  represented  bv  2,  SJ,  and  lies  betwrrn 
the  collar-bone  and  the  fourth  rib,  on  both  sides.  It  covers  a  coii:<id- 
arable  portio:i  of  the  upper  lobe  of  the  lungs.  The  sound  upon  strik- 
ing this  spat  «i  bhonld  be  very  clear. 

tm.m 


lis.  Hi 


The  IHninmnry  Ite$:ion,  represented  by  3,  3,  extends  from  the  fourth 
to  the  seventh  rib,  on  each  side.  In  the  upper  part  of  this  region,  the 
healthy  sound  is  clear;  but  at  the  bottom  of  it,  on  the  right,  the 
sound  is  deadened  by  the  liver ;  on  the  left,  by  the  heart. 

The  liifni-llflmninry  Reg^ion,  4,  4,  lies  between  the  seventh  rib  and 
the  edge  of  the  cartilages  of  the  false  ribs.  On  the  right  side,  the 
liver  makes  the  sound  dull ;  but  under  the  left  side  lies  ttie  stomacl^ 
which  is  hollow,  and  the  sound  is  generally  quite  loud. 

In  the  Stenuil  Rojrioii,  5,  6,  7,  which  covers  the  breast-bone,  the 
sound  is  generally  clear. 

The  Axillary  Ref:ion,  8,  6,  is  in  the  arm-pits.  In  this  the  sound 
should  be  clear. 

The  Lateral  Re^on,  9,  9,  is  immediately  below  the  above,  and 
yields,  likewise,  a  clear  sound. 

The  Lower  L"""nil  Region,  gives  a  dull  sound  on  thi  right  side,  and 
on  the  left  a  very  hollow  one. 

Fig.  90  represents  the  back  part  of  the  chest.  In  looking  at  this, 
we  see  the 


In  this  space  the  sound 


Acroiiiiiil  Reg^ioii,  represented  by  11, 11. 
is  dull,  but  it  has  not  much  meaning. 

The  Scapular  Resrion,  12, 12,  covers  the  part  occupied  by  the  shoul- 
der-blades.    It  gives  rather  a  dead  sound. 


TUe  Intra-Scapnlar  Region,  13, 13,  lies  between  the  shoulder-blades, 
on  each  side  of  the  back  bone.  If  the  patient's  arms  are  crossed,  and 
the  head  beiit  forward,  a  clear  sound  will  be  obtained. 

The  Dorsal  Region,  14,  14,  covers  the  base  of  the  lungs,  and,  in 
health,  gives  a  clear  sound. 

Observation.  —  If,  now,  on  thumping  upon  the  chest,  we  find  a  dull, 
dead  sound  in  any  spot  where  a  clear  one  ought  to  be  yielded,  we  ar» 
to  conclude  that  underneath  there  is  not  the  usual  quantity  of  air; 
but  we  cannot  tell  merely  by  percussing,  whether  tubercles  are  depos- 
ited there,  or  the  lung  has  become  solid  by  inflammation,  or  water 
has  been  poured  out  into  the  cavity  of  the  pleura.  Tliis  point  must 
be  dei/^rmined  by  auscultation,  etc.,  to  be  explained  gradually  as  we 
go  along. 

Auscultation  of  Breathing. —  On  applying  the  ear  or  the  stetho- 
8Cope  to  the  chest,  two  sounds  are  heard  which  immediately  succeed 
each  other, — the  louder  is  produced  by  the  ingoing  breath,  or  inspira- 
tion ;  the  weaker  by  the  outgoing  breath,  or  expiration.  These  sounds 
will  be  further  explained  as  we  go  along. 

Anscnltation  of  the  Toice  and  Congh. — The  chest  of  a  healthy  per- 
son  speaking,  communicates  to  the  ear  no  distinct  sound,  but  only 
a  vibratory  sensation,  called,  in  technical  language,  the  pectoral  fre- 
mitus. 

Over  the  larynx  and  windpipe,  the  examiner  may  hear  natural  pec- 
toriloquy ;  between  the  shoulder  blades,  in  the  space  corresponding  to 
the  roots  of  the  lungs,  natural  bronchophony. 

Philosophy  of  Chest  Sounds. —  The  fulness  and  clearness  of  sound 
upon  percussion,  depends  upon  the  amount  of  air  in  the  chest 

The  sounds  called  breathing  murmurs,  are  caused  by  the  expansion 
and  contraction  of  the  air-cells  or  vesicles,  as  the  air  passes  in  and 
out ;  hence  they  are  called  vesicular  murmurs. 

The  friction  of  the  air  against  the  sides  of  the  windpipe  and  large 
bronchial  tubes,  causes  the  blowing  sound  heard  in  those  parts. 

In  children  a  larger  amount  of  air  enters  the  lungs,  and  the  air  vesi- 
cles are  expanded  with  more  force ;  hence  their  breathing  has  a  louder 
sound,  which  is  called  puerile  respiration.  This  kind  of  breathing, 
heard  in  the  grown  person,  is  a  sign  of  disease. 

The  lung  tissue  is  a  bad  conductor  of  sound  ;  and  the  voice  is  ac- 
cordingly heard  only  over  those  parts  where  large  bronchial  tubes  are 
near  the  surface  ;  heard  elsewhere,  it  indicates  disease. 

Division  of  Consumption. —  Consumption  may  be  divided  into  two 
kinds,  the  tubercular  and  the  bronchial.  The  former  has  a  constitu- 
tional, the  latter  a  local  origin. 

First  Stage  of  Tubercular  Consumption. 

Physical  Sig;ns.  —  Dulness  of  sound  on  and  under  the  collar-bones. 
Inspiration  shortened  ;  expiration  augmented  both  in  duration  and 
intensity. 


nd  a  dull, 
d,  we  ar» 

ty  of  air; 

ire  depo3- 
or  water 
int  must 
ly  as  we 

le  stetho- 
y  succeed 
>r  Inspira- 
86  sounds 

althy  i^er- 
but  only 
toral  frc' 

ural  pec- 
onding  to 

of  sound 
st 

expansion 
»  in  and 

md  large 

rts. 

;  air  vesi- 

i  a  louder 

>reathing, 

»ice  is  ac- 
tubea  are 

into  two 
constitu- 


i. 

ar-bones. 
ition  and 


DISEASES  OF  THE  CHEST. 


213 


Occasionally  a  pulmonary,  crumpling  sound.  Dry,  crackling  rat> 
ties. 

The  resounding  of  the  voice  increased  at  the  top  of  the  lungs. 

General  Symptoms. —  A  sense  of  weariness  and  languor. 

Occasionally,  Hlight,  flying  pains  about  the  chest  and  shoulders. 

A  peculiar  sensitiveness  to  the  effects  of  cold. 

Breathlessness  on  moving  quick,  or  ascending  a  hill  or  stairs. 

In  many  cases  a  blue  lividity  of  the  lips,  and  roots  of  the  finger 
nails,  and  coldness  of  the  hands  and  feet. 

Occasionally,  in  females,  even  at  this  early  stage,  a  cessation  of  the 
monthly  turns. 

Observations.  —  The  formation  of  tubercles  almost  always  begins 
nt  the  top  of  the  lungs.  Laennec  and  others  thought  they  appeared 
oftenest  on  the  right  side  first;  Louis,  Andral  Watson,  Sir  James 
Clarke,  and  others,  believed  they  appeared  more  often  on  the  left  side. 
Recent  investigations  show  that  they  were  all  mistaken.  Tubercles 
appear  first  about  as  often  upon  jne  side  as  upon  the  other. 

The  pulmonary  crumpling  sound  is  caused  by  a  mechanical  ob- 
struction to  the  expansion  of  the  lungs.  It  is  generally  heard  only 
during  the  drawing  in  of  the  breath.  The  sound  is  like  that  pro- 
duced by  blowing  upon  very  fine  paper. 

Ssoond  Stage. 

Physical  Sig^s.  —  Marked  dulness  of  sound  on  the  collar  bones,  and 
extending  below  them. 

Inspiratory  murmui  iiminished  in  duration  and  intensity;  expira- 
tory murmur  augmented  in  both. 

In  upper  lobes  of  lungs,  moist,  crackling  rattles,  succeeded  by  mu- 
cous rattles.     Also  bronchial  respiration. 

In  lower  lobus  of  lungs,  puerile  respiration. 

Sounds  of  the  heart  heard  under  the  collar  bones. 

Bronchophony  heard  in  the  same  parts  as  bronchial  respiration. 

General  Symptoms.  —  A  quickened  pulse ;  slight  fever  towards 
evening. 

Great  susceptibility  to  the  efiects  of  cold,  and  liability  to  take  cold 
easily. 

Bowels  generally  costive. 

The  eye  has  a  peculiar  whiteness  and  lustre. 

The  skin  and  mouth  become  dry  in  the  afternoon  ;  chills  occur 
about  midday,  followed  by  fever,  during  which  the  cheeks  are  flushed. 

As  the  second  stage  advances  to  its  close,  a  dry,  burning  heat 
afflicts  the  palms  of  the  hands  and  soles  of  the  feet. 

•Night-sweats  occur  at  this  time. 

Observations.  —  A  hollow,  elastic  body,  containing  air,  gives,  when 
struck,  a  clear  sound.  The  dulness  of  sound  ou  percussing  the  chest, 
arises  from  the  absence  of  air  in  the  air-cells,  —  these  having  been 
pressed  together,  or  obliterated  by  the  deposit  of  a  mass  of  tuberclf** 


ill 
m 


w 


n: 


MHH. 


214 


DISEASES  OF  THE  CHEST. 


The  destruction  of  these  cells  causes  the  cessation  of  the  respiratory 
murmur. 

This  stage  of  the  disease  is  often  accompanied  by  an  inflammation 
of  the  mucous  membrane  lining  the  air  tubes.  The  air,  pushing  its 
way  through  the  mucous  secretions  in  these  tube  forms  bubbles,  the 
bursting  of  which  causes  the  rattle.  The  crepitant  rattle  is  produced 
by  inflammation  around  the  tubercles.  The  moist,  crackling  rattle  is 
caused  by  the  softening  of  the  tubercles. 

The  lungs,  rendered  more  solid  by  the  deposit  of  tubercles,  become 
better  conductors  of  sound  ;  and  this  causes  the  beating  of  the  heart 
to  be  heard  as  far  off  as  under  the  collar  bones. 

Bronchial  respiration  gives  the  idea  of  air  blown  through  a  tube  ; 
cavernous  respiration,  of  air  passing  into  a  large  enclosed  cavity. 

Third  Stage. 

Physical  Signs.  —  In  this  stage  cavities  are  formed.  If  the  cavities 
be  small,  and  considerable  tuberculated  lung  surrounds  them,  the 
sound,  upon  percussion,  is  still  dull. 

If  the  cavity  be  large,  and  near  the  surface,  there  is  occasionally  a 
tympanitic  sound. 

Sometimes  a  sound  is  heard  like  striking  a  cracked  pot. 

Gurgling;  cavernous  rattle;  cavernous  breathing;  amphoric  breath- 
ing ;  now  and  then,  mctalic  tinkling ;  pectoriloquy  ;  cavernous  cough. 

General  Symptoms.  —  Great  loss  of  flesh,  and  weakness ;  diarrhfea 
and  night-sweats;  swelling  of  the  feet  and  legs;  sore  mouth;  and  rais- 
ing of  matter  with  specks  of  tubercle  in  it  like  crumbs  of  cheezs. 

Observations.  —  The  gurgling  rattle  is  causdd  by  air  displacing 
liquids,  and  the  formation  and  bursting  of  bubbles.  It  resembles  the 
sound  produced  by  blowing  through  »  tube  immersed  in  soap-suds. 

Cavernous  breathing  is  nothing  .iiore  nor  less  than  the  sound  pro- 
duced by  air,  breathed  in  and  out,  entering  and  retiring  from  a  cavity. 
The  air  appears,  sometimes,  to  one  listening  with  the  stethoscope,  as 
if  it  were  sucked  into  his  ear  during  inspiration,  and  blown  back 
again  during  expiration. 

Amphoric  respiration  is  simply  an  augmentation  of  cavernous 
breathing,  and  results,  of  course,  from  an  increase  of  size  in  the 
cavity. 

In  pectoriloquy,  words  uttered  by  the  patient,  seem  to  pass  through 
the  stethoscope,  into  the  ear  of  the  listener.  The  cavity  should  be 
empty,  moderate  in  size,  and  have  dense  walls,  in  order  to  furnish 
the  best  specimen  of  this  sound. 

Air  suddenly  driven  backward  through  the  windpipe,  and  out  of  the 
mouth  and  nose,  by  smart  raps  upon  the  chest  over  a  cavity,  gives 
the  sound  of  the  cracked  pot  It  is  best  heard  when  the  patient's 
mouth  is  partly  open.  The  same  sound  is  produced,  on  the  same 
principle,  by  locking  the  fingers  of  the  two  hands,  and  joining  the 
palms,  so  as  to  leave  a  small  space  or  cavity  between  them,  and  then 
expelling  the  air  from  that  cavity,  by  gently  striking  the  back  of  one 
hand  upon  the  knee. 


J 


^spiratory 

immation 
ashing  ita 
bbles,  the 
produced 
g  rattle  is 

8,  become 
the  heart 

h  a  tube  ; 
ivity. 


le  cavities 
them,  the 

sionally  a 


ic  breath- 
US  cough. 

diarrhoea 
and  rais- 
itees. 

lisplacing 
mbles  the 
p-8uds. 
ound  pro- 
a  cavity. 
>scope,  as 
»wn  back 

cavernous 
ze  in  the 

8  through 
ihouid  be 
o  furnish 

out  of  the 
ity,  gives 
patient's 
the  same 
ining  the 
and  then 
ck  of  one 


DISEASES  OF  THE  CHEST. 


215 


Causes  of  Consumption.  —  The  human  constitution  as  shown  by 
Liebig,  in  his  profound  work  on  Animal  Chemistry,  is  governed  by 
two  forces,  the  nervous  and  the  vegetative.  The  former  disposes  the 
particles  composing  the  body  to  a  state  of  motion  ;  the  latter  inclines 
them  to  a  position  of  rest. 

In  vegetative  life  there  is  motion  in  one  direction  only, so  to  speak; 
that  is,  motion  which  tends  to  the  opposite  of  motion,  namely,  rest 
In  vegetables,  wliose  life  is  wholly  under  this  power,  there  is  no  waste; 
for  here,  all  ultimate  particU^s,  having  once  taken  a  place  of  rest, 
remain  undisturbed.  In  a  tree,  a  layer  of  matter  once  deposited, 
always  remains.  Hence  there  is  g^nnoth  as  long  as  the  tree  lives, 
There  is  no  power  to  break  up  and  destroy. 

But  in  the  animal  body  there  is  motion  in  two  directions,  or  a 
circuit  of  motion.  Particles  which  under  the  vegetative  force  have 
lieen  put  to  rest,  are  perpetually  being  displaced  by  the  nervous  energy, 
and  reduced  to  unorganized  amorphous  compounds,  to  be  burned  m 
warming  the  system,  or  cast  out  by  the  several  excretory  processes. 

So  constant  is  the  action  of  these  two  forces,  that  John  Hunter 
compared  the  human  system  to  a  whirlpool,  into  which  the  particles 
of  matter  are  perpetually  poured,  under  the  influence  of  the  vegeta- 
tive power,  ana  out  of  which  they  are  as  constantly  whirled  by  the 
nervous  force. 

By  a  little  reflection  upon  these  antagonisms,  the  reader  will  see 
that  it  is  just  when  the  vegetative  force  transcends  the  nervous,  that 
the  body  increases  in  weight,  and  acquires  that  state  in  which  the 
blood  corpuscles  abound,  and  the  tendency,  if  to  disease  at  all,  is  to 
that  of  the  inflammatory  kind.  It  is  the  tonic  condition  of  the  sys- 
tem. Nutrition  is  more  rapid  than  destruction.  New  particles  are 
laid  down  faster  than  old  ones  are  taken  up.     The  body  grows. 

On  the  other  hand,  when  the  nervous  force  overmasters  the  vegeta- 
tive, when  the  outward  or  centrifugal  motion  of  the  whirlpool  prevails, 
then  it  is  that  the  body  ia  attenuated,  the  blood  thinned  and  made 
serous,  and  the  consumptive  or  atonic  condition  is  established.  Nou}^ 
there  is  too  much  motion.  The  nutritive  particles,  instead  of  tending 
to  a  state  of  deposit  for  the  re-supply  of  waste  matter,  become  fugi- 
tive in  their  habits,  perpetually  fleeing,  like  convicts  escaped  from 
prison.  Introduce  this  jwwer,  in  excess,  into  the  vegetable  kingdom, 
and  the  matter  deposited  upon  the  tree,  instead  of  remaining  to  swell 
its  bulk,  would  be  driven  off"  by  the  nervous  force ;  and  the  tree,  in- 
stead of  growing,  would  be  annually  kss$ned,  become  sickly,  and  die 
of  consumption. 

In  Tubercular  Consumption,  the  system  is  like  a  field  deluged  with 
a  flood  :  nothing  can  take  root.  The  repeated  shocks  of  the  nervous 
battery  sent  to  the  absorbents  so  quicken  them  in  their  work  of  re- 
moving waste  matter,  that  they  dislodge  much  which  is  not  yet  worn 
out,  and  assist  in  casting  out  of  the  system  not  a  little  designed  to  be 
used  in  its  renewal.  A  healthy  deposit  is  thus  prevented,  and  nutri- 
tion is  at  an  end.  The  nutritive  arteries,  those  little  builders  of  the 
human  frame,  are  overmastered  by  the  stimulated  lymphatics ;  the 
constructive  material  is  wrested  from  them,  and  borne  beyond  their 


;  :\i 


21t> 


DISEASES  OF  THE  CHEST. 


reach,  and  the  body  wastes  from  want  of  nourishment.  The  blood 
becomes  thin  and  watery ;  and  from  the  increased  serous  portion, 
chiefly  albumen,  are  depoited  upon  the  lungs  and  other  tissues  the 
albuminous  tumors  called  tubercles. 

Here  is  found  the  cause  of  that  peculiar  smallness  of  bone  and 
muscle,  and  thinness  and  tallness  of  person,  so  peculiar  to  consump- 
tives. '  ^he  absorbents,  under  the  power  of  a  very  active  nervous 
system,  .cike  down  "the  house  we  live  in"  faster  than  the  nutritivo 
arteries,  confused  by  the  motion  around  them,  can  effect  its  recon- 
struction. It  is  simply  an  unbalancing  of  the  antagonistic  forces, 
which  build  and  pull  down  our  earthly  tenement.  The  men  that  de- 
molish are  more  numerous  and  better  fed  than  the  artisan  builders. 

It  is  this  destructively  nervous  force  which  gives  to  consumptive 
persons  their  proverbial  mental  activity;  wliich  causes  them  often  to 
dazzle  the  world  with  the  splendor  of  their  gifts,  and  to'  bless  their 
friends  with  the  warmth  of  their  affections.  They  are  usually  the 
choice  spirits,  the  idols  of  their  relatives,  and  the  favorites  of  the  com- 
munity in  which  they  live.  Their  mental  movements,  and  the  exer- 
cise of  their  affections,  are  characterized  by  brilliancy  and  warmth. 
Of  all  persons,  they  are  best  fitted  to  enjoy  life,  and  to  impart  happi- 
ness. Loving  all,  they  are  by  all  loved  in  return.  They  are  speci- 
mens of  partially  etherealized  humanity,  stepping  lightly  across  the 
earth,  to  whom  friends  passionately  stretch  out  their  arms,  and  em- 
brace —  their  shadows ! 

These  views  will  appear  the  more  reasonable,  if  we  consider  that 
in  children  the  vegetative  power  is  very  active,  while  the  nervoug 
energy  is  comparatively  weak.  The  preponderance  of  the  former 
over  the  latter  causes  the  rapid  growth  of  children.  .  The  little  arteriaj 
builders  work  faster  than  the  lymphatic  demolishers.  This  explains 
why  so  few  children  die  of  consumption. 

But  from  the  age  of  seventeen  to  thirty-five,  when  the  vegetative 
power  is  losing  something  of  itj*  extraordinary  activity,  and  the  nerv- 
ous force  is  showing  ita  highest  capabilities,  —  then  it  is,  as  this 
theory  indicates,  that  tubercular  consumption  does  its  dreadful  work, 
—  then,  that  the  outward  whirl  of  this  physiological  Maelstrom  casts 
upon  the  shores  of  mortality  so  many  thinned,  exhausted,  and  lifeless 
human  forms.  More  than  three  fourths  of  all  who  sink  under  this 
disorder  die  between  the  ages  just  named.  The  brain,  between  these 
points  of  time,  acquires  its  full  size  and  force. 

This  disease  prevails  most,  too,  in  those  countries  where  an  enlight- 
ened civilization  gives  to  the  nervous  system  its  fullest  development, 
as  in  Great  Britain,  France,  and  the  United  States,  and  in  those 
where  the  nutritive  process  is  most  retarded  by  a  relaxing  climate ; 
and  it  is  carcely  known  among  those  people  who  are  but  little  en- 
lightened and  have  small  brains,  and  among  those  who  live  in  high 
and  invigorating  latitudes.  As  the  most  enlightened,  however,  are 
generally  found  in  temperate  climates,  and  those  with  the  least  culti- 
vated brains  in  low  latitudes,  the  rule  is  not  perfectly  explained  by 
facts ;  yet  it  shows  itself  sufficiently  to  establish  its  validity,  and  to 
afford  another  proof  of  my  theory. 


^m 


1 


DISEASES  OF  THE  CHEST. 


217 


he  blood 
portion, 
3sue3  the 

>one  and 
ionsump- 
nervous 
nutritivo 
ts  recon- 


Bronchial  Consumption. 

The  persons  exposed  to  bronchial  consumption  are  generally  of  an 
opposite  habit  to  those  described  above,  —  having  the  nervous  force, 
in  health,  well  aubordinated  to  the  vegetative,  the  assimilation  good, 
and  the  blood  well  supplied  with  red  globules.  They  have  usually  a 
full  habit  and  an  active  circulation.  The  absorbents,  and  other  ves- 
sels in  the  lungs,  working  in  the  midst  of  a  large  amount  of  caloric 
evolved  by  an  energetic  respiration,  often  take  cold,  which  brings  on 
Inng  fever  and  pleurisy,  and  these  lay  the  foundation  for  the  ultimate 
destruction  of  the  lungs.  For  the  same  reason,  the  skin  of  this  class 
of  persons  becomes  diseased,  and  more  often  the  inner  skin,  or  mu- 
cous membrane,  and  most  often  that  portion  of  mucous  membrane 
which  goes  down  into  the  lungs  and  lines  the  air  tubes.  It  is  inflam- 
mation of  this  which  constitutes  bronchitis,  and  which  lays  the  foun- 
dation for  true  bronchia!  consumption. 

As  that  class  of  persons  who  are  exposed  to  the  tubercular  form  of 
the  disease  suffer  a  general  loss  of  carburetted  hydrogen  in  its  several 
forms,  colliquative  diarrhoea,  sweats,  increased  breathing,  and  all  con- 
ditions that  carry  fat  out  of  the  system,  so  those  who  suffer  from 
attacks  of  the  bronchial  type  of  the  disorder  are  generally  afflicted 
with  the  opposite  condition.     They  have  too  much  carbon. 

It  is  well  ascertained  that  carburetted  hydrogen,  accumulated  in 
the  system,  acts  as  a  poison.  And  that  class  of  bilious  persons  who 
are  subject  to  this  disease  often  have  their  excretions  badly  performed. 
P'or  this  reason,  carbonaceous  compounds  accumulate  in  the  system, 
and  give  rise  to  the  symptoms  of  morbid  poison  circulating  in  the 
blood.  This  led  Dr.  Madden  to  suspect  the  presence  of  such  poison 
in  the  blood  of  all  consumptive  persons.  He  saw  the  evidence  of  it 
in  numerous  cases,  and  not  distinguishing  the  one  class  from  the 
other,  he  inferred  its  presence  in  all. , 

Constitutional  Difference. 

The  constitutional  difference  between  the  two  forms  of  consump- 
tion appears  to  be  this :  the  tubercular  type  is  usually  attended,  in  its 
origin,  by  a  tolerably  good  state  of  the  digestive  function,  in  connec- 
tion with  bad  assimilation  ;  while  the  bronchial  form  generally  has 
its  foundation  laid  in  connection  with  bad  digestion,  accompanied 
with  healthful  assimilation.  In  the  former  case,  the  food  is  well  di- 
gested, the  pabulum  is  properly  prepared,  but  the  nutritive  arteries  do 
not  use  it  for  renewing  the  tissues.  In  the  latter  case,  the  digestion 
is  bad,  the  pabulum  poorly  elaborated ;  but  the  re-constructive  vessels, 
under  the  control  of  a  well-developed  system  of  organic  nerves,  use 
it  to  the  best  advantage.  In  the  one  case  there  are  good  hrick-makers, 
and  lazy  hrick-lai/ers ;  in  the  other,  the  reverse. 

It  happens,  however,  that  before  the  fatal  close  of  the  disease,  tu- 
bercular patients  usually  become  afflicted,  more  or  less,  with  bad 
digestion,  and  bronchial  patients  with  defective  assimilation ;  so  that, 


218 


DISEASES  OF  THE  CHEST. 


in  the  end,  they  present  us  with  much  the  same  class  of  symptoms. 
Starting  from  opposite  poles  in  life's  celestial  sphere,  they  meet  at 
the  culminating  point  of  death,  and  disappear  under  identical  aspects 
of  the  heavens. 


Exciting  Causes  of  Tubercular  Consumption. 

The  preponderance  of  the  nervous  force  being  the  state  which  pre- 
disposes to  disease,  whatever  unduly  excites  the  nervous  energy  in- 
vites an  attack. 

These  causes  relate,  mostly,  to  the  proloriffed  exercise  of  the  iniellect, 
the  passions^  and  the  sentiments. 

Few  are  aware  of  the  mischief  done  by  excessive  stimulation  of 
the  mind  during  the  most  active  period  of  life,  —  especially  if  tho 
muscular  system  be  left  half  developed.  Here  is  where  ambitious 
students  commit  great  errors. 

The  constant  plying  of  the  menttl  powers,  in  the  present  modes  of 
educating  children,  leads  to  a  dreadful  abridgment  of  human  life, 
fetter  to  train  the  bodily  powers  first,  and  let  the  mental  culture 
come  in  later  time.  He  who  would  build  a  lasting  structure  must 
lay  a  solid  foundation. 

The  age  in  which  we  live  abounds  in  the  causes  of  excitement  The 
world  is  trembling  with  excess  of  mental  life.  The  pine  trees  burnt-cl 
by  the  steam  engine  are  scarcely  more  numerous  than  the  human 
constitutions  consumed  by  the  train  of  thought  it  has  set  on  fire. 

Nor  are  the  passions  and  sentiments  less  exercised,  or  less  destruc- 
tive. 

Briefly,  the  causes  of  consumption  embrace  all  those  things  which 
bring  a  destructive  force  against  the  digestive  and  assimilative  func- 
tions, as  insufficient  and  improper  food,  debaucheries,  night-watches, 
sedentary  habits,  anxiety  of  mind,  etc.;  and  those  which  act  injuri- 
ously upon  the  breathing  organs,  as  impure  air,  inflammation  of  the 
lungs,  pleurisy,  measles,  hooping  cough,  et*. ;  and  such  as  disturb  tlie 
sweating  process,  as  insufllicient  clothing,  sudden  changes  of  temper- 
ature, sleeping  in  damp  sheets,  etc.  These  exalt  the  nervous  force, 
or  depress  the  vegetative,  or  inflame  the  mucous  lining  of  the  air 
tubes,  or  the  substance  of  the  lungs,  or  the  membranous  sack  which 
encloses  them,  so  as  to  induce  one  form  or  other  of  consumption  on 
the  principles  I  have  explained. 

Can  Consumption  be  Cured? — In  many  cases  it  can.  It  may  be 
cured,  first,  by  the  absorption  of  the  tubercles.  The  celebrat-ed  John 
Hunter  shows,  in  his  work  on  the  blood,  that  the  absorbent  vessels 
have  a  sort  of  elective  affinity,  by  which  they  take  up  and  remove  "  all 
adventitious  new  matter,  as  tumors,"  (tubercles  are  albuminous  tu- 
mors,) more  easily  "  than  those  parts  which  were  originally  formed." 
Were  this  not  so,  an  activity  in  these  vessels  equal  to  the  removal  of 
tuberples,  would  cause  them  to  waste  all  the  tissues,  and  aggravate 
rai;her  than  cure  consumption.  Probably  this  does  occur  where 
proper  hygienic  means  are  not  used  to  quicken  the  excretions.     This 


DISBA8E8  UF  TIIK  CHR8T. 


219 


Bymptoma. 
ey  meet  at 
cal  aspects 


tion. 

which  pre- 
eiiergy  iu- 

he  intellect, 

lulation  of 
ally  if  the 
ambitious 

t  modes  of 
lumaii  life, 
tal  culture 
cture  must 

nent    The 
■ees  burned 
the  human 
m  fire. 
3S8  destruc- 

lings  which 
ative  func- 
ht-watchcs, 
act  injuri- 
tion  of  the 
disturb  the 
of  temper- 
VOU3  force, 
of  the  air 
sack  which 
mption  on 


It  may  be 
rat«d  John 
Rnt  vessels 
;move  "  all 
ninous  tu- 
y  formed." 
removal  of 

aggravate 
cur  where 
9ns.     This 


hygienic  treatment,  to  be  spoken  of  hereafter,  is  not  generally  em- 
ployed, —  certainly  not  as  effectually  as  it  should  be.  Here  is  the 
Huurcc  of  Laenuec's  fatal  reiuark,  ho  often  quoted  and  so  widely  en- 
dorsed, that "  nature's  efforts  towards  effecting  a  cure  are  injurious, 
and  those  of  art  are  useless."  Laennec's  posit '.oji  cannot  be  true,  if 
Hunter's  statement  is  correct.  If  the  absorbents,  by  an  elective  in- 
stinct, take  up  adventitious  matter  rather  than  the  natural  tissues, 
then  the  reason  why  they  r  verse  this  rule  hi  consumption  is,  that  by 
a  weakened  state  of  the  cvjustitutlnn,  the  ultimate  particles  arc  not 
well  put  tofrether,  and  arc  more  easily  taken  apart  than  those  of  the 
adventitious  tubercular  tumors  ;  and  if  we  would  restore  these  vessels 
to  tht-'ir  natural  activity,  we  must  improve  assimilation,  and  knit  the 
aiiloving  molecules  into  a  firmer  brotherhood.  We  must  make  the 
fleih  hard,  so  that  the  absorbents  cannot  pick  it  to  pieces.  Do  this, 
and  "nature's  efforts  to  effect  a  cure,"  will  not  " be  injurious." 

A  second  lorm  of  cure  is  the  recstablishment  of  the  assimilative 
function,  the  building  up  of  the  general  health,  the  arresting  of  the 
tubercular  deposit,  the  reducing  of  tubercles  already  formed  to  an  in- 
dolent state ;  and  then,  by  a  strict  observance  of  the  laws  of  health, 
keeping  them  in  that  condition  through  life. 

A  third  mode  of  cure  is  the  healing  of  the  cavities  after  the  tuber- 
cles have  softened,  broken  down,  and  been  expelled  in  the  form  of 
expectoration. 

A  fourth  method  of  cure  is  a  change  of  tubercles  to  calcareous  mat- 
ter. These  calcareous  tubercles,  Laen  nee  says,  "  are  consequent  to 
tuberculous  afiections  that  have  been  cured."  And  Andral,  at  one 
time,  hoped  to  learn  how  to  effect  cures  by  changing  tubercles  to  "  the 
calcareous  phosphate." 

I  have  had  several  cases  of  cure  by  this  last  method,  and  have 
quite  a  collection  of  calcareous  substances  which  my  patients  have 
coughed  up,  —  one  of  which  was  raised  in  my  presence  by  a  lady 
who  was  a  few  years  before  in  hopeless  consumption,  but  is  now  in 
good  health. 

Treatmentt  —  This  should  be  of  two  kinds,  local  and  general. 

The  local  treatment  of  consumption  is  by  the  inhalation  of  vapora 
and  powders  into  the  lungs.  It  has  been  practised,  more  or  less,  by  in- 
dividuals, for  many  years,  particularly  in  Europe ;  but  for  some  unaC' 
countable  reason,  the  profession  generally  have  never  used  it,  and  do 
not  know  much  about  it  I  had  the  honor,  some  years  ago,  to  bring 
it  freshly  before  tha  American  public,  in  some  articles  written  for 
popular  reading,  since  which  time  it  has  been  rapidly  gaining  public 
confidence,  and  is  now  attracting  much  attention.  Conveying  the 
remedy  directly  to  the  diseased  parts,  it  strikes  the  pcmmon-sense 
mind  as  eminently  reasonable  and  necessary. 

I  shall  speak  of  inhalation,  therefore,  very  earnestly,  not  as  a  pallia- 
tive of  consumption  only,  but  as  far  more,  as  a  remedy.  After  long 
and  patient  use,  my  experience  allows  me  to  say,  that  I  know  it,  in 
many  cases,  to  be  such ;  and  knowing  this,  I  should  be  criminal  not 
to  press  it  upon  the  public ;  for  it  is  the  great  multitude  of  sufferers^ 


C20 


DISRASB8  OF  TUK  CHEST. 


preHoing  fast  through  the  gate  of  deaths  who  need  to  heur  words  of 
hope. 

Consnmptlon  a  Gfneral  INsease. —  It  is  not  denied  that  consump- 
tion is  a  general  diucase,  needing  constitutional  treatment ;  but  it  hsis 
also  a  local  development  in  the  lungs,  first  in  the  form  of  albuminuud 
tumors,  called  tubercles,  and  then,  after  the  softening,  breaking  down, 
and  discharge  of  these,  in  the  more  formidable  shajie  of  ulcerous  cav- 
ities, which,  beginning  at  the  summit,  devour  the  lungs  down  to  tlu< 
base.     Can  it  be  reasonable  to  apply  no  remedy  directly  to  this  local 
disease  ?     Noi;  so  dues  our  profession  deal  with  other  local  diseases. 
To   an   inflamed   skin   we   apply   poultices,   cold   compresses,  solu- 
tions of  acetate  of  lead,  nitrate  of  silver,  etc. ;  to  leprous  or  scaly 
aH'ections,  sulphuret  of  potash,  bichloride  of  mercury,  zinc  ointment, 
nitrate  of  mercury  ointment,  sulphur,  creosote,  etc. ;   to  weak  and 
inflamed  eyes,  sulphate  of  copjjer,  sulphate  of  zinc,  nitrate  of  silver, 
and   opium ;   to   chronic   ulcers   upon   the   skin,   tannin,   pulverized 
rhubarb,  opium,  or  cinchona ;  and  to  an  inflamed  throat,  nitrate  of 
silver  and  other  articles.     These  are  but  specimens  of  the  thousand 
cases  in  which  we  use  local  remedies.     "Why,  then,  when  the  mucous 
membrane,  which  lines  the  air  tubes,  becomes  inflamed  through  all  its 
branches,  should  we  neglect,  by  the  inhalation  of  medicated  vapor,  to 
apply  a  remedy  directly  upon  the  whole  inflamed  surface  ?     Why, 
when  tubercular  matter  is  beginning  to  be  deposited  upon  the  surface 
of  the  air  cells,  and  of  the  small  bronchial  tubes,  should  not  the  vapor 
go  right  to  those  parts,  and  cause,  as  it  would,  the  immediate  expul- 
sion of  this  offending  and  dangerous  matter  ? 

Uneducated  common  sense  sees  the  reasonablenesp>  of  these  fiug- 
gestions  at  a  glance.  Many  a  person,  with  pulmonary  disoo^ic,  dies 
of  suffocation,  not  because  there  is  not  muscular  strength  to  expel 
the  matter  which  is  strangling  him,  but  because  the  lungs  below  the 
large  pellets  of  mucus,  which  plug  up  the  bronchial  tubes,  cannot  be 
inflated,  and  have  therefore  no  means  of  driving  out  the  offending 
substance.  Yet  a  proper  medicated  vapor,  drawn  in  with  the  breath, 
would  either  dissolve  the  mucus,  or  rouse  up  the  expiring  membrane 
to  cast  it  off. 

If  the  reader  were  to  place  one  end  of  a  stethoscope  directly,  over 
the  disease  upon  the  breast  of  a  person  in  the  third  stage  of  consump* 
tion,  and  should  then  ask  him  to  talk,  the  words  spoken  would  seeiP 
to  rise  up  through  the  instrument,  and  enter,  well  articulated,  into  his 
ear.  This,  in  technical  language,  is  called  pectoriloquy,  —  a  word 
signifying  chest-talking:  It  implies  a  cavity  in  the  lung.  If  now  the 
patient  be  asked  to  cough,  a  gurgling  and  splashing  sound  will  be 
heard.  This  denotes  that  the  cavity  is  partly  filled  with  fluid,  which 
is  dashed  about  by  the  air  explosively  driven  through.it  by  the  portion 
of  lung  below.  Here  we  have  an  excavated  ulcer,  with  all  its  filthy 
contents,  composed  of  pus,  mucus,  serum,  and  dissolved  tubercles, 
lying  in  it  day  and  night  to  aggravate  its  unhealthy  condition.  What 
more  reasonable,  what  more  necessary,  Ihan  that  a  soothing,  altera- 
tive, or  astringent  vapor  should  be  drawn  into  this  cavity,  to  cause  its 


>vords  of 


t  connnrnp- 
;  but,  it  hurt 
albutniiioiirt 
king  down, 

cerouH  cav- 
own  to  tin- 
to  this  local 
n|  di8t>a»i>rt. 
esses,  8olu- 
L's  or  scaly 
c  ointment, 

weak  and 
te  of  silver, 

pulverized 
,  nitrate  of 
le  thousand 
the  mucous 
■ough  all  its 
ed  vapor,  to 
ce  ?  Why, 
the  surfjice 
A  the  vapor 
iiate  exful- 


these  Mug- 
,  dies 


iisoflwc 


;th  to  expel 
8  below  the 
i,  cannot  be 
e  ofTending 
the  breath, 
membrane 

lirectl^-  over 
>f  consuTip- 
rauld  see.p 
ed,  into  his 

I  — a  word 
If  now  the 
ind  will  be 
luid,  which 
the  portion 

II  it»  filthy 
1  tubercles, 
on.  What 
ing,  altera- 
o  cause  ltd 


I 


DISEASES  OF  THE  CHEST. 


221 


Bides  to  heal,  and  its  absorbents  to  remove  this  fluid  ?  A  surgeon 
who  should  permit  an  ulcer  upon  the  surface  of  the  body  to  remain 
in  that  condition  without  a  local  dressing,  would  be  deemed  unfit  to 
practise  his  profession. 

Both  in  tubercular  disease  and  in  simple  bronchitis,  the  bronchial 
tubes  almost  aways  sutler  some  physical  change.  The  mucous  mem- 
brane lining  these  tubes  is  generally  8oft«nea.  At  other  times  the 
tubes  become  enlarged  through  their  whole  length,  so  that  many  of 
them,  from  the  size  of  a  quill,  reach  the  bigness  of  the  finger  of  a  glove. 
In  still  other  cases,  the  straining  produced  by  coughing  causes  a  tube 
to  belly  out  at  some  point,  forming  a  sack,  which  is  generally  filkv. 
with  mucus  or  puruler  t  matter.  At  still  other  times,  a  tubercle  will 
press  against  a  tube  so  as  to  flatten  it  and  convert  it  into  a  musical 
instrument,  th'i  air,  as  it  is  drawn  laboriously  through,  producing  u 
high  or  low  note,  according  to  the  size  of  the  pipe.  These  physical 
changes  are  all  produced  by  causes  which  the  inhalation  of  a  suitable 
vapor,  at  the  proper  time,  would  almost  infallibly  remove.  How 
strange  that  this  remedy,  —  so  simple,  so  effectual,  so  easily  compre- 
hended, —  should  have  been  so  little  used ! 

Right  at  this  vital  point  in  the  lungs,  where  the  blood  runs  in  a 
ceaseless  current,  —  where  the  whole  of  it  goes  every  two  minutes  to 
renew  its  vitality  by  contact  with  atmospheric  air,  —  we  have,  in 
thousands  of  cases  daily  occurring,  inflammation  with  roughening  oi 
softening  of  membrane,  with  its  consequent  harsh  breathing;  we  have 
mucus,  tough  or  glairy,  to  impede  and  interrupt  respiration  ;  we  have 
tubercles  in  the  hard  or  soft  state,  adding  to  the  general  embarrass- 
ment, and  not  only  lessening  the  vitality  of  the  blood,  but  disturbing 
all  the  sympathies  of  the  system ;  —  and  yet  the  practice  has  been, 
and  is,  to  attack  these  central  disturbers  of'^  life  only  through  the  cir- 
cuitous path  of  the  stomach,  lacteals,  etc. 

Since  1849,  my  undivided  attention  has  been  given  to  the  study 
and  application  of  this  mode  of  treatment.  This  is  two  years  in 
advance  of  any  other  physician  in  this  country.  I  have  investigated 
faithfully  the  effects  of  the  various  substances  proposed  for  inhalation 
by  European  physicians,  and  have  explored  a  wide  field  of  new  rem- 
edies, not  before  used,  several  of  which  hifve  proved  to  have  qualities 
of  great  remedial  power. 

Thus  much  I  have  thought  it  proper  to  say  in  behalf  of  this  mode 
of  treating  consumption,  the  most  successful  yet  employed,  not  bc;- 
cause  it  needs  defence,  but  because  the  great  body  of  the  profession 
are  ignorant  of  it,  and  what  is  worse,  are  indifferent. 

The  chief  remedies  I  employ  for  inhalation  are  the  following : 


iodide  of  potas- 
tincture  of  bal- 


Alterative  Inhalant,  composed  of  iodine,  six  grains ; 
sium,  twelve  grains ;  tincture  of  ipecac,  one  ounce  ; 
sam  of  tolu,  six  drams ;  ethereal  tincture  of  conium,  one  and  a  half 
drams;  alcohol,  half  a  pint.  These  are  to  be  mixed.  The  dose  is 
one  to  two  teaspoonfuls,  to  be  inhaled  ten  or  fifteen  minutes,  in  about 
a  gill  of  hot  water. 

The  ethereal  tincture  of  conium  is  made  by  keeping  a  dram  of 
powdered  conium  in  one  ounce  of  sulphuric  ether  a  week. 


^m^Mi^ 


DMBAUKft  Of  THB  CHKi^T. 


The  above  inhaUnt  is  aied  in  the  tvberenlsr  forms  of  conMtmptioi^ 
particularly  that  of  the  aorofulous  kind,  and  in  many  cases  of  bron* 
chitis. 

Expeotonuit  Inhalant  —  Take  plenrisy  root,  half  an  ounce;  squill, 
one  ounce ;  ipecac,  two  drams ;  black  cohosh,  two  ounces ;  queen'it 
not,  one  ounce  and  a  half;  American  hellebore,  two  drams;  diluted 
alcohol,  one  pint  Grind  the  roots,  etc.,  and  add  the  alcohol.  Let  thu 
whc  .e  atand  one  week,  shaking  or  stirring  daily.  Draw  off  and  filter 
through  paper.  Two  teaspoonfule  make  a  dose,  *^r~  be  inh;.L.d  same 
as  preceaing. 

Tlas  is  to  be  used  when  the  cough  is  hard  aad  ury,  and  Uw  expeo- 
torvtion  difficult.  It  makes  the  raising  easy,  lessening  the  scieness 
o{  the  chest,  and  the  harshness  ^t  the  cough. 

Soothinip,  Febrifuge  Inlialant...-Ta]ra  belladonna  leaves,  half  an 
ounce;  black  cohosh,  two  ounces;  American  hellebore,  half  an  ounce; 
poke  root,  two  drama ;  a  onite  ft^ot,  one  ounce ;  diluted  alcohol,  cne 
pint  Grind  the  roots,  etc.*  add  the  alcohol.  Let  the  whole  stand 
one  week,  stirring  daily.  Pour  off  and  filter  through  paper.  Dose, 
one  to  two  tcaHpoonfuls,  to  ba  inhaled  as  the  preceding. 

This  is  excellent  in  all  cases  whero  the  skin  is  hot,  the  pplse  quick, 
the  tongue  and  mouth  parched,  the  chest  sore,  and  the  system  sufl'er- 
ing  during  the  whole  or  a  part  of  each  day,  from  a  general  feverish 
condition.     It  is  proper  in  all  the  foms  of  chest  disease. 

Astrinii^ent  Iiiliulnnt.  —  Take  of  wild  indigo,  one  ounce ;  catechu, 
half  an  ounce ;  Peruvian  bark,  one  ouace ;  golden  seal,  one  ounce ; 
diluted  alcchol,  one  pint  Mix,  and  left  the  whole  stand  one  wep>, 
stirring  daily.  Drain  off,  and  filter  through  paper.  Ad'l  two  drams 
of  creosote.     One  to  two  teaapoonfuls  to  hs  inhaler'  as  preceding. 

This  is  to  be  used  when  the  expectoratiin  is  profuse  and  easy,  un- 
attended by  fever,  either  in  the  latter  stage;;  of  chronic  bronchitis, 
when  the  mucous  membrane  of  the  tubes  is  in  a  relaxed  condition, 
or,  in  the  third  stage  of  tubercular  disease,  for  the  purpose  of  con- 
stringing,  cleansing,  strengthening,  and  healing. 

Antiseptic  Inhalant.  —  Take  wild  indigo,  one  ounce ;  belladonna 
leaves,  half  an  ounce ;  diluted  alcohol,  one  pint  Mix,  and  let  the 
whole  stand  one  week.  Pour  off,  and  filter  through  paper.  Then 
add  solution  of  chloride  of  soda  two  ounces.  Dose,  one  to  two  tea- 
spoonfuls,  to  be  inhaled  as  the  preceding. 

This  is  used  in  cases  of  gangrene  of  the  lungs,  generally  distin- 
guished by  considerable  expectoration  having  a  very  fetid  smell. 

A|iti-IIemorrliag:ic  Inhalant  —  Take  witch-hazel  bark,  two  ounces ; 
black  cohosh,  four  ounces.  Grind,  and  add  one  pint  of  diluted  alco- 
hol. Let  the  mixture  stand  one  week,  stirring  daily.  Pour  off,  and 
filter  through  paper.  Add  to  this  two  drams  of  creosote.  Dose,  one 
to  three  teaspoonfuls,  to  be  inhaled  as  preceding. 

This  is  an  excellent  remedy  for  bleeding  from  the  lungs.  Wh^n 
t'  is  a  tendency  to  bleed,  it  should  be  used  for  a  long  time.  It 
n  ^y  frequently  take  the  place  of  No.  4,  as  Em  astringent  inhalant 


: -;t?  ;^§fiS^-'"  •^^**^*'*' 


J 


==*fl 


nramptioi^ 
of  bron* 


toe;   squill, 


»;  queen'tt 

na;  dilated 

Let.  the 

and  filter 

'  d  same 


)1 


tiiv   expeo 
10  ucieness 

:^3,  half  an 
r  !ui  ounce ; 
ilcohol,  cne 
rhole  stand 
per.     Dose, 

Kilse  quick, 
item  sufier- 
ral  feverish 

;  catechu, 
3ne  ounce ; 

one  wopi'-, 
two  drams 
seeding, 
d  easy,  un- 
bronchitis, 
I  condition, 
)8e  of  con- 
belladonna 
ind  let  the 
jer.     Then 
0  two  tea- 

illy  distin- 
mell. 

'o  ounces ; 

luted  alco- 

ir  off,  and 

Dose,  one 

^.     Wl^n 
time.     It 
ialant 


i£&i<&^Sii^&Jii.ij, 


9MKAMB8  OV  THB  OU»K 


Object  of  lalulaatl.  —  Being  vaporised  and  inhaled,  these  artirlea 
enter  every  air  cell  throughout  the  lungit.  Their  object  is  to  soothe  and 
mollify  inflamed  mucous  surfaces,  to  reduce  enlarged  bronchial  glands 
which  press  upon  neighboring  parts  and  cause  bleeding,  to  stimulate 
the  absorbents  to  take  up  and  remove  tubercles,  to  dissolve  tubercles 
•ut  of  he  pulmonary  tissue,  to  cause  ulcerous  cavities  to  expel  their 
mattery  contents,  and  to  stimulate  their  sides  to  take  on  a  healing 
process.  Thi-y  should  be  used  from  three  to  six  times  a  day,  the  in- 
iiiiiation  co'.itiuuing  from  ten  to  fifteen  minutes. 

Othrr  InhtlldntM.  —  Great  numbers  of  other  •»!  tides  ht-ve  been  used, 
wliich  I  have  not  space  to  describe.  I  will  meiitio;i,  however,  that 
t!;t!  ft>ilowiug  are  sometimes  employed  with  advimtcge  : 

For  an  Expectorant  Inhalant,  take  alcohol,  four  ounces ;  tincture 
of  camphor,  half  an  ounce  ;  tincture  of  tolu,  two  drains  ;  naphtha, 
one  drain  ;  benzoic  acid,  thirty  grains ;  oil  of  bitter  almonds,  four 
drops.     Mix. 

For  an  Anodyne  Inhalant,  take  alcohol,  four  ounces ;  naphtha,  one 
dram;  benzoic  acid,  thirty  grains;  chloroform,  twenty-five  drops; 
tincture  of  henbane,  half  an  ounce.     Mix. 

For  an  Astringent  Inhalant,  take  alcohol,  four  ounces ;  naphtha, 
one  dram  ;  benzoic  acid,  thirty  grains  ;  chloroform,  one  dram  ;  tannin, 
eight  grains.     Mix. 

Mode  of  IllhHlill)(. —  For  inhaling  these,  a  sponge  is  fitted  into  a 
glass  cup,  to  which  a  flexible  tube  is  attached.  A  small  quantity  of 
tlie  mixture  is  poured  upon  the  sponge,  and  the  vapor  arising,  is 
drawn  into  the  lungs  through  the  tube. 

To  the  expectorant  inhalant  may  be  added,  occasionally,  half  a 
dram  of  nitric  acid. 

These  latter  formulas  are  the  principal  ones  used  by  those  who 
practise  what  is  called  coid  inhalation. 

Medicated- Vapor  Inhaler.  —  This  instrument  I  have  had  constructed 
of  britannia  (sometimes  of  silver)  and  glass.  Some 
have  adopted  the  mode  of  inhaling  from  a  sponge 
held  in  the  hand,  which  ia  an  imperfect  method ; 
others,  that  of  inhaling  from  a  sponge  fastened 
upon  the  chest,  which  amounts  to  scarcely  any  in- 
halation at  all,  as  only  a  very  small  amount  of  the 
vapor  reaches  the  nostrils.  It  is,  moreover,  disa- 
greeable to  the  wearer  and  to  those  around,  and 
must  soon  become  extremely  filthy. 

Some  use  a  glass  bottle,  with  an  India-rubber 
tube ;  but  India-rubber  soon  becomes  foui  inter- 
nally, and  might  produce  disease.  Avoid  Inhalers 
with  India-rubber  tubes. 

The  cut  91  represents  the  instrument  I  employ. 
The  tube,  to  which  the  mouth  is  applied,  passes 
through   the   cap,   communicating    with    the    air 
above  the  fluid.     When  the  air  is  drawn  off,  other  air  rushes  into  the 
long  tube  to  fill  the  vacuum,  and  breaking  out  at  the  bottom,  sets 


Fia.  91. 


Ji 


the  fluid  in  commotion,  causing  a  medicated  vapor  to  riae,  wbich/is 
drawn  into  the  lurfgsl'        ■' 

,  Constitutional  Treatment  —  The  rapid  breathing  in  consumption, 
creates  too  niuch  oxydation  of  the  blood,- — so  much,  "'^t  the  muscles, 
especially  the  heart,  ar-i  usually  of  a  bright  red.  To  prevent  the  pa- 
tient from  being  literally  burned  up  by '"oxygen,  the  blood  must  be 
de-oxydated  as  fast  as  possible. 

While  there  is  too  much  of  oxygen,  there  is,  at  the  same  time,  a  defi- 
ciency of  carbon.  Hence  the  colci  hands  and  feet,  and  the  general 
inability  to  bear  frosty  weather.  The  little  nutritive  arteries,  in  these; 
^hin-blooded  persons,  stand  shivering  and  torpid  with  cold,  unable  to 
perform  their  allotted  function  of  nutrition.  There  is  not  fire  enough, 
and  fuel  must  be  had  in  the  form  of  carbon.  Hence  one  of  the  ad- 
vantages of  cod  liver  oil.  This  oil,  too,  as  carbon,  devours  the  oxy- 
gen of  the  blood,  and  prevents  its  destroying  the  patient  This  idea 
also  explains  the  fact  mentioned  by  Bennet  and  others,  that  in  their 
post-mortems,  they  found  the  evidences  of  healed  ulcers  in  numerous 
persons  who  had  been  spirit'drinkers  while  living.  And  Liebig  helps 
the  explanation  by  saying  that  alcohol,  taken  into  the  system,  circulates 
in  a  free  state  in  the  b!ood,  and  devours  its  oxygen.  To  which  I  beg 
to  add,  that  the  malaria  of  intermittent  and  bilious  fever  districts,  has 
been  pretty  satisfactorily  proved  to  be  an  instable  organic  body,  con- 
sisting of  sulphur,  carbon,  and  hydrogen,  all  of  which  have  an  af- 
finity for  oxygen,  and  devour  it  in  the  system.  Consumption  is  not 
found  in  such  districts. 

As  I  am  here  treating  of  the  chemical  effects  of  remedies  (and  to 
this  test,  most  remedies  must  finally  come),  I  will  mention  that  tar- 
trate of  antimony  and  potassa  arrests  the  circulation  ir^  the  pulmonary 
arteries.,  —  which  fact  gives  a  complete  and  luminous  view  of  its 
power  to  prevent  oxydation.  But  I  am  obliged  to  detract  from  its 
merits,  by  stating  that  it  also  retards  the  circulation  in  the  capillaries 
of  the  system  generally,  and  so  hindeid  (2e-oxydation. 

Phospliorns.  —  There  is  an  article  which  has  more  recently  pre- 
sented itself  to  the  notice  of  the  profession,  to  which  I  wish  to  invite 
special  attention.  I  refer  to  phosphorus.  This  agent,  for  a  time, 
challenged  our  notice  in  the  shape  of  phosphate  of  lime  ;  but  we  coukl 
never  feel  sure  that  this  article  was  dissolved  in  the  fluids  of  the  body. 
We  now  use,  and  with  far  more  marked  effect,  the  hypo-phospliites 
of  lime,  soda,  potash,  and  iron.  These  are  used  in  the  form  of  the 
syrup  of  the  hypo-phosphites.  The  dose  is  a  teaspoonful  before 
each  meal.  The  effect  upoix  the  tubercular  disease  is  immediate  and 
gratifying. 

Need  of  Pliosphorus.  —  Cerebric  acid  contains  nitrogen  and  phos- 
phorus, and  is  the  peculic '  component  of  the  brain  and  nervous  sys- 
tem. By  combustion  and  the  changes  of  oxydation  in  the  brain,  the 
phosphorus  of  cerebric  acid  is  converted  into  phosphoric  acid ;  so  that 
every  act  of  the  brain  produces  phosphoric  acid.  How  rapid,  then, 
must  be  the  consumption  of  the  phosphoric  element  of  the  cerebric 


risumption, 
le  muscles, 
nt  the  pa- 
ll must  be 

ime,  a  defi- 
he  general 
Bs,  in  tliest; 
,  unable  to 
ire  enough, 
of  the  ad- 
8  the  oxy- 
This  idea 
lat  in  their 
I  numerous 
iebig  helps 
I,  circulates 
hich  I  beg 
stricts,  has 
body,  con- 
ave  an  af- 
tion  is  not 

ies  (and  to 
n  that  tar- 
pulmonary 
'iew  of  its 
let  from  its 
capillaries 


cently  pre- 
ih  to  invite 
'or  a  time, 
;t  we  coukl 
f  the  body, 
•phosphites 
brm  of  the 
iful  before 
ledlate  and 


and  phos- 
srvous  sys- 
!  brain,  the 
id ;  so  thai 
apid,  then, 
le  cere  brie 


DISEASES  OF  THE  CHEST. 


225 


acid,  in  that  highly  active  and  excitable  state  of  the  nervous  syfetera 
which  I  have  described  as  peculiar  to  consumption.  And  how  neces- 
s.ary  in  order  to  save  the  brain  from  destruction,  to  meet  this  increased 
demand  for  phosphorus,  by  introducing  it  into  the  system. 

Mulder  regards  the  fibrin  of  the  '  'ood  as  the  carrier  of  oxygen ;  and 
by  this  oxydation,  the  fibrin  becomes  converted  into  the  binoxide  and 
tritoxide  of  proteine,  —  its  phosphorus  and  sulphur  (for  it  contains 
both),  being  converted  into  phosphoric  and  sulphuric  acids.  Adding 
phosphorus  and  sulphur,  therefore,  as  medicinal  agents,  would  seem 
to  be  the  proper  way  to  supply  the  fibrin  with  materials  destructive 
of  its  freight  of  oxygen. 

It  is  well  known  that  the  salts  of  phosphoric  acid  are  essential  for 
the  formation  of  azotic  compounds,  —  compounds  which  are  neces- 
sary to  sustain  animal  life.  Ii;  should  be  remembered,  too,  as  collat- 
erally illustrating  this  fact,  that  the  tribasic  phosphates  of  potash,  soda, 
lime,  and  magnesia,  play  ^n  important  part  in  the  growth  and  perfec- 
tion of  plants.  They  are  always  found  in  the  seeds  of  the  cerealia,  and 
no  mature  grains  are  pr»)duced  where  phosphates  are  absent  from  the 
soil.  For  the  production  of  abundant  grain  crops,  it  is  necessary  that 
these  salts  should  exisi  in  the  soil,  or  be  applied  to  it  in  manures. 

It  is  known,  moreover,  that  in  all  chronic  diseases  distinguished  by 
wasting  of  the  tissues,  a  much  larger  quantity  of  phosphates  is  ex- 
creted by  the  kidneys,  than  in  the  normal  state.  Hence  there  is  no 
healthful  growth ;  and  the  human  organism,  like  the  soil,  exhausted 
of  its  phosphates  by  successive  croppings,  brings  nothing  to  perfec- 
tion, and  needs  to  have  its  drained  salts  re-supplied. 

I  cannot  but  call  attention  here  to  the  inorganic  substances  found 
in  healthy  human  blood.  According  to  very  careful  analyses,  by 
Scmidt : 


1000  parts  of  blood-corpuscles,  contain : 


Chlorine,      -        -        . 
Sulphuric  Acid, 
Phosphoric  Acid,  - 
Potassium, 

Sodium,        ... 
Oxygen,    - 
Phosphate  of  Lime, 
Phosphate  of  Magnesia, 


-  1.686 
0.066 

-  1.134 
3.328 

-  1.052 
0.667 

-  0.114 
0.073 


1000  parts  of  lic[uor  sanguinis  (serum  and 
fibnn),  contain : 

Chlorine, 3.664 

Sulphuric  Acid,         -        •        -  0.115 

Pho^horic  Acid,  -        -        -        -  0.191 

Potassium,         .        -        -        .  0.323 

Sodium, 3.341 

Oxygen,    -        -        -        -        -  0.403 

Phosphnte  of  Lime,      -        -        -  0.3 11 

Phospli.iic  of  Magnesia,    -        -  0.22t 


Iron  is  (  nitted.  Now,  I  venture  the  prediction,  that  out  of  these 
figures,  mainly,  in  connection  with  those  which  represent  the  constit- 
uents of  the  saliva,  th<  bile,  the  gastric  juice,  the  pancreatic  secretion, 
and  the  organic  compounds  of  the  blood  and  tissues,  are  to  be  evolved 
within  a  lew  years,  a  correct  and  partially  demonstrative  system  of 
medication.  In  consumption,  all  the  inorganic  bodies  represented  by 
the  above  figures,  with  the  exception  of  oxygen,  are  deficient  in  quan- 
tity. By  reflecting  upon  the  proportions  of  these  several  bodies,  par- 
ticularly upon  the  large  amount  of  chlorine  and  soda  in  the  plasma, 
af.d  of  potassium  in  the  corpuscles,  the  mind  can  hardly  fail  to  obtain 
useful  hints.     I  have  not  hesitated  to  make  one  of  these  hints  the 

29 


226 


DISEASES  OF  THE  CHEST. 


|V,„  r. 


Sonnd  of  a  very  free  use  of  alkalies,  —  particularly  in  the  form  of 
kthing. 

Sofar  of  Hilk. — There  is  one  other  medicinal  article  which  I  deem 
worthy  to  be  made  prominent,  and  to  be  placed  side  by  side  with  cod 
liver  oil  and  the  hypo-phoaphit«8.  I  refer  to  svtgar  of  milk.  It  belongs 
to  that  class  of  non-nitrogenized  articles  >vhich  Liebig  has  denominated 
supporters  of  respiration.  Its  great  affinity  for  oxygen  is  well  worthy 
to  be  taken  into  the  account,  in  considering  its  value  in  consumption. 
So  great  is  this  attraction,  that  with  ammonia  and  other  alkalies,  it 
has  the  power  of  reducing  some  of  the  metalic  oxides.  When  taken 
into  the  stomach,  it  id  rapidly  absorbed  into  the  blood,  which,  being 
an  alkaline  fluid,  augments  its  great  de-oxydating  power  to  a  consider- 
able degree.  It  unites  rapidly  with  oxygen  after  entering  the  blood, 
forming  carbonic  acid  and  water.  A  part  of  it,  however,  does  not 
enter  the  blood  in  an  uncompounded  state,  but  is  changed  in  the 
stomach  into  lactic  acid ;  and  this,  in  the  blood,  becomes  an  alkaline 
lactate.  But  the  portion  thus  changed,  appears  also  very  useful ;  for 
Lehmann  says  :  "  We  know  of  no  substances  which  could  better  act 
in  the  blood  as  food  for  the  respiration,  than  the  alkaline  lactates." 

Corroborative  of  these  views,  is  the  fact  that  all  those  kinds  of 
milk,  such  as  goat's,  ass's,  etc.,  which  contain  the  largest  amount  of 
sugar  of  milk,  have  at  different  times,  and  in  various  countries,  ob- 
tained a  reputation  for  curing  consumption.  Goat's  whey,  in  which 
this  article  abounds,  and  from  which  it  is  largely  manufactured,  has 
been  celebrated  for  its  virtues  in  this  line.  Ancel  speaks  of  it  as  an 
excellent  remedy  ;  and  Pereira  says,  **  Sugar  of  milk,  in  consumptive 
cases  and  chronic  diseases  of  the  digestive  organs,  is  a  most  valuable 
aliment" 

One  of  the  best  forms  of  taking  sugar  of  milk  is  that  of  a  gruel, 
which  is  quite  palatable,  and  may  be  freely  eaten  by  consumptive 
persons. 

The  Confh. — The  best  article  1  have  ever  used  for  this,  is  the  "  Pul- 
monic Cherry  Cordial"  1  was  five  years  in  compounding  this  arti- 
cle to  suit  me,  and  I  believe  it  to  be  the  very  best  cough  preparation 
ever  made.    Dose,  from  one  to  two  teaspoonfuls.    See  page  710. 

When  a  more  quieting  effect  is  needed,  a  little  morphine  may  be 
added  i»  this  preparation ;  if  a  more  expectorant  influence  is  required, 
add  a  few  drops  of  the  tincture  of  veratrum  viride.  For  the  great 
majority  of  cases,  it  will  be  found  to  be  right  without  any  addition. 
When  this  is  not  at  hand,  any  of  the  preparations  (108)  (112)  (109) 
(113)  (110),  etc.,  may  be  used. 

Nifht  Sweats.  —  The  very  best  preparation  for  these  sweats,  is  a  com- 
pound of  the  oxide  of  zinc,  one  dram ;  extract  of  conium,  half  a  dram ; 
to  be  made  into  twenty  pills,  of  which  one  or  two  are  to  be  taken 
every  night.     The  sponge  bath  also  does  much  to  check  these  sweats. 

Diarrhcea. — This  is  a  most  exhausting  symptom  in  the  latter  stages 
of  consumption.     The  only  remedy  which  has  much  effect  in  control- 

s  of  bismuth.    This  should  be  given  in  doses  of 


ling  it,  is  the  tris-nitrate  of  bismuth. 


DISEASES  OF  THE  CHEST. 


227 


le  form  of 

ich  I  deem 
e  with  cod 

It  belongs 
nominated 
^el\  worthy 
isump'.ion. 
alkalies,  it 
''hen  taken 
hich,  being 
a  consider- 
the  blood, 
r,  does  not 
;ed  in  the 
m  alkaline 
useful;  for 

better  act 
ctatea." 
3  kinds  of 
amount  of 
iintries,  ob- 
Yj  in  which 
ctured,  has 
of  it  as  an 
)n8umptive 
st  valuable 

of  a  gruely 
msumptive 

8the«'Pul- 
;  this  arti- 
jreparation 
e  710. 
ne  may  be 
is  required, 
r  the  great 
ly  addition. 
(112)  (109) 

ts,  is  a  com- 
alf  a  dram ; 
X)  be  taken 
lese  sweats. 

atter  stages 
;  in  control- 
in  doHes  of 


thirty  grains  immediately  after,  or  at  the  time  of  each  meaL  These 
doses  are  much  larger  than  used  to  be  given ;  but  they  will  do  no 
harm.     Given  to  this  extent,  I  find  the  bismuth  very  effectual. 

Iron.  —  This  preparation,  in  some  of  its  forms  (316)  (73)  (61)  (84) 
(102),  is  almost'  always  needed  in  consumption.  If  the  scrofulous 
habit  be  strongly  marked,  give  syrup  of  iodide  of  iron,  in  thirty-drop 
doses,  three  times  a  day.     It  should  be  taken  in  a  glass  of  water. 

External  Irritants. — These  are  needed  where  there  is  much  iiifl"'  h 
mation  and  soreness  of  the  chest.  Blisters  should  very  seldom  oe 
used.  Croton  oil,  from  two  to  half  a  dozen  drops,  rubbed  over  the 
sore  part,  generally  answers  very  well.  Sometimes  the  mustard  paste, 
applied  to  the  extent  of  producing  redness,  two  or  three  times  a  week 
is  sufficient.  Nitric  acid,  reduced  with  water  to  a  strength  a  little 
above  the  strongest  vinegar,  answers  a  good  purpose  for  keeping  up 
an  irritation. 

Atmospheric  Iir.lialation.  —  It  has  been  said  by  Laennec  and  others, 
that  asthma  has  sometimes  the  effect  of  arresting  tubercular  con- 
sumption. Dr.  Ramadge  thought  this  was  effected  by  an  expansion 
of  the  vesicular  structure  of  the  lungs ;  and  he  reasoned  that  the 
same  expansion  by  mechanical  means,  would  secure  a  similar  end. 
To  effect  this,  he  made  his  patients  take  long  breaths  through  a  tube 
constructed  for  the  purpose. 

It  is  manifest  that  the  philosophy  of  atmospheric  inhalation  was 
not  understood  by  Dr.  Ramadge,  nor  has  it  been  by  any  of  his  fol- 
lowers in  this  country. 

Rokitansky  thinks  the  tubercular  habit  depends  upon  the  excess  of 
fibrin  in  the  blood ;  and  says  that  the  reason  of  consumption  being 
arrested  by  pregnancy  is,  that  this  condition  offers  a  mechanical  ob- 
stacle to  the  transmission  of  blood  through  the  lungs,  —  thus  prevent- 
ing its  excessive  oxydation,  and  keeping  it  in  a  venous  state.  This 
destroys  the  fibrinous  condition,  on  which  he  thinks  tuberculosis 
depends. 

Now  this  is  precisely  what  is  done  by  atmospheric  inhalation.  Tho 
trachea  divides  on  its  entrance  into  the  lungs,  into  two  branches,  which 
again  divide  and  subdivide  until  the  tubes  become  smaller  than  can 
be  seen,  each  terminating  in  a  minute  air-cell.  Over  this  entire  sur- 
face the  air  is  intended  to  be  brought  into  comnmnication  with  the 
blood  for  the  purpose  of  oxydating  it.  By  forcible  inhalation,  the  air 
vesicles  are  inflated  to  the  extent  of  their  capacity,  by  which  means 
the  extreme  branches  of  the  pulmonary  arteries  are  so  flattened  be- 
tween these  extended  cells,  as  to  be  able  to  convey  but  a  small 
amount  of  blood,  and  but  little  is  oxydated.  This  furnishes  a  me- 
chanical obstruction  to  the  transmission  of  the  blood,  and  secures  th.' 
defibrination  of  which  Rokitansky  speaks. 

This  is  niv  view  of  the  philosphy  of  atmospheric  inhalation.  The 
benefit  results,  not  from  a  larger  amount  of  oxydation,  as  is  gener- 
ally supposed,  but  from  a  smaller.  Asthma  does  the  same  thing  by 
producing  spasmodic  contraction  of  the  extreme  bronchial  tubes,  and 
preventing  air  from  entering  the  cells. 


..;^'Jj*.>iWV«i,''-  ^ep 


The  Bame  end  ia  gained  in  part  by  certain  kinds  of  employment,  as 
glass-blowing,  playing  upon  wind  instruments,  and  the  like.  Writers 
of  distinction  mention  cases  of  recovery  from  incipient  consumption 
by  a  vigorous  use  of  the  lungs  in  singing.  Dentists  subject  their 
lungs  to  a  similar  process  of  expansion  in  the  use  of  the  blow-pipe; 
the  writer  has  known  several  instances  in  that  profession,  in  which 
recoveries  have  taken  place. 

The  Conclusion  to  which  I  come  is,  that  atmospheric  inhalation 
may  be  used  with  great  advantage  in  some  cases,  but  should  never  be 
resorted  to  except  under  the  direction  of  a  competent  physician.  Jn 
a  congested  state  of  the  lungs,  with  hseniorrhagic  tendencies,  or  with 
inflammation  and  soreness,  it  is  well  fitted  to  produce  fatal  bleeding, 
and  is  of  course  dangerous. 

External  Use  of  Water.  —  As  a  relaxation  from  severe  exertions, 
the  ancients  had  frequent  recourse  to  bathing.  Those  who  contended 
in  the  race,  throwing  the  javelin,  and  wrestling,  at  Rome,  plunged 
into  the  Tiber  while  warm  and  panting  with  their  efforts.  That  this 
promoted  prowess  and  physical  endurance,  none  can  doubt. 

Louis,  the  great  French  authority  on  pulmonary  diseases,  lays 
down  several  rules  to  be  observed  by  consumptive  patients,  and  par- 
ticularly mentions  cold  bathing. 

Few  things  give  tone  to  the  capillaries  of  the  skin  like  cold  water, 
systematically  applied.  It  rallies  the  powers  of  the  constitution,  and 
improves  assimilation.  And  by  it  another  object  ia  gained  of  scarcely 
aCss  importance,  —  that  of  guarding  the  system  against  taking  cold. 
Those  in  the  daily  habit  of  applying  cold  water  to  the  whole  person, 
seldom  suffer  from  colds  and  catarrhs ;  and  they  generally  become 
hardened  so  as  to  endure  the  assaults  of  the  el  ;ments. 

Consumptive  persons  should  generally  i>  o  the  sponge  bath,  with 
cold  water,  if  it  can  be  endured,  otherwise  the  tepid  bath,  to  be  fol- 
lowed, in  all  cases  with  brisk  rubbing,  with  a  coarse  towel.  If  a  sense 
of  chilliness  and  discomfort  follows  the  bath,  a  large  portion  of  the 
water  must  be  squeezed  from  the  sponge,  so  as  to  use  but  very  little, 
and  the  washing  must  be  speedy,  and  the  rubbing  more  lively  than 
usual, — beginning  with  tepid  water,  and  gradually  lowering  the  tem- 
perature, till  it  can  be  borne  cold.  A  large  teasjwonful  of  saleratus 
to  each  quart  of  water  should  be  used. 


Diet. 

The  diet,  like  all  other  parts  of  the  treatment,  must  have  reference 
to  the  present  condi/ion  oi  the  patient.  If  the  disease  take  the  bron- 
chial form,  and  rapid  breathing,  and  other  conditions  calculated  to 
carry  fat  out  of  the  system  have  not  yet  supervented ;  or  if  the  patient 
have  thirst  and  hectic,  the  diet  must  be  spare  and  simple,  —  consist- 
ing chiefly  of  milk  and  farinaceous  substajtices. 

But  in  all  cases  where  the  disease  is  tubercular,  or,  being  bronchial, 
has  reached  the  stage  of  emaciation,  the  very  earliest  moment  at 
which  the  fever  can  be  subdued,  should  be  improved  to  build  up  the 


-^ 


yment,  as 
Writers 
sumption 
ect  their 
ow-pipe ; 
in  which 


nhalation 
never  be 
ician.  In 
3,  or  with 
bleeding, 

exertions, 
contended 
plunged 
That  this 

ases,  lays 
,  and  par- 
old  water, 
iition,  and 
M  scarcely 
king  cold, 
le  person, 
y  become 

t)ath,  with 
to  be  fol- 
If  a  sense 
ion  of  the 
very  little, 
ively  than 
f  the  tern- 
saleratus 


reference 
the  bron- 
ulated  to 
le  patient 
-  consist- 

)ronchial, 
)ment  at 
Id  up  the 


DISEASES  OF  THE  CHEST. 


229 


patient  with  a  generous  diet.  I  have  seen  cases  where  the  stuffing 
sometimes  resorted  to  for  fattening  turkies  for  Thanksgiving,  would 
seem  to  be  almost  justifiaUv-.  A.  good  rule  is  to  give  the  most  gener- 
ous diet  that  can  be  taken  without  disturbing  the  stomach,  or  increas- 
ing the  feverish  symptoms.  Animal  food,  with  a  good  quantity  of 
salt,  should  be  freely  taken.  Fat  meats,  if  well  received  by  the  stom- 
ach (and  they  generally  are  if  taken  cold),  are  particularly  usefuL 
The  same  is  true  of  sweet  butter  and  cream. 

Out-Door  Exercise.  —  Without  exercise,  as  a  general  thing,  the  con- 
sumptive patient  will  die.  Exercise  involves  muscular  exertion, 
which  is  attended  by  the  tension,  compression,  and  greater  compact- 
ness of  the  muscles  used.  This  compression  of  the  muscles  within 
the  sheaths  (fasciae)  which  enclose  them,  sends  out  their  blood,  and 
pushes  it  forward  towards  the  surface .  Reaching  the  extremities  of 
the  arteries,  the  blood  passes  through  capillary  tubes,  almost  incon- 
ceivably fine,  into  the  capillary  veins  of  similar  fineness,  whence  it 
flows  through  larger  and  larger  veins  back  to  the  heart.  At  the  mo- 
ment of  its  passage  from  the  capillary  arteries  to  the  capillary  veins, 
it  ceases  to  be  red  or  arterial,  and  becomes  purple  or  venous  blood. 
The  oxygen  in  the  arterial  and  the  carbon  in  the  venous  blood  unite, 
forming  a  literal  combustion,  just  such  as  we  produce  in  our  stoves 
and  grates  by  bringing  together  the  carbon  of  the  wood  and  the  oxy- 
gen of  the  atmosphere.  By  this  combustion  our  bodies  are  warmed, 
and  the  little  secreting,  exhalant,  and  other  vessels,  are  raised  to  a 
temperature  that  enables  them  to  work. 

Every  muscular  contraction  and  compression  helps  push  along  the 
venous  blood  in  larger  quantities  to  the  right  auricle  of  the  heart, 
which,  receiving  a  fuller  supply  of  its  natural  stimulus,  contracts  more 
energetically,  forcing  the  fluid  into  the  right  ventricle.  From  thence 
it  is  expelled  with  increased  energy  likewise  alon^  its  only  pathway, 
the  pulmonary  artery,  into  the  lungs.  Rushing  in  here  in  greater 
volume  than  natural,  a  demand  is  made  for  deeper  inspirations  of 
air  to  vita  e  and  fit  it  for  its  descent  by  the  pulmonary  vein,  to  the 
left  auricle.  Coming  here  aL  as  the  natural  stimulus,  in  larger 
quantities  than  usual,  it  gives  increased  energy  to  its  own  propulsion 
into  the  left  ventricle,  from  whence  it  is  driven  out  through  the  arte- 
ries to  all  parts  of  the  system,  by  the  powerful  strokes  of  that  strong 
muscle. 

Thus  it  goes  its  round,  urged  on  by  exercise,  parting  with  its  oxy- 
gen more  and  more  freely  in  the  capillaries,  giving  more  activity  to 
the  vessels  of  the  skin  and  other  tissues,  increasing  the  depth  and 
strength  of  breathing  by  carrying  more  venous  blood  to  the  lungs; 
improving  the  digestion,  carrying  a  better  elaborated  pabulum  to  the 
nutrient  arteries,  and  causing  them  to  work  it  up  more  diligently  in 
renewing  the  tissues. 

Nor  is  this  all.  Every  wrench  of  a  muscle  forces  some  old,  worn 
out  particles  from  their  places,  allowing  none  to  remain  except  such 
as  are  firm,  and  able  to  bear  the  brunt  of  exertion.  The  flesh  of  those 
who  exercise  much  becomes  hard  and  enduring. 


■•i  '■. 


;   I 


2:30 


DISRASKS  OF  THK  CHEST. 


I  say  thou  to  the  consumptive,  if  you  would  live  and  not  die, 
exercise,  exercise,  exkrcise.  It  i»  the  first,  second,  and  third  thing. 
If  you  ask  for  the  modes  of  exercise,  I  say  take  it  on  foot,  out  of 
door,  every  day,  to  the  extent  of  a  small  amount  of  fatigue.  Don't 
be  frightened  by  a  single  cloud,  or  even  by  a  cohort  of  them.  You 
have  as  good  a  right  to  be  out  as  the  clouds  ;  and  they  will  not  look 
more  angry,  but  rather  more  agreeable  from  finding  you  abroad  in 
their  company.  The  elements  of  nature  are  at  war  with  organic  life. 
Against  them  the  vital  princiole  has  to  maintain  a  perpetual  struggle; 
and  he  who  loses  the  powei  to  meet  and  gain  the  victory  over  them 
by  out-door  exercise,  is  beginning  to  die. 

Gro  abroad,  therefore,  often.  Try  it  again  and  again.  Extend 
your  walk  a  little  every  day.  Stretch  it  out  to  the  distant  fields. 
Gather  flowers  from  the  top  of  the  hills  and  from  the  bosom  of  the 
vallies,  and  bring  them  home  as  trophies  of  your  victory. 

If  not  able  to  begin  with  walking,  ride  aa  often  as  possible  in  a 
carriage.  The  jolting  of  a  vehicle  will  jog  the  blood  along  much 
better  than  no  exercise. 

Horseback  riding  is  still  better.  It  combines,  in  some  measure,  the 
passive  exercise  of  carriage  riding,  with  the  active  exertion  of  walk- 
ing on  foot. 

Numerous  other  modes  of  exercise  may  be  resorted  to  with  advan- 
tages. Dumb-bells,  adapted  in  size  to  the  strength  of  the  patient,  and 
used  with  caution,  are  highly  serviceable.  The  battledoor,  the  foot- 
ball, jumping  the  rope,  pitching  quoits,  and  the  athletic  sports  of  the 
gymnasium,  all  have  their  appropriate  place.  The  greater  the  variety 
the  better,  as  by  it  all  parts  of  the  system  are  brought  into  play,  and 
both  the  mind  and  tha  muscles  get  the  change  which  they  need. 

It  is  hard  to  impress  patients  with  the  importance  of  this  subject. 
Say  what  you  will,  they  somehow  or  other  get  the  idea  that  a  mod- 
erate amount  of  exercise,  taken  when  they  feel  like  it,  is  all  that  is 
required.  Fatal  mistake  !  Whatever  the  physici;  may  do,  the  pa- 
tient has  a  great  deal  to  do  for  himself.  He  must  strive  to  develop 
his  physical  powers  to  the  utmost  He  must  train  himself  as  runners 
and  fighters  do  when  preparing  for  their  surprising  feats ;  for  he  is 
running  against  the  swiftest  disease  (or  the  surest  winner)  of  our  cli- 
mate, and  fighting  with  the  elements. 

'^  K  he  regards  life  as  not  worth  this  exertion,  of  course  he  will  not 
make  it ;  but  I  beg  him  to  consider  that  without  it,  recovery  will  be 
uncertain,  and  in  many  cases,  impossible.  Do  as  I  have  directed,  and 
if  your  medical  attendant  is  skilful,  the  current  of  health  will,  in 
many  cases,  begin  to  flow  back  to  you.  Life  wi!'  renew  to  you  its 
policy  of  insurance,  and  multiply  your  days. 

Travelling.  —  Consumptive  patients  have  generally  boen  sent  to  a 
southern  climate.  But  where  the  case  involves  dyspepsia  and  affec- 
tions of  the  liver,  low  latitudes  are  generally  unfriendly.  Liver  com- 
plaints are  the  banc  of  a  southern  climate,  and  a  sallow  complexion 
is  the  inheritance  of  a  southerner. 

Tubercular  persons,  chilled  by  our  northern  climate,  are  sometimes 


A 


:^^ 


not  die, 

d  thing. 

t,  out  of 
Don't 
You 

not  look 
broad  in 
anic  life, 
struggle ; 
ver  them 

Extend 
nt  fields, 
m  of  the 

lible  in  a 
ig  much 

isure,  the 
of  walk- 

h  advan- 
\i('i\t,  and 
the  foot- 
*ts  of  the 
le  variety 
play,  and 
sed. 

i  subject, 
it  a  mod- 
11  that  is 
9,  the  pa- 
>  develop 
3  ninners 
for  he  is 
f  our  cli- 

!  will  not 
r  will  be 
cted,  and 
will,  in 
0  you  its 


lent  to  a 
nd  affec- 
ver  com- 
tiplexion 

rnetimes 


DISK  ASKS  OF  THK  CHEST. 


231 


temporarily  relieved  by  the  warmer  atmosphere  of  the  south.  Z,at 
the  relief  is  only  temporary ;  for,  having  lost  the  power,  as  they  im- 
agine, to  bear  the  frowns  of  our  northern  sky,  they  are  dying,  and 
will  die  anywhere  unless  they  recover  this  power.  And  the  way  to 
retrieve  a  lost  advantage  over  an  enemy,  is,  not  to  retreat  to  a  point 
where  recovery  will  be  harder,  but  to  meet  him  at  once.  If  the  con- 
stitution cannot  bear  up  against  an  enemy  under  the  bracing  of  a 
northern  atmosphere,  it  will  be  still  harder  to  do  so  under  the  wilting 
of  a  southern. 

After  all,  the  objects  aimed  at  should  be  change  and  iravelUng:  The 
exercise  involved,  the  constant  exertion  required  in  getting  from  place 
to  place,  the  agreeable  sensations  produced  by  the  motion  of  cars 
and  steamboats,  the  ever  varying  change  of  sights  and  sounds,  and 
the  constantly  increasing  stock  of  one's  ideas  of  men  and  things, — 
these  are  what  rally  the  constitution,  and  open  anew  the  springs  of 
life. 

Especially  should  all  journeys  for  health  be  taken,  if  possible,  with 
an  object  in  view.  Let  the  consumptive  start  with  the  view  of  see- 
ing the  cave  of  Kentucky,  the  prairies  of  the  West,  the  great  lakes 
of  the  ^orth,  the  falls  of  Niagara,  the  fortress  of  Quebec,  the  Sag- 
uenay  river,  the  doctor,  who  he  has  reason  to  think  will  cure  him, — 
anything  which  he  is  willing  to  make  exertion  to  see,  and  that  he  is 
sure  his  eyes  will  rejoice  in  beholding. 

I  have  thus  spoken  of  consumption  more  at  large  than  of  other 
complaints,  because  it  is  the  great  disease  of  the  world,  and  is  in- 
creasing with  the  advancement  of  civilization. 

Acute  Bronchitis. 

This  is  an  acute  inflammation  of  the  mucous  membrane  lining  the 
air  tubes  in  the  lungs.     It  is  generally  quite  a  serious  disease. 

Physical  Sig;ns.  —  The  sound  upon  percussion  is  generally  good.  If 
there  be  any  dulness,  it  is  commonly  in  the  lower  and  back  part  of 
the  chest. 

The  breathing  murmurs  are  sometimes  more,  sometimes  less  in- 
tense than  natural.     Occasionally  they  are  almost  extinct. 

In  the  early  stage,  sibilous  and  loud  rattles. 

In  the  more  advanced  stage,  mucous  rattle. 

Now  and  then  sub-crepitant  rattle  accompanies  the  inward-drawn 
breath. 

General  Symptoms. —  The  disease  begins  with  chills  followed  by 
fever;  tightness  across  the  chest,  difficulty  of  breathing,  hoarseness, 
loss  of  strength,  costive  bowels,  and  a  quick  and  hard  pulse.  Water 
runs  from  the  eyes  and  nostrils,  and  there  is  a  dry,  harsh,  croupy 
cough. 

After  a  few  days,  mucous  begins  to  be  raised.  This  expectoration 
gradually  becomes  more  copious,  and  is  opaque,  yellowish,  or  green- 
ish, and  occasionally  streaked  with  blood.  This  mucus  is  very  ropy, 
and  adheres  to  the  vessel. 


■,i 


A 


232 


I)I8RASR8  OF  THR  CURST. 


There  is  more  or  less  pain  in  the  chcHt ;  pain  across  the  forehead, 
which  is  increased  by  coughing ;  and  a  pale  and  anxious  counte- 
nance. 

In  severe  cases,  the  tightness  across  the  chest  is  extreme,  with  a 
sense  of  suffocation,  causing  the  patient  to  call  for  the  opening  of  the 
windows.  There  is  great  difficulty  of  breathing;  a  paleness  and  liv- 
idity  of  the  checks  and  lips ;  a  loud  wheezing  and  rattling  in  the 
throat,  followed  by  cold  sweat,  insensibility  and  death. 

In  children  the  disease  comes  on  like  a  common  cold,  attended  by 
a  sore  throat,  a  great  desire  to  drink,  but  a  disinclination  to  take 
food.  But  two  or  three  swallows  of  drink  can  be  taken  at  a  time 
for  want  of  breath.  The  phlegm  is  frequently  vomited  up  spontane- 
ously. 

Observattons.  —  The  loud  and  sibilous  rattles  are  produced  by  simi- 
lar causes,  namely,  the  passage  of  air  along  tubes  whose  interior  \h 
dry  and  rough  from  inflammation,  or  whose  calibre  is  contracted  or 
altered  in  form  by  the  swelling  of  the  membrane,  effusion  upon  its 
inner  surface  of  a  tough  mucous  substance,  or  a  pressure  upon  its 
external  surface  of  tubercles,  swollen  glands,  aneurismal  tumors, 
etc.  The  two  sounds  differ  mainly  in  the  key  upon  which  they  are 
pitched,  —  the  sonorous,  or  low-keyed,  coming  from  the  larger  tubes  ; 
the  sibilous,  or  high-keyed,  from  the  smaller, — just  as  the  low  notes 
of  an  organ  come  from  the  large  pipes,  and  the  high  notes  from  the 
small  ones. 

The  sibilous  rattle  has  been  compared  to  the  chirping  of  birds,  the 
squeaking  of  puppies,  the  whistling  of  air  passing  through  a  key- 
hole, etc.;  the  sonorous,  to  the  snoring  of  a  sleeping  person,  the  coo- 
ing of  doves,  and  the  sound  of  the  bass  string  of  the  violincello  rub- 
bed w'th  the  finger. 

€anse8.  —  It  is  generally  brought  on  by  a  sudden  cold,  by  changes 
of  the  weather,  and  by  inhaling  irritating  substances.  It  is  a  second- 
ary result,  too,  of  scarlet  fever,  measles,  small  pox,  hooping  cough, 
and  the  remittent  fever  of  infants. 

Treatment.  —  In  mild  cases,  give  warm  balm  or  flax-seed  tea,  hot 
lemonade,  or  other  similar  drinks,  —  at  the  same  time,  soaking  the 
feet  in  hot  water,  and,  on  retiring  to  bed,  apply  bottles  of  hot  water  to 
the  feet  and  sides,  to  produce  sweating.  If  the  bowels  be  costive, 
some  gentle  physic,  as  rhubarb  and  magnesia,  or  salts  and  senna,  may 
be  taken. 

In  the  case  of  infants,  an  emetic  of  wine  of  ipecac,  or  compound 
tincture  of  lobelia,  should  be  given,  and  followed  with  slippery  elm 
and  flax-seed  tea.  The  compound  tincture  of  lobelia,  with  tincture 
of  veratrum  viride,  may  be  continued  for  a  time  as  an  expectorant 
_  In  more  severe  cases,  both  of  adults  and  children,  an  active  emetic 
is  required,  —  perhaps  the  compound  powder  of  lobelia  is  as  good  as 
any.  This  must  be  followed  with  tincture  of  veratrum  viride,  in  full 
doses,  60  as  to  reduce  the  pulse  at  once,  and  keep  it  down  to  the 
natural  standard.  This  is  one  of  the  very  best  articles  in  this  com- 
plaint, and  will  generallv  very  much  lessei*    U  violence  and  duration. 


v^SiiO^' 


DISEASES  OF  THE  CHEST. 


233 


forehead, 
counte- 

le,  with  a 
ng  of  the 
and  liv- 
g  in  the 


it 


nded  by 

to  take 

a  time 

pontane- 


by  simi- 

iiterior  i» 

acted  or 

upon  ita 

upon  its 

tumors, 

they  are 

er  tubes ; 

ow  notes 

from  the 

birds,  the 

h  a  key- 

the  coo- 

:ello  rub- 

'  changes 
1  secoiid- 
g  cough, 

tea,  hot 
king  the 
water  to 

costive, 
ina,  may 

impound 
>ery  elm 
tincture 
orant. 
B  emetic 
good  as 
e,  in  full 
I  to  the 
lis  com- 
uration. 


If  there  is  much  difficulty  of  breathing,  the  air  of  the  room  must 
be  kept  moist,  as  recommended  in  croup. 

The  room  should  also  be  kept  warm,  —  decidedly  warmer  than  in 
the  case  of  other  fevers. 

A  gentle  pcrspiratioi  i^hould  be  kept  up  by  small  doses  of  com- 
pound tincture  of  Virginia  snake-root,  and  by  frequently  bathing  the 
surface,  or  else  by  tincture  of  veratrum. 

Mustard  should  be  applied  to  the  cheat,  and  to  the  soles  of  the  feet. 

The  cough  may  be  managed  by  preparations  (104)  (106)  (110), 
freely  given. 

The  diet  should  be  confined  to  barley-wuter,  toast-water,  apple- 
water,  rice-water,  and  a  solution  of  gum  arabic. 

Chronic  Bronchitis. 

This  is  an  inflammation  of  the  mucous  membrane  of  the  air-tubes, 
which  continues  a  great  length  of  time,  without  any  sudden  or  re- 
markable changes. 

Physical  8i|pis.  —  The  percussion-sounds  are  similar  to  those  of 
acute  bronchitis.  When  a  bronchial  tube  is  dilated,  we  sometimes 
have  dulness  around  the  dilated  part 

The  breathing  murmur  is  always  accompanied  by  a  mucous,  sono- 
rous, or  sibilant  rattle,  —  sometimes  by  a  subcrepitant. 

When  dilatation  of  the  tubes  exists,  the  intensity  and  duration  of 
the  sound  of  the  ingoing  breath  is  decreased^  —  of  the  outgoing 
increased. 

In  this  state  of  the  tubes,  we  also  have  cavernous  breathing,  bron- 
chophony, sometimes  pectoriloquy,  and  bronchial  or  cavernous  cough. 

General  Symptoms.  —  A  cough  is  generally  present,  which  is  in- 
creased in  wet  weather,  and  by  every  slight  cold.  This  comes  on  in 
paroxysms ;  is  generally  worse  in  the  morning ;  and  is  relieved  by 
raising  freely.  The  matter  raised  is  generally  yellowish,  but  some- 
times whitish  and  sticky  ;  and  in  the  latt«r  stages,  is  thick,  and  some- 
times very  much  like  that  of  consumption.  Indeed,  the  disease  often 
ends  in  bronchial  consumption. 

Remarks.  —  The  breathing  is  bronchial  or  cavernous  when  the  di- 
lated portion  of  the  tube  '  empty ;  —  if  it  contain  fluid,  the  mucous 
rattle  will  be  heard. 

Dulness  on  percussion  will  exist  if  a  dilated  tube  press  upon  tlio 
surrounding  portion  of  lung  so  as  to  condense  or  make  i»  solid. 

Dilatation  of  the  tubes  occurs  only  in  chronic  bronchitis  of  long 
standing.  Its  physical  signs  are  much  like  those  of  a  cavity  in  ad- 
vanced consumption.  The  examiner  may  learn  to  distinguish  them 
by  considering  that  in  consumption,  dulness  precedes  the  cavity,  while 
in  bronchial  dilatations,  the  cavity  precedes  dulness. 

The  dilatation  or  swelling  out  at  some  point  of  a  bronchial  tube,  is 
caused  by  obstructions  to  the  passage  of  air  through  it, — just  as  an 
India-rubber  tube,  partially  closed  up  at  a  given  point,  will  bulge  out 


234 


DISEASES  OF  THE  CHEST. 


just  in  front  of  the  obotructed  place,  when  air  is  forcibly  blown 
through  it,  and  just  as  the  left  ventricle  of  the  heart  enlarges  when 
the  blood  ia  obstructed  in  its  passage  through  the  aortic  valve. 

Causes.  —  It  often  occurs  as  the  result  of  acute  bronchitis,  and  ai^o 
of  measles,  hooping-cough,  etc.  But  taking  cold,  and  damp  and  change- 
able weather,  are  more  frequently  its  causes.  It  moHt  often  follows 
chronic  inflammations  of  the  throat,  which,  being  neglected,  gradually 
creep  down  the  windpipe  into  the  tubes,  and  become  very  obstinate 
in  their  character. 

Treatment —  Medicinal  inhalation  is  one  of  the  best  remedies  for 
this  complaint.  The  inhaling  powder  has,  in  many  cases,  great  effi- 
ciency.  The  dose  is  about  what  can  lie  on  a  ten  cent  piece.  It 
should  be  used  once  a  day,  in  an  instrument  represented  in  the  cut 

This  instrument  I  had  constructed  in  1850.  It  consists  mainly  of 
a  glass  tube  and  a  receiver,  —  the  latter  being  something  like  a  tube 
vial,  pierced  with  fine  holes  around 
the  lower  end. 
poured  into  the 
placed  in  the  larger  tube, 
twirled  between  the  thumb 
finger  while  inhaling. 

When   the   powder   cannot  be 
easily  got  down  into  the  tubes 
the  inhalation  of  medicated  vapor 


The   powder  is 
receiver,  which  is 


FlO-  92. 


[Patented  March  16,  1859.] 


and 
and 


^ 


in 


the  lungs,  —  as  often  happens,  — 
will  do  better.  If  the  expectora- 
tion be  difficult,  the  expectorant  inhalant,  described  under  "  consump- 
tion," should  be  used ;  if  the  expectoration  be  too  profuse  and  free, 
the  astringent  inhalant  must  be  taken. 

The  cough  preparations  recommended  for  consumption,  also  (113) 
(112),  will  be  the  proper  ones  in  this  complaint. 

The  daily  alkaline  bath,  ai'd  brisk  friction,  are  particularly  service- 
able. 

Out-door  exercise  is  almost  as  necessary  in  this  disease  as  in  con- 
sumption. 

Enlargement  of  the  Air  Cells. — Emphysema. 

This  disease  consists  in  enlargement  of  the  air  cells,  the  obliteration 
of  their  vessels,  and  the  wasting  of  their  walls. 

Physical  Sig^s. —  Thumping  upon  the  chest  gives  a  clearer  and 
louder  sound  than  natural,  —  one  which  is  tympanitic,  or  drum-head 
like. 

The  murmur  of  the  ingoing  breath  is  diminished  both  in  duration 
and  intensity,  —  of  the  outgoing  breath,  it  is  increased. 

Dry,  crepitant  rattle  attends  the  ingoing  breath  only ;  occasionally, 
sibilous  rattle. 

General  Symptoms.  —  Habitual  shortness  of  breath,  and  very  great 
difficulty  of  breathing,  occurring  in  paroxysms,  which  cause  the  pa- 
tient to  rush  to  the  open  window  for  uir. 


'<!i^M^^tj£t- 


Jibly  blown 
farges  wliuii 
live. 

Itis,  and  al.<4o 
jandchtingu- 
Uten  follows 
Id,  gradually 
Iry  obstinate 

remedies  for 
[»,  great  effi. 
t  piece.  It 
In  the  cut 
|a  mainly  of 
like  a  tube 


1853] 

happens,  — 
3  expectora- 
'  "  consump- 
se  and  free, 

1,  also  (113) 

arly  service- 

>e  as  in  con* 


sema. 
obliteration 

clearer  and 
■  drum-head 

in  duration 

ccasionally, 

I  very  great 
use  the  pa- 


DI8EASES  OP  THE  CHEST. 


233 


There  is  generally  a  cough,  and  the  matter  raised  is  frothy,  licinid, 
and  mucous,  or  watery. 

The  face  has  a  peeiiliar  dusky  color,  and  the  countenance  an  anx- 
ious, melancholy  expression.  The  nostrils  are  tlii(rk,  and  the  lower 
lip  full.  The  muscles  of  the  neck  are  large,  and  the  gait  of  the  pa- 
tient is  stooping.  The  strength  is  wasted  in  proportion  to  the  ditii- 
cully  of  breathing. 

Kinphysema  tends  to  produce  disease  of  the  heart,  Bright's  disease, 
and  v(;nous  congestions  in  the  head. 

ObservatioilM.  —  The  tympanitic  sound  is  caused  by  the  increased 
amount  of  air  in  the  cells. 

The  air  cells  having  h)st  their  elasticity,  the  air,  in  a  great  degree, 
remains  in  them,  —  not  passing  in  and  out,  —  hence  the  absence  of  the 
vesicular  murmur. 

The  crepitant  rattle  attends  the  ingoing  breath  only,  and  is  sup- 
posed to  arise  from  the  expansion  of  lungs  which  are  in  a  drier  state 
than  natural.  It  has  been  compared  to  the  sound  produced  by  blow- 
ing into  a  dried  bladder. 

rreatllieilt. —  To  whatever  extent  the  air-cells  are  destroyed,  to  that 
extent,  of  course,  flic  disease  is  incurable.  It  may,  however,  be  pal- 
liated and  relieved  to  a  great  extent. 

Generally,  bronchitis  exists  in  connection  with  emphysema ;  and 
when  this  is  found  to  be  case,  the  remedies  for  that  disease  must  be 
em))loyed. 

The  inhalation  of  tincture  of  stramonium,  in  one  or  two  teaspoon- 
ful  doses,  the  same  as  the  alterative  inhalant  is  used,  will  be  useful. 

'J'o  be  taken  internally,  an  excellent  preparation  may  be  made  by 
uniting  one  dram  of  ethertial  tincture  of  lobelia,  with  two  drams  of 
tincture  of  ipecac,  and  two  ounces  of  ammoniac  mixture.  The  dose 
is  one  to  two  tablespoonfuls.  Half  grain  to  grain  doses  of  extract  of 
cannabis  iiidica,  are  excellent  to  relieve  the  difficulty  of  breathing. 

The  diet  must  be  very  carefully  regulated,  as  overindulgence  at  the 
table  aggravates  the  symptoms. 

Change  of  air  is  often  highly  beneficial ;  but  it  is  impossible  to 
predict  ita  effects  beforehand  in  each  individual  case. 

j     Swelling  of  the  Lungs. — Hifpertrophy  of  the  Lungs. 

This  can  hardly  be  regarded  as  a  disease.  It  generally  takes  place 
in  but  one  lung,  and  is  the  result  of  the  inaction  of  the  other.  Thus, 
when  one  lung  is  diseased,  tl-o  other  has  to  do  the  work  of  both  ;  and 
being  overworked,  it  enlarges  as  the  heart,  or  an  arm  does,  when  very 
much  exercised. 

The  only  treatment  required  is  to  eat  sparingly,  and  exercise  with 
great  iV.oderation,  so  as  not  to  increase  the  rapidity  of  the  breathing. 

Pulmonary  Apoplexy. 

This  is  generally  the  result  of  a  disease  of  the  heart,  particularly 
of  the  mitral  valve. 


\ 


■! 


Nl 


236 


DISEASES  or  THE  CHEST. 


PhyHicHl  RiyrnR.  —  P'TmsHion  yields  a  clear  ttound,  except  where 
the  I'ligorgcniont  of  blood  iu  large,  and  near  the  surface,  —  in  which 
case,  it  is  dull. 

The  Bound  of  breathing  is  feeble  or  abnent  over  a  limited  Hpace. 

Broncliiul  breathing  Ih  heard  in  some  placeit,  and  bronchophony  in 
part,  in  the  ^arne  regions. 

Mucous  rattle  is  also  heard. 

Observations. —  In  this  diHcasc  the  small  air-tubes  and  air-cells  are 
the  seat  of  bleeding ;  and  the  blood  becoming  coagulated  hrre,  cIosch 
these  vessels  against  the  entrance  of  ai..  This  explains  the  feeble- 
ness or  absence  of  the  breathing  murnuii.  ^ 

The  fluidity  of  blood  in  the  iiniuediato  vicinity,  giveu  rise  to  th« 
mucous  rattle. 

General  SymptoniH.  —  These  .arc,  difficulty  of  breathing,  tightness, 
and  dull  pain  in  the  chest.  The  mucus  raised  is  tinged  or  streakeil 
with  blood.  The  blood  raised  is  darkish,  and  dirty-looking.  This 
last  symptom,  the  dirty  look  of  the  blood,  is  peculiar  in  this  disease. 

Treatment.  —  The  most  important  remedy  is  dry-cupping  upon  the 
chest.  This  will  often  arrest  the  disease  at  on(!C.  Counter-irritation 
by  croton  oil  is  also  useful.  A  free  movement  of  the  bowels  by  a 
preparation  ox)ntaining  croton  oil,  or  elaterium  (31)  (38),  has  an  ex- 
cellent eflect 

Air  in  the  Chest. — Pneumothorax. 

This  disease  consists  in  the  presence  of  air  in  the  cavity  of  the 
pleura.  Generally,  there  is  also  water  in  the  pleural  sac  at  the  same 
time ;  the  water,  being  the  heavier  fluid,  occupying  the  lower  part  of 
the  cavity,  und  the  air  the  upper  part. 

Physical  >Sig;ns.  —  Tympanitic  or  drum-like  sound  over  the  upper 
part  of  the  side.  Dull  sound  over  the  lower  part.  Breathing  mur- 
mur diminished  or  suppressed.  Amphoric  breathing.  Metallic  tink- 
ling. 

General  Symptoms.  —  Great  oppression  of  the  chest,  and  difficrUy 
of  breathing ;  generally  attended  by  palpitation  of  the  heart,  and  fre- 
quently by  severe  pain  under  the  breast-bone,  on  the  affected  side. 
The  patient  generally  has  to  remain  in  the  sitting  posture,  and  cannot 
lie  an  instant  on  the  sound  side. 

I^  on  percussion,  one  side  of  the  chest  sounds  louder  than  the  othei; 
and  the  breathing  murmur  is  heard  distinctly  on  the  side  which  gives 
only  a  moderate  sound,  and  is  not  beard  at  all  on  the  loud-sounding 
side,  we  may  be  >ure  it  is  a  case  of  air  in  the  chest. 

Observations. —  The  metallic  tinkling  is  like  the  sound  produced  by 
dropping  a  pin's  head  into  a  metallic  dish,  or  like  the  distant  tinkling 
of  a  sheep-bell,  or  the  gentle  pulling  of  the  string  of  a  violin. 

It  is  supposed  that  when  the  fluid  in  the  cavity  of  the  pleura  hap- 
pens to  be  higher  than  the  orifice,  the  air,  when  it  enters  at  each 


kcept  where 
|  — in  which 

•<l  Hpace. 
■Iiophoiiy  in 


lair-cells  are 

^  Iktc,  cIomoh 

tile  feeble- 

rise  to  th« 

tightnesfl, 
or  Btreak«!(l 
fing.  This 
iu  disease. 

g  upon  the 

<'r-irritatioii 

owela  by  a 

liaa  an  ex- 


vity  of  the 
it  the  same 
wer  part  of 

'  the  upper 
thing  iTiur- 
itallic  tinl:- 

i  difficrlty 
rt,  and  fre- 
ected  side, 
md  cannot 

I  the  othei; 
''hich  gives 
1-sounding 

oduced  by 
it  tinkling 
n. 

eura  hap- 
8  at  each 


DISRABK8  OK  THK  CUICBT. 


237 


i'i)-drawn  breath,  forceH  its  way  up  through  the  fluid,  in  the  shape  of 
Dubblt'H,  and,  bursting  at  the  Hurface,  gives  the  tinkling  Hound.  This 
houikI  is  sotnctinies  produced,  too,  by  the  falling  of  dropn  of  liipiid 
iriun  the  upper  part  of  the  cavity,  u|)on  the  surface  of  the  fluid. 

Tho  amphoric  breathing  is  like  the  sound  produced  by  blowing 
oblicpicly  into  an  enipfy  cask.  One  writer  siiys  he  heard  the  snnie 
Hoinul  when  out  shooting  in  a  rough  day,  produced  by  the  wind  blow- 
ing sideways  into  the  gun-barrel. 

TrcMfnient.  —  I  would  recomtnend  the  use,  two  or  three  times  a 
(lay,  of  the  antiseptic  inlialunt,  mentioned  under  the  head  of  con- 
-tinnption. 

To  this  should  be  added  dry-cupping  over  the  whole  chest,  which 
generally  gives  great  relief.     Blisters  may  also  be  used. 

Sweating  must  be  encouraged  in  the  n.anner  recommended  under 
aoute  bronchitis. 

For  the  dilliculty  of  breathing,  give  half  grain  doses  of  cannabis 
indica,  or  five  drop  doses  of  tinctu.e  of  aconite,  or  one-sixth  of  a 
grain  doses  of  morphia.  Extract  of  belladonna,  or  of  stramonium,  is 
also  worthy  of  trial. 

^   >  .  ■  '      ■   .  ;  _ 

Water  in  the  Chest. — Ilydrothorax. 

This  disease  consists  ia  a  collection  of  water  in  the  cavity  of  the 
pleura. 

IMiysical  Sii^is.  —  There  is  a  dull  sound  over  the  effusion. 

The  breathing  murmur  is  diminished,  and  gradually  disappears 
altogether  over  the  space  occupied  by  the  effusion. 

Bronchial  breathing  is  heard  in  the  same  part. 

When  the  amount  of  fluid  is  small,  egophony  is  heard  in  the  mid- 
dle regions  of  the  chest. 

Bronchophony  is  heard  when  the  effusion  is  larger. 

General  Symptoms. —  Either  iipon  lying  down,  or  using  active  bodily 
exercise,  the  patient  finds  his  difficulty  of  breathing  increased.  When 
in  bed,  he  lies  with  his  head  and  shoulders  raised,  which,  by  causing 
the  fluid  to  settle  at  the  bottom  of  the  cavity,  prevents,  in  a  measure, 
its  pressure  upon  the  lungs,  and  gives  him  a  little  rest.  His  sleep  is 
interrupted  by  sudden  starts,  with  alarm  and  terror.  The  pulse  is 
hard,  the  thirst  great,  the  urine  scanty  and  high-colored,  and  has  a 
sediment.  After  a  time,  the  feet  swell,  the  face  is  pallid  and  livid, 
and  the  countenance  expresses  anxiety  and  alarm.  There  is  a  short, 
dry  cough. 

When  the  quantity  of  fluid  in  the  chest  becomes  large,  the  patient 
cannot  lie  down  at  all,  and  only  gets  short  and  disturbed  naps  in  the 
sitting  posture. 

Of  all  the  symptoms,  the  starting  in  sleep  is  the  most  certain  sign 
of  the  disease. 

Causes.  —  In  some  rare  cases,  this  may  occur  as  a  primary  disease, 
—  that  is,  as  a  disease  not  dependent  uuon  an    other  as  its  cuose. 


238 


DISEASES  OF  THE  CHEST. 


The  greater  number  of  cases,  however,  are  secondary.  They  arise 
from  organic  disease  of  the  heart,  or  liver,  or  stomach.  Inflammation 
of  the  pleura  is  a  very  frequent  cause. 

A  plethoric,  or  full  state  of  the  system,  predisposes  to  this  com- 
plaint,—  particularly  in  those  persons  who  indulge  freely  at  the 
table. 

It  may  arise,  too,  from  the  striking  in  of  skin  eruptions ;  from  the 
free  use  of  liquors ;  and  from  frequent  excessive  bleedings  or  purg- 
ings. 

Treatment — Dry-cupping  is  a  valuable  remedy,  and  should  always 
be  practised. 

The  chest  should  be  painted  with  the  tincture  of  iodine,  and  a  good 
degree  of  substantial  soreness  be  kept  up. 

The  internal  remedies  are  purges  (31)  (14)  (30),  and  diuretics 
(128)  (129)  (130)  (131). 

The  iodide  of  potassium,  in  doses  of  five  or  six  grains,  once  in 
three  or  four  hours,  is  an  excellent  remedy.  The  following  is  a  good 
form  of  taking  it, — iodide  of  potassium,  one  once;  fluid  extract  of 
pipsissewa,  two  ounces ;  water,  half  a  pint^    Dose,  one  teaspoonful. 

The  skin  should  be  bathed  and  rubbed  daily,  three  or  four  times, 
with  much  friction. 

Pleurisy. — Pleuritis. 

Pleurisy,  or  pleurisy  fever,  as  it  is  sometimes  called,  is  an  inflam- 
mation of  the  pleura,  or  the  membrane  which  lines  the  chest,  and,  at 
the  same  time,  is  folded  back  so  as  to  cover  the  outer  surface  of  the 
lungs. 

The  pleura,  as  is  elsewhere  explained,  is  a  short  sac  or  bag,  whose 
inner  sides  are  kept  moist,  so  that  they  may  slide  easily  upon  each 
other  as  they  are  moved  by  the  alternate  contractions  and  expan- 
sions of  the  lungs  in  the  act  of  breathing,  and  whose  outer  sides  are 
made  to  grow,  —  one  to  the  inside  of  the  chest,  and  the  other  to  the 
outside  of  the  lungs. 

Pleurisy  and  lung  fever,  then,  must  be  kindred  diseases,  and  exist, 
more  or  less,  togetner.  In  truth  there  is  almost  always  some  affection 
of  the  pleura  in  lung  fever,  and  some  affection  of  the  lungs  in  pleu- 
risy. The  pain  in  lung  fever  is  owing  to  some  inflammation  of  the 
pleura ;  and  the  appearance  of  the  rusty-colored  phlegm  in  pleurisy 
indicates  that  the  lungs  have  been  reached  by  the  inflammation  of  the 
membrane  which  covers  them. 

Physical  Si^ns.  —  Dulness  on  percussion,  at  the  lower  part  of  the 
chest,  which  ascends  as  the  effusion  of  water  increases. 

If  the  effused  fluid  is  not  great,  there  is  puerile  breathing  at  the  top 
of  the  lung. 

Friction  sound  is  heard  occasionally. 

Egophony  is  heard  when  the  amount  of  fluid  in  the  pleura  is 
email. 

As  the  amount  of  water  iiicreases,  bronchophony  appears. 


[They  arise 
lamination 

this  com- 
fely  at  the 

,  from  the 
?8  or  purg- 

buld  always 

[and  a  good 

Id  diuretics 

08,  once  in 
J  is  a  good 
extract  of 
Jaspoonful. 
four  times, 


an  inflam- 
est,  and,  at 
face  of  the 

bag,  whose 
upon  each 
md  expan- 
ir  sides  are 
ther  to  the 

and  exist, 
e  affection 
?s  in  pleu- 
ion  of  the 
n  pleurisy 
tion  of  the 


art  of  the 
at  the  top 

pleura  is 


DISEASES  OF  THE  CHEST. 


239 


General  SymptomSt — This  disease  is  most  frequently  introduced 
by  shiverings,  which  are  soon  succeeded  by  high  fever,  with  a  pecu- 
liarly hard,  resisting  pulse  ;  sharp,  stabbing  pain  in  the  side,  —  gener- 
ally just  below  the  nipple,  but  sometimes  extending  to  the  shoulder, 
arm-pit,  and  back ;  hurried  and  interrupted  breathing ;  and  a  short, 
dry  cough. 

The  pain  is  greatly  aggravated  by  motion,  coughing,  or  an  attempt 
to  take  a  long  breath.  It  holds  the  patient  under  constant  and  power- 
ful restraint.  We  find  him  lying  upon  his  back,  or  his  well  side  ;  his 
countenance  full  of  anxiety, — fearine;  to  move,  cough,  or  even  breathe 
needlessly ;  and  often  crying  out  ;i  the  keen  torture  these  neces- 
sary acts  inflict  in  spite  of  all  his  caution. 

At  a  more  advanced  stage,  when  the  tenderness  has  somewhat 
abated,  he  will  prefer  to  lie  on  the  diseased  side,  as  this  leaves  the 
healthy  lung  more  at  liberty. 

Obseirations.  —  The  first  effect  of  the  inflammation  of  the  pleura 
in  to  dry  up  the  moisture  with  which  its  inner  surfaces  are  lubricated, 
or  made  smooth  and  slippery.  As  a  consequence,  these  surfaces  be- 
come rough,  and  rub  harshly  upon  each  other,  and  produce  a  sound, 
in  the  early  stages  of  pleurisy,  like  that  of  rubbing  two  pieces  of  wet 
leather  together.  It  may  be  imitated  by  rubbing  the  finger  back  and 
forth  upon  a  table.  It  is  sometimes  a  creaking  noise,  like  that  of 
new  shoes. 

As  the  disease  advances  an  important  change  takes  place  in  the 
state  of  things.  Instead  of  an  unnatural  diyness,  a  watery  fluid  is 
poured  out  copiously  from  the  inflamed  surmces  of  the  pleural  sac. 
This  is  called  the  period  of  effusion.  This  generally,  though  not  al- 
ways, relieves  the  pain.  But,  by  compressing  the  lung,  causes  dan- 
gerous difficulty  of  breathing. 

The  air-cells  are  compressed  by  the  effiised  fluid,  and  are  not  pene- 
trated by  air.     Hence  the  absence  of  the  breathing  murmur. 

The  pouring  out  of  water  between  the  layers  of  the  pleura,  com- 
presses the  lung,  and  removes  it  from  the  walls  of  the  chest  Hence 
the  dulness  or  deadness  of  sound  upon  percussion. 

When  listening  with  the  stethoscope,  the  voice  of  the  patient  sounds 
feeble  and  interrupted,  like  the  bleating  of  a  goat,  and  is  hence  termed, 
egophom/,  or  goat'Voice. 

This  peculiar  voice  is  heard  only  when  the  effusion  of  water  has 
been  moderate  in  quantity,  and  only  a  thin  layer  of  liquid  lies  be- 
tween the  ribs  and  lung.  It  is  caused  by  the  voice  passing  over  this 
thin  layer,  which  is  thereby  thrown  into  vibrations^  or  wavy,  quiver- 
ing motions.  When  thus  agitated,  the  fluid  reacts  upon  the  voice, 
making  it  sharp  and  tremulous. 

When  the  effusion  has  become  large,  these  effects  cease ;  but  an- 
other sign  then  shows  itself,  and  distinguishes  pleurisy  from  the 
heau..j  state,  and  likewise  from  the  solid,  hepatized  state  of  the  lung 
in  lung  fever.     It  may  be  discovered  thus  : 

If  the  hand  be  laid  flat  upon  the  chest  of  a  healthy  person,  while 
he  is  speaking,  a  vibration  or  thHll  will  be  felt     If,  in  like  manner, 


V         If 


■/vi 


240 


DISEASES  OF  THE  CHBST. 


the  hand  be  laid  upon  the  cheat  rf  a  person  having  lung  fever,  with 
hepatized  lung,  this  thrill  will  be  found  still  more  perceptible.  But 
when  the  hand  is  placed  over  the  place  of  watery  effusion  on  the  chest 
of  a  person  having  pleurisy,  there  will  be  discovered,  when  the  person 
speaks,  no  thrill,  whatever.  The  absence  of  this  thrill.,  then,  is  one  of 
the  very  best  signs  of  pleurisy  with  effusion. 

Persons  recover  from  pleurisy  sometimes  very  rapidly,  before  effu- 
sion has  taken  place  It  is  then  said  they  have  had  an  attack  of  dry 
pleurisy.  When  liquid  has  been  poured  out,  even  in  considerable 
quantity,  it  is  sometimes  reabsorbed,  and  the  patient  recovers  per- 
fectly. In  other  instances,  it  compress(;s  the  lungs,  interferes  seriously 
with  breathing,  reduces  his  strength,  and  he  sinks  rapidly. 

Treatment.  —  Pleiuisy  has  been  divided  for  description  and  treat- 
ment into  three  stages,  following  the  natural  events  of  the  inflamma- 
tion. The  first  stage  comprises  the  period  from  the  first  onset  to  the 
time  when  effusion  commences.  The  second  stage  or  stage  of  effu- 
sion extends  to  the  time  when  the  liquid  begins  to  diminish  ;  and  the 
third  stage  consists  of  the  period  occupied  by  the  absorption  of  the 
liquid. 

Should  the  quantity  remain  stationary  or  diminish  very  slowly 
after  the  lapse  of  two  or  three  weeks,  the  disease  becomes  chronic 

The  indication  for  treatment  during  the  first  stage  is  to  arrest  the 
progress  of  the  disease,  to  diminish  its  intensity,  to  limit  the  amount 
of  morbid  products,  and  to  relieve  suffering. 

If  the  patient  is  robust,  has  a  hard,  frequent  pulse,  accompanied 
with  extreme  pain  and  fever,  blood-letting  is  i»"^icated.  The  abstrac- 
tion of  ten  to  fifteen  ounces  of  blood  will  give  g,rtocit  relief  and  diminish 
the  intensity  of  the  attack ;  but  if  the  patient  is  not  seen  early,  and  is  of 
a  feeble  constitution,  some  other  measures  should  be  substituted  for  it. 
The  mass  of  blood  may  be  lessened  by  saline  cathartics,  such  as  the 
sulphate  of  magnesia,  or  the  bitartrate  of  potash  n  combination  with 
jalap. 

The  effect  of  a  full  dose  of  Epsom  kialts  is  equal  to  the  abstraction 
of  a  pint  of  blood  from  the  system.  Depletion  is  obtained  this  way 
without  the  impoverishment  of  the  blood. 

The  frequency  and  force  of  the  heart's  action  may  also  be  affected 
by  the  nauseant  sedati  'es,  such  as  tartarized  antimony  and  ipecacuanha, 
and  by  the  direct-  ««dauve/3,  su^-h  as  the  tincture  of  aconite  and  of 
veratrum  viride ;  thereto  -e.  if  blood-letting  is  contra^indicated,  the 
first  thing  to  be  done  is  to  gV,  c  the  sulphate  of  magnesia,  and  follow 
it  with  a  full  opiate  in  the  shape  of  Dover's  powder,  to  alleviate  the 
painful  stitch  in  the  side  and  to  tranquilize  the  system.  (See  addi- 
tional treatment  p.  876.) 

Lung  Feyer.  —  Pneumonia. 

This  disease,  by  common  usage,  has  been  called  a  fever;  but  by 
physicians  it  is  reckoned  one  of  the  inflammations.  It  is  inflamma- 
tion of  the  lungs  or  lights;  and  whatever  fever  there  may  be  results 
entirely  from  this  local  inflammation. 


on 


DISEASES  OF  THE  CHEST. 


241 


fever,  with 
tible.  But 
»n  the  cheat 

tlie  person 
»,  is  one  of 

jefore  effu- 

ack  of  (In/ 

Dusiderable 

overs  per- 

d  seriously 


and  treat- 
inflamma- 
nset  t()  the 
ge  of  effu- 
h ;  and  the 
tion  of  the 

ery  slowly 
chronio 
arrest  the 
the  amount 

companied 
'he  abstrac- 
id  diminish 
ly,  and  is  of 
tuted  for  it. 
Buch  &a  the 
nation  with 

abstraction 
id  this  way 

be  affected 
ecacuanha, 
lite  and  of 
icated,  the 
and  follow 
leviate  the 
(See  addi- 


r;  but  by 
inflamma- 
be  results 


8ig^  and  Symptoms, —  A  patient  suffering  with  lung  fever,  is  gen- 
erally found  lying  upon  his  back,  with  some  pain  in  the  side ;  more 
or  less  difficulty  of  breathing ;  a  cough,  at  first  dry,  but  soon  accom- 
panied by  raising  a  thick,  sticky,  rusty-colored  matter,  composed  of  a 
mixture  of  phlegm  and  blood.  As  the  disease  increases  in  severity, 
this  matter  will  become  more  sticky  and  tenacious,  so  that  it  will  ad- 
here to  a  spit-cup  turned  upside  down.  There  will  be  more  difficulty 
of  breathing,  greater  prostration,  and  perhaps  some  delirium. 

For  the  purpose  of  more  clearly  describing  this  complaint,  it  is 
foui)  I  convenient  to  divide  it  into  three  stages,  or  degrees  of  progress. 

First  Stage, —  This  is  called  the  stage  of  engorgement.  The  lungs 
during  this  stage  are  engorged  or  crowded  with  blood.  If  we  could 
inspect  them,  we  should  find  the  inflamed  portion  redder,  thicker,  and 
heavier  than  usual.  We  should  find  them  weaker,  that  is,  more 
easily  torn  than  in  the  natural  state ;  with  less  air  in  them,  and  con- 
sequently crackling  less  upon  pressure,  —  yet  not  entirely  destitute  of 
air  and  crackling,  and  not  so  heavy  as  to  sink  in  water.  Rapping 
upon  the  chest  at  this  period  gives  out  a  flatter,  duller,  or  less  hollow 
pound  than  usual.  On  applying  the  stethoscope,  we  hear  less  of  the 
natural  rustling  sound  of  health  ;  and,  either  mingling  with,  or  over- 
coming it,  we  hear  a  minute  crackling  sound,  as  the  air  passes  in  and 
out  in  breathing. 

This  crackling  has  been  compared  to  that  produced  by  fine  salt 
throwii  upon  red-hot  coals  ;  or  by  that  of  rubbing  a  lock  of  fine  hair 
between  the  thumb  and  finger  near  the  ear.  It  is  caused  by  small 
bubbles  of  air  being  forced  along  the  moist  and  sticky  sides  of  the 
small  tubes  and  air-cells.  It  is  heard  only  while  the  breath  is  being 
drawn  in. 

Second  Stage.  —  If  the  inflammation  advances  to  the  second  stage, 
the  swelling  of  the  diseased  lung  increases  so  as  to  force  out  the  air 
entirely,  and  it  becomes  solid,  and  wholly  useless  for  the  purpose  of 
breathing.  In  solidity  and  general  appearance,  it  resembles  a  piece 
of  liver.  Hence  it  is  said  to  be  hepatized,  or  liverized ;  and  this  is 
called  the  stage  of  hepatization. 

As  the  lung  grows  more  solid,  its  vitality  and  strength  diminish ; 
il  is  not  near  as  strong  as  a  piece  of  healthy  liver,  though  it  looks  like 
it ;  it  is  soft  and  easily  broken ;  indeed  it  seems  to  be  in  a  state  of 
commencing  decay  or  rottenness.  Hence  some  writers,  in  order  to 
L-e  more  precisely  correct,  call  this  the  stage  of  red  softening. 

With  increased  solidity,  there  is  of  course  increased  dulness  on 
percussion.  When  the  stethoscope  is  applied  to  the  chest,  we  hear 
no  bound  of  air  passing  into  and  out  of  the  diseased  lung ;  no  natu- 
ral rustling,  or  minute  crackling ;  but  in  their  stead,  we  have  a  kind 
of  whistling,  produced  by  the  air  passing  back  and  forth  in  the  wind- 
pipe and  its  branches,  but  finding  no  entrance  into  the  solidified  air- 
cells.  The  breathing  sometimes  sounds  fike  a  sort  of  puff,  —  owing 
to  the  columii  of  air  rebounding  when  refused  admission  to  the 
closed-up  cells. 

The  general  symptoms  now  increase  in  severity.     There  is  gpreater 

31 


difficulty  of  breathing  ;  the  phlegm  is  more  gluey  ;  perhaps  some  delirium 
shows  itself  ;  and  the  patient  grows  weaker. 

Third  Stage.  —  At  this  period,  the  lung  changes  from  red  hepatization  or  red 
toftening  to  gray  hepatization  or  gray  eoftening,  and  matter  is  now  found  dif- 
fused through  its  waole  substance.  The  percussion  sounds  are  much  the  same 
as  in  the  second  stage.  On  listening,  wo  hear  more  of  the  rattling  sound  pro- 
duced by  disturbed  phlegm.  The  matter  raised  is  thinner,  —  more  like  liquid  ; 
and  looks  like  prune-juice.  The  symptoms  generally  indicate  that  the  patient 
is  sinking.  Patients  may  recover  from  the  Aiat  and  second  stages,  but  rarely 
from  the  third. 

TrMtnent.  —  Pneumonitis  has  been  divided  into  three  stages,  corresponding 
to  the  inflammatory  events  of  the  disease:  the  first  stage  is  that  of  active  con- 
gestion, the  second  that  of  solidification,  and  the  third  that  of  resolution. 
The  duration  of  the  first  stage  is  from  twenty-four  to  forty-eight  hours,  of  the 
second  from  two  to  four  days,  and  the  stage  of  resolution  lasts  from  eight  to 
ten  days.  Different  cases  vary,  however,  in  these  times.  These  different 
stages  furnish  different  remedial  indications. 

The  objects  of  treatment  in  the  first  stage  are  to  arrest  the  disease,  to  lessen 
its  intensity,  to  relieve  pain,  and  to  promote  toleration  of  the  disease. 

When  high  fever,  a  hard  pulse,  and  extreme  pain  are  present  in  a  robust 
constitution,  the  abstraction  of  blood  from  the  arm  is  indicated.  These  cases 
are  not  frequent,  for  lung  fever  mostly  occurs  in  patients  with  feeble  constitu- 
tions, but  when  practised  in  the  proper  cases,  the  relief  to  pain  and  embarrass- 
ment of  breathing  is  often  immediate  and  marked.  In  those  cases  where 
blood-letting  is  contra-indicated,  the  same  end  can  be  secured,  but  more  slowly, 
by  saline  cathartics  and  sedative  remedies.  After  saline  purgation,  if  the 
skin  is  hot  and  the  pulse  is  frequent,  tartar  emetic  may  be  given  in  small 
doses  as  a  nauseant  sedative;  but  it  must  not  be  carried  to  the  extent  of  dis- 
tressing nausea.  After  this  follows  the  use  of  vascular  sedatives,  such  as  the 
tincture  of  aconite  and  the  tincture  of  veratrum  viride,  if  not  contra-indicated 
by  the  feebleness  of  the  patient  with  a  tendency  to  depresuion. 

Sometimes  the  sulphate  of  quinine,  in  a  full  dose  of  from  twenty  to  forty 
grains,  at  the  onset  or  within  eight  or  ten  hours,  will  arrest  the  disease.  It 
may  be  well  to  try  it,  as  it  can  be  administered  with  perfect  safety.  Opium  is 
o'  great  importance  also,  to  relieve  pain  and  tranquillize  the  system. 

Cold  or  warm  application  to  the  chest  may  be  used  according  to  the  prefer, 
ences  of  the  patient.  Warm  applications  act  as  revulsents;  the  cold  diminishes 
the  determination  of  blood  to  the  part,  and  relieves  the  pain  by  obtunding 
sensibility.    Counter-irritants  are  not  advisable  in  this  stage. 

The  treatment  of  the  second  stage  aims  at  the  promotion  of  resolution  of  the 
Inflammation,  the  palliation  of  the  symptoms,  and  the  maintenance  of  the  powers 
of  life. 

The  tinctures  of  veratrum  viride  and  aconite  may  be  continued  in  this  stage, 
if  there  is  considerable  fever  and  there  is  no  tendency  to  asthenia;  but  the 
leading  measure  is  to  support  the  system. 

This  course  embraces  the  use  of  tonics,  stimulants,  and  nutritious  diet 
The  use  of  alcohols  is  uecessaty  in  most  cases,  and  sometimes  very  freely. 


.._3Si.2^ii.33sc,%';"M,T^\a®;.SfSKs/.?'yar^ 


■  lIBHf  MMUll^WWliJI 


t,»wmuiH...  JUWIMBIWI 


me  delirium 


zation  or  red 
iw  found  dif- 
uch  the  same 
g  sound  pro- 
e  like  liquid ; 
it  the  patient 
is,  but  rarely 


orresponding 
f  active  con- 
f  resolution, 
hours,  of  the 
Tom  eight  to 
lese  different 

ase,  to  lessen 
sase. 

t  in  a  robust 
These  cases 
eble  constitu- 
id  embarrass- 
i  cases  where 
;  more  slowly, 
jation,  if  the 
Ten  in  small 
extent  of  dis- 
I,  such  as  the 
atra-indicated 

renty  to  forty 

e  disease.    It 

;y.    Opium  is 

3m. 

to  the  prefers 

>ld  diminishes 

by  obtuuding 

iolution  of  the 
I  of  the  powers 

in  this  stage, 
tenia;  but  the 

iitritious  diet 
8  very  freely. 


DISEASES  OF  THE    CHEST. 


213 


The  diet  should  consist  of  milk,  farinaceous  substances,  and  animal  broths. 
Quinine  in  tonic  doses  is  the  best  remedy  in  this  stage. 

The  preparations  of  opium  are  very  useful,  and  only  contra-indicated  by  the 
accumulation  of  mucus  in  the  bronchial  tubes. 

Digitalis  is  useful  in  five  to  ten  grain  doses  three  or  four  times  a  day,  when 
it  is  necessary  to  increase  the  heart's  action. 

The  carbonate  of  ammonia  is  necessary  in  cases  of  extreme  prostration. 

The  external  application  of  the  tincture  of  iodine  is  the  best  counter-irritant 
in  this  stage. 

During  the  third  stage,  all  those  hygienic  measures  which  improve  the  gen- 
eral health  are  to  be  pursued.  .      • 

Typhoid  Lung  Fever.  —  Typhoid  I^ieunionia. 

This  is  an  inflammation  of  the  lungs,  differing  from  the  preceding  only  in 
the  character  of  the  fever  attending  it,  which  is  of  a  low,  typhoid  character. 
The  disease,  like  typhoid  fever,  is  characterized  by  great  debility  and  prostra- 
tion. 

KymptODis.  —  These  are  a  combination  of  the  symptoms  of  pneumonia  and  of 
typhoid  fever.  The  disease  begins  with  great  weariness,  lassitude,  dizziness, 
pain  in  the  head,  back,  and  limbs.  Soon  there  is  much  difficulty  of  breathing, 
tightness  across  the  chest,  with  a  dry,  short,  Iiacking  cough. 

As  the  disease  advances,  the  active  symptoms  pass  away;  there  is  a  dull  pain 
across  the  chest;  drowsiness  is  very  apt  to  come  on,  with  the  various  symptoms 
of  sinking  peculiar  to  tjrphoid  fever.  The  skin  is  harsh  and  dry,  the  tempera- 
ture uneven,  the  tip  and  edge  of  the  tongue  red,  and  the  middle  covered  with  a 
yellow  or  brown  fur.  The  bowels  are  tender,  swollen,  and  drum-head  like; 
while  there  is  often  a  diarrhoea,  —  the  discharges  having  a  dirty-yellow  color. 

TrMtment.  —  This  should  be  like  the  treatment  of  pneumonia  and  typhoid 
fever  united. 

Great  care  must  be  taken  not  to  use  reducing  remedies.  While  active  pur- 
ging must  not  be  used,  yet,  if  there  are  symptons  of  an  inactive  state  of  the 
bowels,  podophyllin  and  leptandrin,  (34),  (39),  may  be  employed  with  ad  van- 
tage. 

When  there  are  symptoms  of  great  depression,  use  tonics  (46),  (48),  (50), 
(63),  (60),  (64),  (67),  (73),  taking  care  to  keep  the  cough  loose  by  flaxseed, 
slippery  elm,  and  marshmallow  tea,  and  by  some  external  irritant. 

Asthma. 

Asthma  may  be  defined  to  be  great  difficulty  of  drawing  in  the  breath,— 
coming  on  suddenly,  sometimes  gradually,  —  accompanied  with  a  sense  of 
extreme  suffocation,  and  a  desire  for  fresh  air;  continuing  for  a  longer  or 
shorter  period,  and  then  passing  away,  and  leaving  the  patient  a  period  of  com- 
paratively easy  respiration. 

Symptoms.  — There  are  sometimes  no  premonitory  symptoms,  the  attack 
coming  on  suddenly,  and  without  warning;  but  more  frequently  there  are,  for 
some  days  before  the  onset,  loss  of  appetite,  flatulence,  belching  of  winJ,  irri- 
tability, languor,  chilliness,  oppression,  and  drowsiness.  The  hard  breathing 
generally  makes  its  appearance  in  the  night,  —  quite  often  at  three  or  four  o'clock 


in  the  morning,  when  tlie  nervous  pysfcrni  aS  at  its  lowest  ebb.  There  is  first  a 
sense  of  tightness,  or  stricture,  across  tlio  chest,  which  seems  to  expand  with 
ditticulty.  The  patient  can  no  longer  '  cm.iin  lying  dov.n;  he  rises  up,  draws  up 
his  knees,  and,  leaning  forward,  pi  ts  Ms  elbows  upon  them,  and  his  head  upon 
his  hands,  and  then  struggles  hari  t  >  d.-aw  in  his  breath;  which,  passing  in 
slowly  and  laboriously,  produces  a  loi  1  v/heezing  sound.  Sometimes  he  feels 
that  he  must  have  fresh  air,  and,  rus  ilng  to  a  window,  puts  his  head  far  out, 
to  catch  a  stirring  breeze.  The  hsnd  ;  ar.d  feet  are  cold,  the  face  haggard  and 
distressed,  —  sometimes  a  little  red  a  id  swollen,  but  more  generally  pale  and 
shrunk,  —  the  body  wet  with  persp  Ira  ion,'tlio  pulse  irregular,  feeble,  and  small, 
though  sometimes  not  disturbed.  Tl  eso  symptoms  continue  for  some  hours, 
n)oro  or  less,  when  the  breathing  bt  covnes  more  easy,  and  there  is  a  little 
phk'gra  raised,  sometimes  consiienbl !.  This  cessation  of  diflScult  breathing 
m;iy  be  complete,  or  only  partial ;  a  id  asts  for  a  longer  or  shorter  period,  when 
the  attack  again  recurs. 

Canses.  —  It  is  well  known  that  A.st,.\ma  has  its  cause  mainly  in  the  nervous 
system.  The  air  tubes  are  encircled  with  a  series  of  little  bundles  of  fibres, 
which  are,  in  fact,  muscles,  and  like  all  other  muscles,  have  the  power  of 
contracting  or  shortening  themsolvts.  These  muscles,  too,  like  all  others, 
have  nerves  distributed  to  them;  and  when  these  nerves  become  diseased  or 
irritable,  they  will  become  disturbed  on  certain  occasions,  and  cause  these 
small,  circular  puckering  strings  to  contract  and  close  up  the  air  tubes  near 
their  termimations,  very  much  as  the  puckering  string  closes  the  mouth  of  the 
work-bag,  so  that  veiy  little  air  can  pass  into  the  air  cells,  and  that  little  with 
great  difficulty  and  slowness.  When  these  contractions  take  place,  and  the  air 
is  thus  shut  off,  the  result  is  a  fit  of  asthma.  This  disease  may  be  brought  on 
ey  any  of  those  states  of  the  atmosphere  which  disturb  or  irritate  the  bron- 
chial surfaces,  or  by  any  of  the  numerous  causes  which  mysteriously  unbalance 
the  nervous  system.    A  fit  may  be  brought  on  by  whatever  disturbs  the  mind. 

Treatment.  —  The  disease  has  been  regarded  as  extremely  difficult  of  cure. 
There  are  certain  remedies,  however,  which  have  a  remarkable  control  over  it, 
and  if  skilfully  used,  will  frequently  bring  it  to  a  complete  termination,  and 
even  in  the  worst  cases,  to  a  state  of  very  great  mitigation  and  improvement. 

Inhalation.  —  The  most  important  and  certain  remedy  is  the  use  of  the 
Alterative  Inhalant,  described  on  page  221.  I  have  with  this  article  alone 
effected  some  surprising  cures;  yet  it  is  well  to  combine  other  treatment  with 
ft.  I  have  had  several  cases  of  a  most  distressing  character,  —  the  attaoks  con- 
tinuing night  and  day,  —  in  which  the  inhalation,  judiciously  administered, 
has  caused  the  disappearance  of  the  complaint  within  twenty-four  hours,  and 
in  which  no  return  of  suffering  has  occurred  for  several  weeks,  and  then  only 
in  a  modified  form.    This  remedy  should  be  used  four  or  five  times  a  day. 

Iodide  of  potassium  is  a  most  valuable  internal  remedy  in  this  complaint, 
indeed,  in  a  certain  sense,  it  is  almost  a  specific.  It  should  be  used  (prescrip- 
tions 101, 138, 140, 151)  at  the  same  time  with  the  inhalation.  Tlie  following 
preparation  is  a  very  good  remedy  for  this  disease:  Ethereal  tincture  of  lobe; 
lia,  two  ounces;  tincture  of  asafoetida,  one  ounce;  laudanum,  one  ounce; 
iodide  of  potassium,  two  ounces;  simple  syrup,  four  ounces.  Mix.  Dose, 
from  a  teaapoonful  to  a  tablespoonful,  every  hour  or  two. 

.Several  oUier  remedies  are  used  for  asthma,  with  more  or  less  success,  — 


kre  is  first  a 
Ixpand  with 
|p,  draws  up 

head  upon 
I,  passing  in 
|es  he  feels 
ijad  far  out, 
laggard  and 
}\y  pale  and 
!,and  small, 
bome  hours, 

is  a  little 
It  breathing 
keriod,  when 

the  nervous 

es  of  fibres, 

»e  power  of 

all  others, 

diseased  or 
cause  these 

tubes  near 
nouth  of  the 
it  little  with 
,  and  the  air 

brought  on 
te  the  bron- 
ly  unbalance 
bs  the  mind. 

cult  of  cure, 
atrol  over  it, 
lination,  and 
nprovement. 

use  of  the 
article  alone 
satmeut  with 
attacks  con- 
drainistered, 
r  hours,  and 
id  then  only 
IS  a  day. 
3  complaint, 
ed  (prescrip- 
le  following 
ure  of  lobe; 
one  ounce; 
ilix.     Dose, 


DISEASES   OF   THE   OH  EST. 


245 


such  as  electro-magnetism,  smoking  stramonium  leaves,  burning  paper  dipped 
in  a  strong  solution  of  nitrate  of  potash,  and  inhaling  the  smoke,  etc.,  —  but 
none  of  these  have  us  much  value  as  the  two  remedies  first  named. 

In  as  grave  a  complaint  as  a  severe  case  of  asthma,  it  is  always  well  to  seek 
the  aid  of  a  physician.  I  intended  to  have  given  some  interesting  cases,  but 
want  of  space  forbids. 

^        Hay- Asthma.  —  Hay-Pever. 

This  is  a  very  troublesome  complaint,  which  seems  to  combine  the  peculiar- 
ities  both  of  asthma  and  of  influenza.  Fortunately,  it  attacks  but  few  persons, 
and  those  only  at  particular  seasons  of  the  year,  —  namely,  while  hay  is  in  blos- 
som, and  during  hay-making. 

Symptoms*  —  These  are  a  combination  cf  the  symptoms  of  the  two  diseases 
above  named.  There  is  great  irritation  of  the  eyes,  with  sneezing,  and  a  free 
discharge  from  the  nose.  There  is  tightness  across  the  chest,  diflSculty  of 
breathing,  and  a  pricking  sensation  in  the  throat.  These  symptoms  often 
appear  in  great  severity,  making  the  complaint  a  really  distressing  one. 

Caose.  —  This  disorder  appears  to  have  but  one  cause,  —  namely,  some  sort  of 
emanations  from  the  grasses,  flowers,  etc.,  while  in  blossom;  which  emanations 
come  in  contact  with  the'mucous  lining  of  the  eyes,  nose,  and  throat,  producing 
very  great  and  teasing  irritation. 

Treatment.  —  One  of  the  best  remedies  for  this  troublesome  complaint  is  to 
avoid  the  cause,  by  removing,  during  the  flowering  and  haying  season,  to  some 
large  city,  or,  still  better,  close  down  to  the  seashore,  where  flowers  and  hay  do 
not  grow. 

Of  medicines,  the  tincture  of  lobelia,  taken  in  moderate  doses,  is  a  very  good 
remedy.  Quinino  and  iron,  given  in  combination  (75),  are  valuable  prepara- 
tions. Strychnine  and  nux  vomica,  in  connectioJi  with  iron,  or  otherwise 
(316),  (83),  (84),  (85),  (86),  (95),  are  very  useful.  Iodide  of  potassium  (101), 
(138),  (140),  is  also  worth  a  trial.  Another  very  good  remedy  is  the  chloride  of 
Ume,  or  the  chloride  of  soda,  placed  in  sswers  about  the  sleeping-room. 
Pieces  of  cotton  cloth  may  also  be  dipped  in  one  of  these  solutions,  and  hung 
about  the  apartments  of  the  house.  The  laands  and  face  may  likewise  be 
washed,  once  or  twice  a  day,  in  a  weak  solution. 

The  oxide  of  zinc  and  the  extract  of  nux  vomica,  made  into  pills,  two  grains 
of  the  zinc  to  half  a  grain  of  the  extract  to  each  pill,  and  one  pill  taken  mom* 
lug  aad  eTeumg,  should  not  be  forgotten. 


HEART   DISEASES. 


Life  rests  upon  a  tripod,  —  the  brain,  the  lungs,  and  the  heart 
These  are  equally  important  to  its  well-being  and  continuance. 

In  substance,  the  human  heart  h  u  bundle  of  muscles,  so  put  to- 
gether as  to  bear  the  greatest  possible  amount  of  work.  In  size, 
shape,  and  look,  it  is  much  like  the  heart  of  the  hog.  I  wish  it  never 
had  a  likeness  to  it  in  its  moral  nature. 

The  heart  is  enclosed  in  a  case  or  sac,  called  the  pericardium.  It 
lies  between  the  two  lungs,  a  little  to  the  left  side  of  the  chest.  Its 
point  is  under  the  sixth  rib  on  the  left  side,  and  its  lower  surface  rests 
on  the  diaphragm, — a  horizontal  partition  between  the  chest  and  belly. 

The  heart  is  double.  It  has  four  cavities,  —  two  for  receiving  the 
blood,  which  are  called  auricles,  and  two  for  driving  it  out,  called 
ventricles. 

The  venous,  or  dark  blood,  is  brought  from  all  parts  below,  and 
emptied  into  the  right  auricle  through  the  ascending  vena  cava,  and 
from  all  parts  from  above,  and  poured  into  the  same  cavity  through 
the  descending  vena  cava.  From  this  it  passes  into  the  right  ventri- 
cle, which  contracts,  and  forces  it  through  the  pulmonary  artery  into 
the  lungs,  where  it  becomes  red,  and  passes  into  the  left  auricle 
through  the  pulmonary  vein,  thence  into  the  left  ventricle,  which  con- 
tracts, and  throws  it  out  through  the  great  aorta  to  all  parta  of  the 
body.  Fig.  93  gives  a  good  idea  of  the  circulation  through  the  heart 
and  lungs. 

The  heart  is  divided  into  two  sides,  which  are  separated  from  each 
other  by  a  muscular  partition,  —  each  side  having  an  auricle  and  a 
ventricle. 

The  auricles  have  comparatively  thin  walls,  as  they  are  only  used 
for  reservoirs.  The  walls  of  the  ventricles  are  much  thicker,  being 
used, —  particularly  that  of  the  left  side,  —  for  forcing  the  blood  over 
a  large  surface. 

Between  the  auricle  and  ventricle  on  the  right  side,  are  three  folds 
of  triangular  membrane,  called  the  tricuspid  valves.  Between  the 
auricle  and  ventricle  on  the  left  side,  are  three  valves,  called  mitral. 

At  the  beginning  of  the  pulmanarp  artery,  and  the  aorta,  are  three 
half-moon  shaped  folds  of  membrane,  called  semilunar  valves. 

The  office  of  all  these  valves  is,  to  close  after  the  blood  has  gone 
through,  and  prevent  its  flowing  baok  while  the  cavity  is  being  agaia 
filled.     They  do  the  same  duty,  in  fact,  as  the  valves  of  a  pump. 


|he  heart 

e. 
put  to- 
In  size, 
it  never 

lium.  It 
lest.  Its 
face  rests 
ind  belly, 
iving  the 
ut,  called 

slow,  and 
cava,  and 
f  through 
nt  ventri- 
rtery  into 
ft  auricle 
hich  cou- 
rts of  the 
the  heart 

rom  each 
cle  and  a 

)nly  used 
:er,  being 
ood  over 

ree  folds 
veen  the 
mitral. 
ire  three 

las  gone 
ng  agaia 
mp. 


HEART  DISEASKS. 


247 


Through  this  heart,  thus  constructed,  all  the  blood  in  the  body,  — 
about  twenty-eight  poundu,  —  paHues  once  in  about  one  minute  and  a 
halt  This  is  r.  pid  work  ;  and  when  we  consider  that  the  heart 
works  in  this  way  through  the  whole  life,  resting  not,  day  or  night, 
we  cannot  wonder  that  it  gets  out  of  order. 

Fia.  ge. 


The  whole  heart  is  seldom  afTected. 
to  disease  than  the  right. 


The  left  side  is  more  liable 


Impulse  of  the  Heart. 

The  ear  when  placed  over  the  heart,  feels,  at  each  beat,  a  slight 
shock.  This  is  felt  at  the  same  time  the  first  sound  is  heard.  This 
impulse  is  caused  by  the  apex  or  point  of  the  heart  being  thrown  up 
against  the  ribs  by  the  contraction  of  the  ventricles.  It  is  felt  best 
between  the  cartilages  of  the  fifth  and  sixth  ribs  on  the  left  side. 

The  Sounds  of  the  Heart. 

On  applying  the  ear  to  the  chest  just  over  the  heart,  two  sounds 
are  heard.  The  first  one  is  dull  and  slightly  prolonged ;  the  second 
is  a  shorter  and  smarter  sound,  having  a  sort  of  clack.  These  occur 
in  pretty  rapid  succession,  and  then  comes  a  brief  interval.  And  this 
round  of  action,  first  a  long  and  dull  sound,  then  a  short  and  smart 
one,  and  then  an  interval,  —  called  the  heart's  rhythm,  —  is  repeated 
continually.  If  the  space  of  time  occupied  by  the  rhythm  be  divided 
into  five  parts,  the  first  sound  will  take  about  two  parts,  the  second 
one,  and  the  interval  of  repose,  the  remaining  two.  The  first  sound 
is  heard  about  the  time  of  the  contraction  of  the  ventricles,  and  is 
therefore  called  the  systolic  sound    the  second  is  synchronous  with 


the  opening  of  the  ventricIeB,  and  is  called  the  diastolic  Bound. 
The  syllables  too-to  —  too-lo,  very  fairly  repreHent  the  two  sounds  of 
the  heart.  These  sounds  are  heard  over  the  largeit  space  in  lean 
persons. 

Percussion  Sounds. 

If  the  endj  of  the  fingers  be  struck  upon  the  chest  over  the  heart, 
a  dull  sound  will  be  heard  over  a  space  from  one  and  a  half  to  two 
inches  square, —  beginning  at  the  fourth  rib  on  the  left  side,  and  ex- 
tending down  nearly  to  the  sixth.  The  dulness  is  diminished  by 
lying  upon  the  buck,  and  increased  by  leaning  forward,  and  by  taking 
a  full  breath.  The  deadness  of  S'  und  is  caused  by  the  heart  being 
a  partially  solid  body.  The  lungs  which  surround  it,  yield  a  clear 
sound. 

If  a  solid  substance,  as  large  as  the  heart,  were  placed  on  the  inside 
of  a  drum,  against  the  head,  only  a  dead  sound  would  be  obtained  by 
striking  on  that  spot ;  everywhere  else,  the  sound  would  be  louder. 


\m 


•a; 


Altered  Sounds  of  the  Heart. 

These  sounds  are  changed  by  disease  in  a  variety  of  ways,  both  as 
to  their  character  and  duration.  One  or  both  sounds  may  be  turned 
into  a  noise  like  the  blowing  of  a  pair  of  bellows.  This  is  called  the 
bellows  sound.  When  this  sound  is  very  harsh,  it  may  become  like 
the  noise  of  a  rasp,  or  file,  or  saw.  These  altered  sounds  are  all  pro- 
duced by  an  altered  condition  of  the  valvular  passages  through  which 
the  blood  passes.  If  you  build  an  aqueduct  of  equal  dimensions 
throughout,  and  smooth  on  the  inside,  you  may  send  a  certain  vol- 
ume of  water  through,  at  a  given  speed,  without  noise.  But  if  you 
make  sudden  contractions  in  the  aqueduct,  or  allow  large  stones  to 
project  into  it,  and  then  attempt  to  send  through  the  same  body  of 
water,  at  the  same  rate  of  speed,  you  will  hear  all  sorts  of  noises. 


Enlargement  or  Hypertrophy  of  the  Ventricles. 

This  is  simply  a  thickening,  or  an  increase  of  bulk,  in  the  walls  of 
the  ventricles.  The  muscles  composing  the  walls  of  one  or  both  of 
these  cavities,  grow  thick  and  large. 

Physical  Sifns.  —  Impulse  stronger  than  natural.  When  consider- 
able, it  is  accompanied  with  a  lifting  and  heaving  of  the  parts.  DuU 
sound  on  percussion  over  a  larger  space.  First  sound  of  heart  pro- 
longed ;  second  sound  feeble.  The  interval  of  silence,  shorter  than 
natural.     In  bad  cases,  the  second  sound  is  nearly  extinguished. 

General  Symptoms.  —  Hypertrophy  of  left  ventricle  gives  a  strongs 
prolonged,  and  tense  pulse.  Palpitation  more  constant  than  in  any 
other  disease  of  the  heart  In  advanced  stages,  the  patient  is  easily 
out  of  breath.     There  is  a  rush  of  blood  to  the  head  on  making  exer- 


HEART  PI8RA8RS. 


349 


itc  Bound. 
Bounds  of 
ce  in  lean 


the  heart, 
alf  to  two 
and  ex- 
nished   by 

by  taking 
!art  being 

d  a  clear 

the  inside 
Jtained  by 
louder. 


rs,  both  as 
be  turned 
called  the 
come  like 
ire  all  pro- 
igh  which 
imensiona 
?rtaiii  vol- 
Jut  if  you 
stones  to 
e  body  of 
loises. 

icies. 

B  walls  of 
)r  both  of 


consider- 
rts.  Dull 
leart  pro- 
rter  tnan 
led. 

a  strongs 

n  in  any 

is  easily 

:ing  exer- 


tion, or  stooping,  with  more  or  less  throbbing  and  lancinating  head- 
aches,  which  are  aggravated  by  suddenly  lying  down  or  rismg  up. 
There  arc  vertigo,  ringing  in  the  ears,  spnrkn  of  light  and  other  illusions 
before  the  eyes;  also  a  purplish,  violet,  or  livid  color  upon  the  checks, 
nose,  and  lips.  In  many  cases  there  is  a  dull,  severe,  aching  pain  in 
the  region  of  the  heart,  and  extending  towards  the  shoulder  and  the 
inside  of  the  arm. 

When  the  right  ventricle  is  enlarged,  there  is  a  swelling  of  the  ex- 
ternal jugular  veins. 

CuusfS.  —  The  walls  of  the  heart  are  thickened  by  overwork,  in  the 
same  way  that  the  blacksmith's  arm  is  made  muscular  and  large.  All 
mp^cles  grow  in  the  same  way.  More  action  sends  more  blood  to 
them,  and  this  causes  an  increase  of  nutrition. 

Whatever  int/Crposes  an  obstacle  to  the  passage  if  the  blood  through 
the  valvular  openings,  will  cause  the  ventricles  which  force  it  through 
to  work  harder.  Hence,  obstructions  in  the  semilunar  valves  cause 
hypertrophy  of  the  ventricles. 

Any  excitement  of  the  mind,  or  any  great  exertion,  which  causes 
the  heart  to  beat  harder  and  faster,  if  it  be  often  repeated,  will  induce 
a  thickening  of  the  ventricles. 

Treatment.  —  First,  remove,  as  far  as  possible,  all  causes  of  excite- 
ment which  produce  palpitation.  If  the  head  is  much  afl'ected,  apply 
wet  cups  to  the  back  of  the  neck.  The  same  may  be  applied  over  the 
heart  This  will  generally  improve  the  symptoms  at  once.  A  blister 
placed  over  the  heart  will  likewise  make  a  favorable  impression. 

The  meals  should  be  taken  at  regular  intervals,  and  should  be  very 
light.  The  food  should  be  plain  and  simple,  and  composed  much 
more  of  vegetable  than  of  animal  food.  In  fact,  the  diet  should  be 
so  spare  as  slightly  to  reduce  the  strength. 

The  patient  should  be  careful  never  to  take  violent  exercise,  or,  in- 
deed to  be  in  a  hurry  about  anything.  In  bad  cases,  walking  up  hill, 
or  against  a  strong  wind,  is  often  out  of  the  question,  and  must  in 
any  case  be  attempted  with  great  caution.  Stair-cases  are  to  be 
shunned  as  enemies.  An  attempt  to  run,  even  to  avoid  being  left  by 
the  cars,  might,  in  some  cases,  prove  immediately  fatal.  Carriage 
riding  is  not  objectionable. 

The  passions  must  be  held  in  the  most  thorough  subjection.  Ex- 
citements of  all  sorts  are  dangerous,  and  must  be  avoided. 

For  the  first  week  or  two  of  treatment,  active  purgatives  will  be 
useful.  For  this  purpose,  epsom  salts  ajid  senna  will  answer  a  good 
purpose,  and  should  be  used  so  as  to  procure  two  or  three  watery 
stools  a  day. 

In  addition  to  this,  some  sedative  to  lessen  the  force  of  the  heart's 
action,  is  generally  needed,  —  especially  when  there  is  considerable 
palpitation.  For  this  purpose,  tincture  of  black  cohosh,  and  tincture 
of  scullcap,  or  the  former  with  tincture  of  digitalis  (285)  (94),  are 
quite  useful  Three  to  ten  drops  of  tincture  of  the  American  helle- 
bore (veratrum  viride)  will  reduce  the  action  of  the  heart  perhaps 
more  effectually  than  any  other  medicine. 


f! 


SCO 


IIRART  DIRRASRS. 


Dilatation  of  the  Ventrioles. 

The  several  cavitiea  of  the  heart  hold  about  one  and  a  half  ounces 
each.  Dilatation  ia  siniplv  an  enlargement  of  thene  cavities,  so  that 
they  will  hold  more.  Ancl  this  increase  in  the  size  of  the  cavity  in 
simple  dilatation  is  generally  at  the  cost  of  the  walls,  which  are  made 
thinner  and  weaker, — just  as  the  walls  of  a  bladder  are  made  thinner 
by  blowing  into  it  and  increasing  its  internal  dimensions. 

Phygfcal  8ig;iu.  —  Impulse  more  abrupt,  and  less  marked  than  nat- 
ural. Dull  sound  on  percussion  commensurate  in  extent  with  the 
dilatation.  The  first  beat  of  the  heart,  clearer,  louder,  and  shorter 
than  natural,  and  more  nearly  resembling  the  second. 

General  Symptoms.  —  Difficulty  of  breathing;  terrific  dreams ;  start- 
ing from  sleep ;  swelling  of  the  feet  and  legs ;  purple,  violet,  or  blue 
color  of  cheeks,  nose,  lips,  and  especially  around  the  eyes ;  feeble  and 
oppressed  palpitation ;  various  disturbances  in  the  head ;  bleeding 
from  the  nose,  stomach,  bowels,  and  womb  ;  and  frequently  enlarge- 
ment of  the  liver. 

Explanations. —  The  first  sound  of  the  heart  is  short  and  not  well 
marked,  in  consequence  of  the  muscular  walls  of  the  ventricles  in 
this  di9eas(!  being  thin  and  in  a  weakened  condition,  so  that  every 
stroke  they  make  is  short,  quick,  and  spasmodic,  instead  of  strong 
and  lifting,  as  in  hypertrophy.  For  the  same  reason,  the  impulse  is 
a  brief  blow  dealt  the  walls  of  the  chest,  which  gives  a  slight  shock, 
but  has  not  power  enough  to  lift  the  chest  up.  The  blow  is  quick, 
because  the  muscle  is  thin  and  can  contract  quicker  than  a  thick  one. 

Dilatation,  by  thinning  the  walls  of  the  cavities,  enfeebles  the  heart, 
and  shows  us  an  obstructed  circulation.  Accordingly  the  blood  is 
not  transmitted  by  the  left  ventricle,  and  being  retained  in  the  lungs, 
it  causes  a  crowcfed  state  of  the  vessels,  and  difficulty  of  breathing ; 
also  congestion  of  the  brain,  with  terrific  dreams,  etc.  And  this  en- 
gorgement of  the  lungs,  being  propagated  backwards  to  the  right 
heart,  great  veins,  and  all  their  ramifications,  produces  dropsy  of  the 
feet  and  legs,  discoloration  of  the  face,  passive  hemorrhages,  and  con- 
gestion of  the  brain,  liver,  and  membranes.  Fig.  93  gives  an  idea 
of  how  all  this  happens. 

Treatment. —  As  in  many  other  diseases,  search  out  the  causes,  and 
remove  them.  If  it  be  obstruction  of  the  circulation  in  the  lungs  by 
bronchitis,  or  other  complaint,  that  needs  the  first  attention.  If  it  be 
caused  by  violent  exercise,  by  strong  emotions  of  the  mind  habitually 
indulged,  or  by  drunkenness,  or  any  other  irregularity  of  life,  these 
habits  must  be  corrected  without  delay. 

If  it  be  caused  by  organii  isease  of  the  valves  of  the  heart,  relief 
cannot  be  so  readily  obtaintid ;  but  even  in  these  cases,  it  is  to  be 
Bought  and  expected. 

The  circulation  is  to  be  kept  as  tranquil  as  possible  by  a  strictly 
quiet  and  orderly  life,  and  a  plain,  moderate,  unstimulating  diet     In 


half  ounces 

lities,  BO  that 

■the  cavity  in 

|ch  are  made 

lade  thinner 

\rd  than  nat- 

•nt  with  the 

and  shorter 


reams;  start- 
iolet,  or  blue 
feeble  and 
d ;  bleeding 
ntly  enlarge- 

nd  not  well 
ventricles  in 

0  that  every 
ad  of  strong 
e  impulse  is 
slight  shock, 
DW  is  quick, 

1  a  thick  one. 
les  the  heart, 
the  blood  is 
n  the  lungs, 
f  breathing ; 
vnd  this  en- 
to  the  riffht 
ropsy  of  the 
es,  and  con- 
vea  an  idea 


causes,  and 
he  lungs  by 
n.  If  it  be 
i  habitually 
•f  life,  these 

beart,  relief 
it  is  to  be 

>y  a  strictly 
g  diet     III 


HEART  DI8RA8RS. 


251 


this  disease,  however,  it  should  be  more  nutritious,  and  composed  to 
a  larger  extent  of  meats,  than  in  hypertrophy. 

In  some  cases  the  general  health  and  tone  of  the  system  will  need 
to  be  imoroved  by  bitters  (50)  (G7)  (<)4)  (69)  (79),  mineral  acids  (60), 
iron  (269)  (61),  and  aromatics  (115).  The  compound  mixture  of  iron 
is  a  good  preparation  when  this  mineral  is  calleu  fur  by  a  low  state  of 
the  blood. 

The  stomach  should  be  kept  in  the  best  possible  condition,  as  a 
very  small  disturbance  of  it,  even  from  acidity,  will  set  the  heart  to 
beating  very  violently. 

If  hysterical  symptoms  are  present,  the  compound  galbanum  pill, 
and  valerian  (97),  and  other  nervines  will  be  called  for. 

In  attacks  of  great  dilRculty  in  breathing,  immerse  all  the  extremi- 
ties in  warm  water,  and  throw  a  blanket  around  the  patient  to  pro- 
mote sweating,  —  at  the  same  time  admitting  fresh  air  to  satisfy  the 
desire  for  breath.  Give  a  draught,  composed  of  ether,  laudanum, 
ammonia,  etc.  (135).  This  may  be  repeated  two  or  three  times,  at 
intervals  of  half  an  hour,  or  an  hour,  according  to  the  urgency  of  the 
case. 

Hypertrophy  with  Slight  Dilatation. 

This  is  one  of  the  most  common  complications  of  heart  disease. 
It  consists  both  in  a  thickening  of  the  walls  of  the  heart,  and  an  en- 
largement of  the  cavities,  —  the  former  being  more  marked  than  the 
latter. 

Physical  Sig^S.  —  Both  sounds  are  louder  than  in  any  other  disease 
of  the  heart,  and  are  heard  sometimes  over  the  whole  chest.  The 
impulse  is  strong  and  heaving,  with  an  abrupt  buck-stroke.  In  bad 
cases,  the  whole  person,  and  even  the  b(!d,  is  shaken  by  it.  The  dull 
sound  on  percussion  covers  a  large  space. 

General  Symptoms. —  The  same  as  those  of  the  two  diseases  of 
which  it  is  composed,  slightly  modified  by  the  action  of  each  upon 
the  other. 

Dilatation  with  Slight  Hypertrophy. 

This  is  an  enlargement  of  the  cavities  of  the  heart,  with  a  slight 
thickening  of  its  walls  ;  the  dilatation  being  the  predominant  disease, 
or  greater  than  hypertrophy. 

Physical  Si^s. —  Percussion  gives  a  dull  sound  in  the  region  of  the 
heart,  in  proportion  to  its  size.  The  first  beat  resembles  the  second. 
The  second  beat  is  louder  than  natural. 

The  impulse  is  a  short,  quick  stroke,  which  contrasts  strongly  with 
the  slower  and  heaving  one  of  hypertrophy  with  dilatation. 

The  general  symptoms  and  the  treatment  are  a  modification  of 
those  of  the  two  diseases  united  in  it.  It  is,  however,  to  be  kept  in 
mind  that  the  dilatation  takes  the  lead ;  and,  furnishing  the  predomi- 
nant symptoms,  is  specially  to  be  regarded  in  the  treatment. 


w 


252 


HEART  DISRASES. 


Aneurismal  Tumors  of  the  Heart. 

When,  from  some  obstruction  in  the  valves,  the  blood  cannot  easily 
pass  out  of  an  auricle  or  a  ventricle,  its  inner  walls  may  beconie 
unable  to  bear  the  distending  force,  and  giving  way,  let  the  blood 
through  against  the  outer  coats,  which  stretch,  and  swell  out  into  the 
shape  of  a  tumor,  —  the  inside  of  the  tumor  becoming  a  regular  sac. 
Such  a  state  of  things  constitutes  an  aneurism  of  the  heart.  Of 
course  it  is  a  grave  disease. 

Softening  of  the  Heart. 

In  this  disease  the  substance  of  the  heart  becomes  soft,  and  easilj 
broken.     It  is  generally  the  result  of  some  form  of  inflammation. 

Physical  8i|;ns. —  The  contra^;';i(.  us  of  the  heart  being  weakened  by 
softening,  the  impulse  is  reduced  in  force,  and  both  beats  ave  weaker, 
and  often  they  are  intermittent  The  first  beat  becomes  short  and 
flapping,  like  the  second. 

Generei  Symptoms. — A  quick,  feeble,  small,  and  faltering  pulse, 
great  anxiety,  and  a  disposition  to  faint.  General  languor ;  a  sallow, 
bloodless,  withered  complexion,  with  a  purple,  livid  tint  of  the  lip» 
and  cheeks,  and  frequently,  general  dropsy,  from  the  inability  of  the 
heart  to  propel  its  contents. 

Treatment  —  When  accompanied  by  acute  inflammation,  softening 
is  to  be  treated  on  the  same  principles  as  inflammation  of  the  heart- 
case. 

If  it  be  a  result  of  chronic  inflammation,  it  calls  for  iron,  bitters, 
nutritious  animal  food,  and  good  air. 

Induration  of  the  Heart. 

The  muscular  substance  of  the  heart  sometimes  undergoes  a  hard- 
ening process.  It  is  occasionally  so  much  hardened  as  to  sound, 
when  struck,  like  a  hollow  horn  vessel.     The  disease  is  rare. 

It  increases  the  heart's  impulse,  like  hypertrophy ;  and  it  require* 
about  the  same  treatment  with  that  disease. 

Fatty  Degenerations  of  the  Heart. 

The  heart  ouictimes  becomes  overloaded  with  fat,  which  is  depos- 
ited betyeen  the  heart-case  and  the  muscular  substance,  —  covering 
the  organ  all  over  externally,  and  in  some  cases  penetrating  to  some 
depth  into  its  substance.  The  muscular  walls  themselves  become 
thin  and  flabby. 

Symptoms.  —  The  sounds  of  the  heart  are  diminished,  —  especially 
the  first  The  pulse  is  irregular.  Pain,  and  a  feeling  of  oppression 
in  the  region  of  the  heart,  with  general  signs  of  retarded  circulation, 


lannot  easily 
lay  beconie 
It  the  blood 
lout  into  the 
I  regular  sac. 
heart     Of 


h  and  easily 
(mation. 

'^eakened  by 
Bve  weaker, 
3  short  and 


ering  pulse, 
;  a  sallow, 
of  the  lips 

)ility  of  the 

'n,  softening 
►f  the  heart- 
iron,  bitters, 


fees  a  hard' 
}  to  sound, 
e. 
it  requires 


h  is  depos- 
—  covering 
ig  to  some 
es  become 

•  especially 
oppression 
sirculation, 


HEART  DISEASES. 


25ii 


such  as  congestion  of  the  brain  and  liver.     There  is  occasionally  gid- 
diness, loss  of  memory,  and  palpitation. 

Treatment.  —  Exercise,  mental  excitement,  and  stimulating  drinks 
must  be  avoided  ;  and  the  patient  must  live  for  one  or  two  years  on 
a  very  light  diet,  taking  but  very  little  animal  food. 

Bony  and  Cartilaginous  Productions  in  the  Heart. 

These  productions  in  the  heart  are  fortunately  rare.  Yet  they 
occur ;  and  the  point  of  the  heart,  in  its  whole  thickness,  is  some- 
times changed  to  cartilage.  The  ventricles  are  sometimes  so  ossified 
as  to  resemble  the  bones  of  the  head. 

The  symptoms  of  these  degenerations  are  obscure ;  and  as  such 
cases  are  not  curable,  it  is  of  less  consequence  that  we  should  be  able 
to  know  their  precise  nature  during  the  life  of  the  patient.  The  treat- 
ment can  only  afford  temporary  relief,  and  should  be  such  as  is  pre* 
scribed  in  other  heart  diseases  with  similar  symptoms. 

Shrinking  of  the  Heart. — Atrophy, 

The  heart,  like  any  other  muscle,  is  liable  to  defective  nutrition, 
and  in  consequence  of  it  may  become  small.  It  shrinks,  in  some 
cases,  to  the  size  of  an  infant's  heart. 

The  complaint  is  generally  caused  by  whatever  reduces  the  general 
flesh,  as  consumption,  diabetes,  chronic  dysentery,  cancer,  and  exces- 
sive loss  of  blood. 

It  can  hardly  be  called  a  disease.  Persons  who  have  it  are  less 
subject  to  inflammatory  diseases  than  others,  though  they  faint  from 
slight  causes,  and  have  nervous  affections. 

Treatmentt  —  If  its  causes  can  be  discovered,  treat  them ;  if  not 
the  treatment  should  be  the  same  as  for  dilatation. 

Acute  In^ammation  of  the  Heart-Case.  —  Pericarditis. 


The  pericardium,  or  heart-case,  is  a  membranous  sac,  in  which 

the  heai*  is  contained.     It  is  composed  of  two  layers.     The  outside 

one  \i  fibrous.,  dense,  and  white  ;  the  inside  one  is  serous.     The  serous 

layer  forms  the  lining  of  the  fibrous  one,  and  then  is  reflected,  over 

le  heu  t,  and  the  roots  of  +he, large  blood-vessels. 

When  the  pericardium  becomes  acutely  inflamed,  '  *hrow8  out, 
both  lymph,  and  serum  or  water.     The  lymph  often  .  the  two 

layers  of  the  sac  to  grow  together. 

Physical  8ig;ns.  —  The  impulse  is  strong  when  the  efTusion  of  water 
is  small,  —  feeble  and  unequal  -vhen  it  is  large.  Percussion  yields  a 
dull  sound  in  proportion  to  the  i  mount  of  fluid  in  t^e  sac. 

When  listening  with  the  stethoscope,  a  rough  noise  is  heard,  resem- 
bling either  the  rasping  of  wood,  the  grating  of  a  nutmeg,  the  rustling 
of  silk,  or  the  crackling  oi  parchnicnt.     SometimeA  it  is  softer,  like 


■ 


■  :irtSj?fvsE:AS;^c>v'' 


%■  -i — 


254 


HEART  DISEASES. 


the  blowing  of  a  pair  of  bellows.  Occasionally,  it  resembles  the 
creaking  of  a  new  shoe-sole,  or  has  a  low  creaking,  like  the  tearing 
of  linen  cloth. 

When  there  is  effusion,  the  ordinary  beats  of  the  heart  sound  dull 
and  distant. 

General  Symptoms.  —  Acute  inflammatory  fever  generally  preceded 
by  chills,  with  pungent  pain  in  the  region  of  the  heart,  shooting  to  the 
left  shoulder-blade,  shoulder,  and  upper  arm. 

Pain  increased  by  taking  a  full  breath,  by  stretching  the  left  side, 
by  percussion,  and  by  pressure  between  the  ribs  over  the  heart.  Some- 
times the  pain  is  in  the  epigastrium,  or  left  hypocondrium.  Inability 
to  lie  on  the  left  side. 

Explanation.  —  The  noises  mentioned  above,  are  produced  by  the 
rubbing  together  of  opposite  surfaces  of  the  heart-case,  made  rough 
by  the  exudation  of  lymph.  The  rasping  is  supposed  to  be  caused 
hy  firm  and  rvgged  lymph ;  the  rustling  and  crealang,  by  soft  and  wet 
lymph ;  the  bellows  murmur,  by  soft  and  dry  lymph ;  the  creaking, 
croaking,  and  crackling,  by  dry^  tough  lymph.  These  sounds  may  all 
be  imitated  by  rubbing  a  damp  finger  upon  the  back  of  the  hand, 
while  listening  with  the  stethoscope  applied  to  the  palm. 

Chronic  Inflammation  of  the  Heart-Case. 

"When  acute  pericarditis  runs  for  more  than  ten  days  or  a  fortnight, 
it  becomes  chronic.  It  is  chronic  from  the  beginning,  when  it  runs  a 
slow,  insidious  course,  without  marked  or  violent  symptoms. 

The  symptoms  are  much  the  same  in  kind  with  those  of  the  acute 
form,  only  less  in  degree.  This  low  grade  of  the  symptoms  of  the 
disease  renders  it  more  obscure  than  the  acute. 

Treatment.  —  In  the  acute  form  of  the  disease,  apply  wet  cups  over 
the  region  of  the  heart,  or  apply  from  a  dozen  to  forty  leeches  to  the 
same  parts. 

At  the  same  time,  move  the  bowels  freeiy  by  en  injection  (247),  or 
by  a  purgative  pill  (31). 

The  strength  and  amount  of  the  remedies  employed  in  each  case> 
must  be  in  proportion  to  the  vigor  of  the  patient's  constitution. 

It  is  oi'  great  importance  that  the  treatment  should  le  active  and 
prompt,  and  that  the  disease  should  be  broken  down  early. 

Diluent,  cooUng  drinks  (132)  (129)  (298)  (299)  should  be  allowed 
as  freely  as  the  patient  desires,  in  order  to  dilute  the  blood,  and  ren- 
der it  less  stimulating  to  the  heart. 

At  the  same  time,  five  to  fifteen-drop  doses  of  tincture  of  veratrum 
viride  should  be  given  every  hour,  to  bring  down  the  action  of  the 
heart 

Let  the  diet  be  wholly  of  barley-water,  thin  gruel,  weak  tea,  or 
airow  r«-  ot 

During  recovery,  the  diet  must  be  spare,  and  the  greatest  tranquil- 
lity of  mind  and  body  be  preserved. 


pembles  the 
the  tearing 

sound  dull 

lly  preceded 
loting  to  the 

le  left  side, 
^art.   Some- 
Inability 

iced  by  the 
lade  rough 
be  caused 
^oft  and  wet 
e  creaking, 
nds  may  all 
>f  the  hand, 


ise. 

'  a  fortnight, 
en  it  runs  a 

IS. 

f  the  acute 
toms  of  the 


it  cups  over 
Jches  to  the 

m  (247),  or 

each  case, 
ition. 
active  and 

be  allowed 
d,  and  ren> 

f  veratrum 
tion  of  the 

Jak  tea,  or 

3t  tranquil* 


HEART  DISEASES. 


255 


In  the  treatment  of  chronic  cases,  when  the  cavity  appears  to  con- 
tain fluid,  counter-irritation  is  suitable.  Blisters,  croton  oil,  the  com- 
pound tar  plaster,  and  especially  the  tincture  of  iodine.  The  diet 
may  be  a  little  more  nutritious  than  in  the  acute  form  of  the  disease, 
—  embracing  light  animal  food  and  broths. 

Inflammation  of  the  Heart. — Carditis. 

This  is  an  inflammation  of  the  muscular  substance  of  the  heart 
When  existing  alone,  it  is  a  very  rare  disease.  Being  mixed  up  with 
other  forms  of  heart  disease,  it  does  not  require  any  separate  account 
of  its  symptoms  or  treatment. 

Acute  Inflammation  of  the  Lining  of  the  Heart. 

Endocarditis. 

The  heart  is  one  of  the  citadels  of  life.  Disease  attacks  it  on  all 
sides.  In  this  complaint,  it  has  entered  the  fort,  and  taken  possession. 
The  inflammation  is  on  the  lining"  membrane. 

Physical  Signs.  —  The  impulse  is  violent,  abrupt,  and  regular,  as 
long  as  the  circulation  through  the  heart  is  free,  but  when  this  is  im- 
peded, it  is  at  first  a  confused  tumult  (which  generally  happens  when 
a  fort  is  first  taken),  and  gradually  sinks  to  a  feeble  flutter. 

The  dull  sound  upon  percussion  covers  a  space  of  from  three  to 
seven  square  inches. 

The  beats  of  the  heart  are  generally  accompanied  or  marked  by  a 
bellows  murmur, — the  loudness  of  wmch  depends  on  the  strength  of 
the  heart's  action. 

General  Symptoms.  —  Inflammatory  fever.  The  action  of  the  heart 
being  generally  violent  and  abrupt,  the  pulse  corresponds  with  it,  and 
is  strong,  full,  and  har'}; 

Explanation.  —  The  bellows  sound  is  supposed  to  depend  on  the 
inflamed  and  swollen  condition  of  the  valves. 

The  dulness  on  percussion  will  be  slight  when  the  curculation 
through  the  heart  ia  firee;  —  more  distinct  and  marked  when  it  is 
obstructed. 

Dr.  Hope  says  the  disease  may  be  anticipated,  if  a  person  be  sud- 
denly attacked  with  these  three  signs :  namely,  fever,  violent  action 
of  the  heart,  and  a  murmur  which  did  not  exist  before. 

This  disease,  like  inflammation  of  the  heart-case,  is  often  produced 
by,  and  is  intimately  connected  with,  acute  rheumatism. 

Chronic  Inflammation  of  the  Heart's  Lining. 

Physical  Signs,  —  The  impulse  more  perceptible  and  diffused  than 
natural. 

The  dull  sound  upon  percussion  covers  a  space  of  from  four  to 
Mght  square  inches. 


.k-F.B..».fJU.T 


u 


256 


HEART  DISEASES. 


There  is  a  sawl  ^,  rasping,  or  filing  sound.  This  sound  may  cover 
one  or  both  beats  of  the  heart.  Sometimes  these  unnatural  sounds 
are  doable  ;  in  which  case,  the  first  is  caused  by  an  obstruction  to  the 
natural  flow  of  the  blood  forward ;  the  second,  by  the  regurgitation 
or  retrograde  flow  of  the  blood  from  some  defect  in  the  valve,  just 
as  a  pump  valve  may  get  out  of  order,  and  allow  the  water  \?i?hich 
has  gone  through  to  flow  back. 

Explanation.  —  A  variety  of  organic  changes  occur  in  th'ii  valves, 
which  give  rise  to  the  murmurs.  Inflammation  of  the  liiiiig  mem- 
brane of  the  heart,  reaches  the  valves,  causes  puckering,  thickening, 
vegetatious, cartilaginous,  bony, and  fat-like  degenations,  whicW  obstruct 
the  blood  in  its  onward  flow,  or  prevent  a  closure  of  the  valves,  and 
allow  it  to  flow  back ;  the  former  causing  the  first  sound,  the  latter 
the  second.  If  the  unnatural  noise  be  synchronous  with  the  first  beat 
of  the  heart,  it  implies  disease  in  either  set  of  the  semilunar  valves, 
or  an  impossibility  of  closing  the  auriculo-ventricular  openings ;  if  it 
accompany  the  second  beat,  it  signifies  that  either  set  of  the  semilu- 
nar valves  may  be  open. 

A  murmur  attending  the  first  beat  of  the  heart,  must  be  caused  by 
a  current  of  blood  from  a  ventricle ;  one  attending  a  second  sound, 
by  a  like  necessity,  is  produced  by  a  current  into  a  ventricle. 

Treatment.  —  The  same  as  that  for  pericarditis.  It  should  be  equally 
prompt  and  vigorous.  It  must  not  be  forgotten  that  this  disease  leads 
to  various  organic  diseases  of  the  valves  of  a  very  grave  character, 
and  that  such  mischiefs  can  only  be  escaped  by  cutting  the  disease 
short  in  the  very  beginning. 

Disease  of  the  Semilunar  Valves. 

The  inflammation  of  the  lining  of  the  heart  makes  sad  work  with 
the  valves.  The  semilunars  are  subject  to  various  changes  in  their 
structure. 

Physical  Sipis.  —  Obstractive  Narmnr.  —  In  disease  of  the  semilu- 
nars, the  first  beat  of  the  heart  is  accompanied  or  obscured  either  by 
the  bellows  murmur,  or  a  sawing,  rasping,  or  filing  sound.  The  un- 
natural murmur,  whatever  it  is,  appears  superficial  or  near.  The 
second  beat  is  natural. 

When  the  opening  into  the  aorta  is  contracted,  or  in  any  way  ob- 
structed by  unhealthy  growths,  so  that  the  blood  is  subjected  to  more 
t'  a  natural  degree  of  friction  in  passing,  this  sound  will  be  heard. 
It  is  called  obstructive.,  because  '.t  arises  from  the  obstruction  of  the 
blood  in  lis,  forward  course. 

Regui^itant  Murmurs.  —  First  beat  of  heart  natural.  Second  beat 
accompanied  or  replaced  by  bellows  murmur.  There  is  sometimes  a 
musical  murmur. 

Explanation.  —  The  regurgitant  murmurs  arise  from  the  valves  be- 
ing too  small,  or  defective  in  some  way,  and  allowing  the  blood  to 
flow  back  through  the  orifice. 


i 


HEART  DISEASES. 


257 


may  cover 
iral  sounds 
ition  to  the 
gurgitation 
live,  just 
atei   \vhich 

ih'.".  valves, 
ni'ig  mem- 
thickening, 
obstruct 
valves,  and 
the  latter 
e  first  beat 
nar  valves, 
nings ;  if  it 
the  semilu- 

caused  by 
ond  sound, 

be  equally 
sease  leads 
!  character, 
the  disease 


work  with 
ges  in  their 

the  semila- 

d  either  by 

The  un- 

iear.     The 

ly  way  ob- 
ed  to  more 
U  be  heard, 
tion  of  the 

econd  beat 
tmetimea  a 

valves  ba- 
le blood  to 


This  murmur  is  loudest  opposite  the  semilunar  valves,  and  is  more 
audible  above  these  valves  than  beloio  them. 

When  the  aortic  valves  are  contracted  or  shortened,  and  the  open- 
ings are  not  guarded  by  them,  so  as  to  prevent  the  backward  passage 
of  the  blood,  there  is  a  double  bellows  murmur,  —  one  when  it  is 
driven  throuffhthe  orifice,  and  another  when  it  flows  back. 

Disease  of  the  Mitral  Valves. 

Physical  Signs. — Obstructive  IHununr. —  First  beat  of  heart  nattu 
ml.     Second  beat  accompanied  or  replaced  by  bellows  murmur, 

Re^rgitant  Mnnnnrs. — The  first  beat  of  the  heart  accompanied  by 
a  loud  and  rough  bellows  murmur.  This  sound  is  like  sawing  or 
filing.  It  ia  loudest  above  or  below  the  nipple,  between  the  fourth 
and  seventh  ribs.  There  is  occasionally  a  musical  murmur.  ThtJ 
jccond  beat  of  the  heart  is  natural  Sometimes  there  is  a  purring 
tremor. 

General  Symptoms  of  Yahiilar  Disease.  —  Cough,  in  many  cases 
with  watery  expectoration ;  difficulty  of  breathing ;  frightful  dreams, 
and  starting  from  sleep ;  congestion  of  the  lungs ;  expectoration 
stained  with  dark  and  grumous  blood  ;  swelling  of  the  jugular  veins ; 
a  livid  look  of  the  face  ;  a  feeling  as  if  a  cord  were  tied  tight  around 
the  lower  part  of  the  chest ;  general  dropsy,  of  the  legs  and  feet  in 
particular;  passive  hemorrhages  from  the  mucous  membranes;  en- 
gorgement of  the  liver  and  spleen  ;  congestion  of  the  brain,  with  feel- 
ings of  oppression.  When  the  mitral  valve  is  contracted,  admitting 
regurgitation,  the  pulse  ia  small,  weak,  irregular,  and  intermittent. 

These  are  the  worst  symptoms  of  an  advanced  stage. 

Explanations.  —  The  examiner  will  distinguish  the  various  sounds 
thus : 

The  murmurs  generated  at  the  origin  of  the  arteries,  spread  theii 
sonorous  currents  upwards  along"  these  arteries. 

Those  produced  in  the  auricular  orifices,  will  be  conducted  into  the 
auricles,  and  propagated  downwards  towards  the  apex  of  the  heart. 

Which  Set  of  Valves.  —  To  learn  in  which  set  of  valves  it  origi- 
nates, therefore,  find  its  seat,  and  trace  its  direction. 

Finding  the  murmur  to  be  in  the  aortic  orifice,  it  is  then  known  to 
be  obstructive,  if  the  first  sound  is  morbid,  and  the  second  sound  natu- 
ral; and  regurgitant,  if  the  first  sound  is  natural,  and  the  second  sound 
morbid. 

But  if  the  murmur  be  in  the  mitral  orifice,  it  is  obstructive  when  the 
first  beat  of  the  heart  is  natural,  and  the  second  beat  morbid ;  and  re- 
gurgitant, when  the  first  beat  is  morbid,  and  the  second  beat  natural. 

The  Pitch  or  Key  of  a  murmur  depends  on  the  distance  of  its  seat 
from  the  ear  of  the  listener ;  —  nearness  giving  a  high,  and  distance  a 
low  key.  Thus,  a  murmir  seated  in  the  orifice  of  the  pulmonary 
artery,  being  nearer  the  eurface,  has  a  'tgher  pitch  than  any  other 

«"HJ 


258 


HKART  DISEASES. 


It  is  on  about  the  same  key  with  a  whispered  s,  —  sometimes  a  little 
lower,  and  depending  somewhat  on  the  strength  of  the  current  of 
blood,  —  a  strong'  current  elevating,  and  a  weak  current  depressing  the 
tone. 

The  mitral  orifice  is  situated  opposite  the  junction  of  the  cartilago 
of  the  third  rib  with  the  left  side  of  the  breast  bone.  The  aortic 
orifice  is  about  half  an  inch  to  the  right  of  this,  and  the  same  dis- 
tance lower.  It  is  known  by  the  key  being  lower,  —  about  like  a 
whispered  r,  which  is  the  ordinary  type  of  the  sawing  sound. 

Murmurs  from  pulmonic  and  aortic  regurgitations,  are  about  two 
tones  lower,  in  consequence  of  the  currents  of  the  blood  being  weaker. 
They  are  like  whispering  awe  by  inspiration  ;  and  if  the  click  of  the 
valve  be  heard,  the  sound  will  be  changed  to  paw. 

Murmurs  in  the  mitral  valve,  being  more  deeply  seated,  are  about 
four  tones  lower,  and  are  like  a  whispered  who. 

The  tricuspid  murmurs  are  higher  than  the  mitral,  because  nearer 
tfie  surface. 

The  musical  murmur  has  been  compared  to  whistling,  the  cooing 
of  a  dove,  and  the  mewing  of  a  kitten.  It  generally  results  from  re- 
gurgitation. 

The  purring  tremor  is  caused,  generally,  by  regurgitation  through 
the  mitral  valve. 

Otiier  Symptoms  Eiplained.  —  The  difficulty  of  breathing,  frightful 
dreams,  congestion  of  the  lungs,  hemorrhages,  engorgements,  etc., 
mentioned  above,  all  proceed  from  such  valvular  stiffenings,  pucker- 
ings,  ossifications,  enlargements,  and  contractions,  as  occasion  a  decid- 
edly obstructed  circulation. , 

The  small,  weak,  irregular,  and  interrupted  pulse,  is  caused  by  con- 
traction of  the  mitral  valve,  which  occasions  an  insufficient  or  irregu- 
iar  supply  of  blood  to  the  ventricle,  and  causes  the  ventricle,  by  losing 
the  resistance  of  the  valve,  to  expend  its  force  in  a  backward  as  well 
a  forward  direction,- — thus  sending  but  little  blood  into  the  arteries. 

Treatment. —  The  tendency  of  valvular  disease  is  to  produce  hyper- 
trophy and  dilatation.  The  strong  and  ceaseless  efforts  of  the  ven- 
tricle to  drive  the  blood  through  an  orifiice  obstructed  by  valvular 
disease,  will  of  course  make  the  walls  grow  thick,  which  is  hypertro- 
'>phy ;  and  at  the  same  time,  the  accumulation  of  blood  which  cannot 
be  driven  lorward  fast  enough,  must  tend  to  swell  and  enlarge  the 
cavity,  —  which  is  dilatation. 

The  great  object  of  treatment,  therefore,  is  to  diminish  the  foroe 
and  activity  of  the  circulation,  —  to  induce  the  heart  to  cease  striving 
to  do  what  cannot  be  done. 

To  accomplish  this,  give  sedatives  (285)  (94)  (124).  The  hellebore 
and  cohosh  will  be  found  particularly  serviceable. 

The  tincture  of  the  American  hellebore  is  about  the  best  of  all 
Purgatives  may  be  given  according  to  the  strength  of  the  patient. 

When  there  is  dropsy,  and  a  scanty  secretion  of  high-colored  urincj 
diuretics,  or  medicines  to  increase  the  action  of  the  kidneys,  are  very 
important.     For  this  purpose,  digitalis  and  acetate  of  potash  (130) 


meg  a  little 
current  of 
yressuig-  the 

he  cartilago 
The  aortic 

same  dis- 
bout  like  a 
nd. 

about  two 
jing  weaker, 
click  of  the 

1,  are  about. 

jause  nearer 

,  the  cooing 
ults  from  re- 

tion  through    j 

ing,  frightful 
BmentB,  etc., 
ings,  pucker- 
sion  a  decid- 

used  by  con- 
jnt  or  irregu- 
3le,  by  losing 
ward  as  well 
the  arteries. 

oduce  hyper- 

i  of  the  ven- 

by  valvular 

is  hypertro- 

vhich  cannot 

enlarge  the 

sh  the  force 
ease  striving 

?he  hellebore 

!  best  of  all 
!  patient, 
olored  urincj 
eys,  are  very 
potash  (ISO) 


■•' 


HEART  DISEASES. 


af>9 


are  excellent.  Should  this  not  succeed  in  reducing  the  dropsy,  an 
active  purgative  (31)  may  accompany  it. 

Diaphoretics,  or  medicines  which  promote  perspiration,  are  also 
useful.  This  opening  of  the  skin,  however,  is  generally  brought 
about  by  the  hellebore,  etc.  (124). 

The  diet  should  be  unstimulating,  and  yet  should  be  sufficient!}! 
nourishing  to  prevent  the  patient  from  running  too  low.  Animal 
food  of  the  most  digestible  kind  may  be  taken  once  a  day ;  though 
there  are  many  cases  requiring  its  entire  rejection. 

The  passions  should  be  kept  in  the  most  perfect  subjection,  and 
the  life  should  be  as  tranquil  as  possible.  Nothing  must  be  done  in  a 
hurry.  •  r- 

Water  in  the  Heart-Case. — Hydropericardium. 

This  disease  is  common  as  an  attendant  of  general  dropsy. 

Physical  Sig;iis.  —  The  impulse  is  undulatory,  as  if  transmitted 
through  a  fluid,  and  it  is  not  always  of  the  same  strength. 

The  dulness  extends  upward  in  a  conical  form,  in  proportion  to  the 
amount  of  fluid  ;  —  sometimes  rising  as  high  as  the  second  rib.  The 
impulse  does  not  coincide  with  the  first  beat  of  the  heart. 

General  Symptoms.  —  The  patient  has  a  sensaiiorr  of  the  heart  being 
in  a  floating  state.     The  pulse  is  small,  frequent,  and  intermittent. 

Explanation.  —  The  reason  that  the  impulse  does  not  occur  at  the 
same  time  with  the  first  beat  of  the  heart  is,  that  the  apex  does  not 
immediately  strike  the  walls  of  the  chest,  —  3ome  time  being  required 
to  push  it  up  through  the  fluid. 

The  beats  of  the  heart  sound  more  distant  than  natural  in  conse' 
quence  of  the  organ  being  pushed  away  from  the  walls  of  the  chest 
by  the  fluid. 

Palpitation.— NeryooB  Palpitation.— Anaemic  Palpitation. 

There  is  a  great  deal  of  palpitation  of  the  heart  dependent  on 
dyspepsia,  hypochondria,  hysterics,  mental  agitation,  excessive  study 
with  deficient  sleep,  venereal  excesses,  and  masturbation. 

Palpitations  likewise  occur  from  what  is  called  ancemia,  or  a  low 
and  deficient  state  of  the  blood. 

Physical  J^igpns.  —  The  impulse  is  weak,  fluttering,  or  tumultuous, 

—  generally  increased  by  trifles. 

The  beats  of  the  heart  are  increased  in  frequency,  and  sometimes 
marked  by  intermission.  Now  and  then  they  are  accompanied  by  a 
beHows  murmur.     There  are  musical  murmurs  in  the  jugular  veins, 

—  loudest  a  little  above  the  collar  bones. 

General  Symptoms. —  The  complexion  is  generally  pallid  and  blood- 
less ;  the  lips  and  the  inside  of  the  mouth  partaking  of  the  same  pale« 


i 
i 


;J 


■1 


1 


1 


-'■ 


ness ;  the  pulse  quick,  small,  weak,  and  jerking ;  and  during  palpita- 
tion, it  sometimes  has  a  thrill.  Hlight  causes  i)roduce  breathlessncss 
and  faintness.  A  dislike  of  aniuml  food,  ancl  a  fondness  for  acids. 
The  monthly  discharge  in  females  is  deficient,  and  the  whites  take  its 
place.  Sometimes  the  menses  are  too  profuse,  lasting  for  several  days, 
and  consisting  only  of  blood.  In  this  state  of  things  there  is  great 
feebleness  both  of  mind  and  body,  with  rushing  noises  in  the  ears. 

Explanations. — The  murmurs  depend  on  a  lack  of  blood.  The  con 
ditions  of  their  existence  are,  thinness  of  blood,  a  swift  and  spasmodic 
circulation,  and  particularly  an  unfilled  condition  of  the  blood-vessels. 
A  brook  is  the  more  babbling  in  proportion  as  its  water  is  more 
shallow.  It  is  a  law  in  physics,  that  heaviness  of  freight  gives  stead- 
iness of  motion ;  and  lightness  of  freight  gives  unsteady  motion. 
The  fireman's  hose  trembles  and  vibrates  when  only  half  full  of  water. 
In  like  manner  the  blood-vessels  are  agitated  when  imperfectly  filled. 

Treatment  —  This  is  to  be  governed  altogether  by  the  cause  of  the 
trouble.  If  it  be  dyspepsia,  hypochondria,  hysterics,  etc.,  these  sev- 
eral diseases  require  their  usual  treatment ;  when  they  are  cured,  the 
palpitation  will  stop. 

But  when  it  is  caused  by  a  low  state  of  the  blood,  then  g^ve  for 
several  weeks,  iron,  the  compound  mixture,  and  (316)  (310). 

The  food  must  likewise  be  nourishing,  —  tender  meat,  beef  and 
mutton,  with  broths,  etc. 

Gentle  exercise  will  be  required,  and  much  exposure  to  a  bracing, 
out-door  air. 


Neuralgia  of  the  Heart. — Angina  Pectoris. 

This  is  a  strictly  nervous  disease.  It  begins  with  a  sensation  of 
pain  and  constriction  in  the  region  of  the  heart.  This  pain  is  accom- 
panied with  more  or  less  pain  and  numbness  in  the  left  arm.  In 
females  it  is  not  uncommon  for  it  to  be  attended  by  great  sensitive- 
ness and  pain  of  the  breasts.  When  the  attack  is  violent,  the  pain 
in  the  heart  is  excruciating,  and  even  terrific-  There  is  attending  this 
a  feeling  of  great  oppression  in  the  chest,  amounting,  in  the  worst 
cases,  to  a  sense  of  sufTocation.  The  heart  palpitates  violently,  the 
brain  is  oppressed,  and  fainting  sometimes  occurs. 

The  disease  is  brought  on,  in  nervous  subjects,  by  over  excitement 
of  the  heart  Walking  up  hill,  against  a  strong  wind,  may  bring  it 
on.  If  walking  at  the  time  of  the  attack,  the  patient  is  compelled  to 
stop,  and  stand  still  till  the  pain  subsides. 

The  disease  is  often  connected  with  organic  changes  in  the  heart's 
structure,  such  as  ossifications,  and  other  alterations. 

Treatment. — When  the  complaint  depends  on  organic  disease  of 
the  heart,  the  treatment  must  be  directed  to  the  cure  of  these  dis- 
eases. 

To  relieve  a  severe  attack,  the  patient  should  be  instantly  placed 
in  a  quiet  position ;  wind  in  the  stomp  a,  if  present,  should  be  ex- 


fig  nalpita- 
ithlessuess 
for  acids. 
Jtes  take  its 
Iveral  days, 
Ire  is  great 
|he  ears. 

The  con 
spasnjodit 

l-vessels. 
|er  is  more 
jives  stead- 
Jv  motion. 
Ill  of  water. 
Fectly  filled. 

ause  of  the 
,  these  sev- 
cured,  the 

en  give  for 

P)- 
t,  beef  and 

0  a  bracing, 


sensation  of 
in  is  accom- 
ft  arm.  In 
it  sensitive- 
nt,  the  pain 
tending  this 
I  the  worst 
iolently,  the 

excitement 
ay  bring  it 
impelled  to 

the  heart's 


disease  of 
'  these  dis- 

itly  placed 
iild  be  ex- 


pelled by  peppermint  or  anise  water,  or  ether,  or  (115),  or  some  other 
arottiutic.  If  there  is  acidity  or  sourness  of  the  stomach,  it  must  be 
corrected  by  a  teaspoon ful  of  soda  in  half  a  tumbler  of  water ;  and 
if  the  stomuch  be  full  of  undigested  food,  let  the  patient  take  a  table- 
spoonful  of  ground  mustard,  stirred  up  with  a  teacupful  of  warm 
water.     This  will  cause  almost  instant  vomiting. 

These  things  being  done,  give  some  quieting,  or  antispasmodic 
medicines,  as  one  sixth  of  a  grain  of  morphine,  or  one  of  the  following 
prescriptioiw :  (285)  (97)  (135)  n24). 

Great  relief  is  often  obtained  by  sending  a  current  of  magnetism 
through  the  region  of  the  heart,  by  applying  one  pole  of  the  machine 
in  front,  and  the  other  upon  the  back. 

During  the  intervals,  the  general  health  is  to  be  improved  by  a 
wholesome,  nourishing  diet,  gentle,  out-door  exercise,  and  a  careful 
control  of  all  the  passions. 

Polypus  of  the  Heart. 

A  PORTION  of  the  fibrine  sometimes  separates  from  the  blood  in  the 
heart  and  large  vessels,  and  becoming  more  or  less  organized,  forms 
polypuses,  which  fill  the  cavities  to  which  they  are  attached,  and  seri- 
ously obstruct  the  circulation. 

Physical  Si^s.  —  When  the  pulsations  of  the  heart,  previously 
regular,  become  suddenly  anomalous,  confused,  and  obscure,  so  that 
they  cannot  be  analyzed,  we  may  suspect  a  polypus. 

General  Symptoms.  —  A  sudden  and  great  aggravation  of  the  bad 
breathing,  without  any  visible  cause,  —  the  patient  being  in  agony 
from  a  sense  of  impending  suffocation,  and  tossing  about  from  side 
to  side,  struggling  for  breath.  The  pulse  small,  weak,  irregular,  in- 
termittent, and  unequal ;  the  surface  and  extremities  cold ;  the  face, 
livid,  —  to  which  there  is  generally  added  nausea  and  vomiting. 

Treatment.  —  When  the  polypus  is  once  formed,  the  case  is  hope- 
less.    The  treatment,  therefore,  can  only  be  preventive. 

The  chief  things  to  be  done  are,  to  keep  the  patient  in  a  state  of 
entire  tranquillity,  and  to  bring  the  circulation  to  the  surface,  by  keep- 
ing the  skin  warm,  and  excited  by  friction.  This  will  call  the  blood 
away  from  the  heart  and  great  vessels,  and  lessen  the  chances  of  the 
polypus. 

Displacements  of  the  Heart. 

The  heart  may  be  misplaced  from  birth.  1  have  seen  a  case  in 
which  it  lay  upon  the  right  side,  and  had  always  been  in  that  posi- 
tion.    Its  action  was  natural. 

A  variety  of  causes  may  tend  to  push  it  out  of  its  place,  as  water 
in  the  cavity  of  the  pleura.  In  such  cases,  it  will  return  to  its  place 
when  the  water  is  drawn  off  or  absorbed. 


I 


DISEASES   OP  THE  ABDOMINAL  CAVITT. 


Under  the  above  head  I  shall  consider  most  of  the  diiieases  which 
occur  in  the  great  cavity  below  the  diaphragrii,  called  the  abdomen 
t)r  belly.  These  affections  an^  quite  itnporlant,  and  make  up  a  con- 
siderable part  of  the  ills  we  suffer  from  disease. 

Before  speaking  of  these  dirfcases,  however,  I  will  call  the  reader's 
attention  to  a  profile  view  of  the 
relative  position  of  the  several  or-  F10.94. 

gans  lodged  in  this  cavity. 

In  Fig.  94,  L  is  the  liver.,  S  the 
stomach,  C  the  colon,  R  the  rectum, 
B  the  bladder,  P  D  the  pancreas, 
and  I  the  intestines.  The  double 
lines,  folded  back  upon  each  other, 
and  surrounding  most  of  the  or- 
gans, represent  the  peritoneum,  a 
membrane  which  lines  the  great 
cavity  of  which  I  am  speaking. 

It  will  bo  well,  too,  before  pro- 
ceeding further,  to  make  the  reader 
acquainted  with  the  names  of  cer- 
tain regions  of  the  abdomen  which 
he  will  find  constantly  spoken  of 
in  medical  books.  I  have  not 
used  these  terms  much  in  my 
book;  but  it  will  be  convenient 
to  be  acquainted  with  them.  Phy- 
sicians who  are  careless  in  their 
readings,  are  not  always  familiar 
with  their  exact  locality. 

In  P'ig.  95,  the  abdomen  is  di- 
vided into  nine  different  regions 
by  the  drawing  of  two  parallel 
lines  up  and  down,  2,  2,  and  3,  3, 
and  two  lines  across,  4,  4,  and  1,  1. 
three  in  the  middle,  and  three  below. 

In  the  upper  row,  6  is  the  epigastrium,  or  epigastric  region,  m  which 
•xre  the  left  lobe  of  the  liver,  and  a  portion  of  the  stomach  ;  5,  on  the 


This  gives  three  regions  above, 


1 


ses  which 
ibdomen 

lip  a  con- 
reader's 


18  above, 

in  which 
>,  on  the 


DISKAHKH  OF  THR  ABnOMINAL  CAVITY, 


S(Ki 


na.se. 


right  Bide,  iti  the  riffftt  hypochondrium,  in  which  jh  tlie  right  lobe  of  the 

liver ;  and  5,  on  the  left  aide,  is  the  left 
hypochondrium,  which  containH  the  spleen, 
and  a  portion  of  the  ntomach  and  liver. 

In  the  middle  row,  7  is  the  umbilical 
region,  which  contains  the  small  intestines. 
On  th«'  ght  Hide,  8  is  the  rii^ht  lumbar  re- 
gion, v.i..ch  holds  the  right  kidney  and  the 
ascending  colon  ;  and  8,  on  the  left,  is  the 
left  lumbar  region,  wliich  contains  the  left 
kidney  and  the  deMC(>ndlng  colon. 

In  the  lower  row,  9  is  the  hyjmgastrium, 
or  hypogastric  region,  which  contains  a  por- 
tion of  the  small  intestines  and  bladder. 
On  the  right,  10  is  the  right  iliac  fassa, 
containing  the  ccecum  ox  caput  coli;  and  10, 
on  the  left,  is  the  left  iliac  fassa,  contain- 
ing the  sigmoid  flexure. 

And   now   I   may  as   well   present,  in 


Via  86- 


Fig.  96,  a  front  view  of 
many  of  the  organs  both 
in  the  chest  and  abdo- 
men :  1,  1,  1,  1,  are  the 
muscles  of  the  chest ;  2, 
2,  2,  2,  the  ribs  ;  3,  3,  3, 
the  upper,  middle,  and 
lower  lobes  of  the  right 
lung;  4,  4,  the  lobes  of 
the  left  lung ;  5,  the  right 
ventricle  of  the  heart ;  6, 
the  left  ventricle  ;  7,  the 
right  auricle  of  the  heart; 
8,  the  left  auricle ;  9,  the 
pulmonary  artery ;  10, 
the  aorta;  11,  the  vena 
cava  descendens ;  12,  the 
windpipe ;  13,  oesopha- 
gus ;  14,  14,  14,  14,  the 
pleura  ;  15,  15,  15,  the 
diaphragm;  16,  16,  the 
light  and  left  lobes  of 
the  liver;  17,  the  gall 
bladder  ;  18,  stomach  ; 
2Q,  the  spleen;  19,  19, 
the  duodenum;  20,  the 
ascending  colon ;  21,  the 
transverse  colon ;  25,  the 
descending  colon ;  22, 22, 
22,  22,  the  small  intes- 
tines ;  23,  23,  the  walls  of  the  belly  turned  down ;  24,  the  thoracic 
duct,  opening  into  the  left  subclavian  vein  (27). 


I 


tW 


#■ 


i, 


964 


D18EARK8  OK  TIIK  ABDOMINAL  CAVITY. 


Acute  Inflammation  of  the  Liver. 

The  liver  is  the  largcHt  gland  in  the  body.  (See  Fig.  31.)  It  lies 
in  the  right  side,  and  at  the  top  of  the  great  abdominal  cavity,  di* 
rectly  under  tlie  midriff,  and  hipping  upon  the  stomach.  Fig.  94 
shows  its  relative  position.  Its  otHce  is  to  take  the  superabi;ndnnt 
carbon  out  of  the  bloof*  This  carbon  it  unites  with  other  elements 
and  formH  bile,  the  peculiar  bitter  subHtance,  which  is  poured  into  the 
upper  bowel,  and  greatjy  aids  digestion. 

The  liver  is  liable  to  become  inflamed  from  several  causes,  such 
as  gravel  stones,  external  violence,  suppressed  secretions,  hot  climatesr 
inflammat.';>n  of  the  duodenum,  etc. 

Symptoms.  —  These  are  sympathetic  fover,  with  pain,  and  a  sense 
of  tension  in  the  right  side,  inability  to  lie  on  the  left  side,  difficulty 
of  breathing,  a  dry  cough,  vomiting,  and  hiccup. 

The  pain  is  acute  and  lancinating  generally,  though  sometimes 
dull  and  tensive.  When  sharp,  it  is  hke  the  stitch  of  pleurisy,  and  it 
indicates  that  the  peritoneum  which  covers  the  liver  is  inflamed. 
When  dull,  it  is  the  body  of  the  organ  which  is  suffering.  When  the 
convex  surface  of  the  liver  is  the  seat  of  the  disease,  the  pain  is  apt  to 
run  up  to  the  right  collar-bone,  and  to  the  top  of  the  right  shoulder. 
Breathing,  coughing,  and  lying  on  the  left  side,  increase  the  pain. 
A  soreness  is  felt  by  pressing  over  the  liver.  The  pube  is  full,  hard, 
and  strong,  the  bowels  are  costive,  and  the  stools  are  clay  colored, 
owing  to  not  being  tinged  with  bile,  —  this  having  stopped  flowing. 
The  tongue  is  covered  with  a  yellow,  dark  brown,  or  even  black  coat, 
and  there  is  a  bitter  taste  in  the  mouth. 


by  the  liver,  is  poured  into  the 
the  yellow  color  to  the  contents 


Explanation.  —  The  bile,  secreted 
upper  bowel,  and  gives  the  brown  or 

of  the  bowels.  When  the  liver  is  inflamed,  it  caimot  work,  —  it  se- 
cretes little  or  no  bile,  and  the  discharge  from  the  bowels  lose  their 
color.  The  bile  is  alightly  physical,  and  when  it  ceases  to  flow  into 
the  bowels,  they  become  bound  or  costive.  When  the  liver  does  not 
work,  the  bile  has  to  be  taken  out  of  the  blood  by  the  kidneys,  and 
the  urine  becomes  of  a  deep  yellow  color.  Much  of  it  goes  out 
through  the  skin,  too,  which  is  likewise  yellow,  and  the  sweat  be- 
comes so  yellow  as  to  stain  the  linen. 

Treatment.  —  Apply  wet  cups  or  leeches  over  the  liver  pretty  freely. 

Purgatives  will  also  need  to  be  used  pretty  freely  at  first.  Those 
which  produce  watery  stools  (31)  (247)  (34)  will  be  of  the  greatest 
service. 

After  the  cups  and  purgatives  have  been  thoroughly  used,  blisters 
will  be  useful,  and  it  wiU  be  better  to  apply  several  in  succession^ 
rather  than  to  keep  the  first  one  open.  Or,  in  the  milder  cases,  a 
mustard  poultice  may  be  applied  over  the  whole  side,  and  even  along 
the  spine. 
'  Frictions  over  the  stomach  ard  liver  with  the  nitro-muriatic  acid. 


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DISEASES  OF  THE  ABDOMINAL  CAVITY. 


26.0 


and  a  foot  bath  of  the  same,  will  sometimes  do  weH.  The  acid 
(■hoiild  be  reduced  with  water  to  about  the  strength  of  sharp  vinegar. 
Water  a  little  soured  with  this  same  acid  makes  an  excellent  drink 
for  the  patient. 

Perspiration  should  he  induced  by  the  spirit  vapor  bath,  and  kept 
up  gently  by  the  tincture  of  the  American  hellebore,  from  three  to 
ten  drops  every  hour.  Or,  the  same  thing  may  be  done  by  prescrip- 
tion (126). 

When  the  urine  is  small  in  quantity  and  red,  give  some  diu- 
retic, as  infusion  of  marshmallow  root,  pumpkin  seeds,  or  trailing 
arbutus. 

The  diet  should  be  rice-water,  gruel,  and  toast-water.  While  get- 
ting up,  it  may  gradually  be  improved,  and  some  light  tonics  (49) 
(58)  (64)  be  added  to  it 


Chronic  Inflammation  of  the  Liver. 

There  are  few  chronic  diseases  for  which  the  physician  is  more 
often  consulted  than  this.  In  the  warm  climate  of  the  South,  in  the 
bilious  districts  of  the  West,  and  indeed  even  in  the  Middle  and 
Eastern  States,  it  meets  us  continually,  and  demands  our  attention. 
That  it  is  difficult  to  cure  must  be  admitted  ;  but  a  constant  famil- 
iarity with  chronic  diseases,  for  several  years,  has  convinced  me  that 
it  is  generally  curable. 

Symptoms. —  A  sense  of  fulness  and  weight  in  the  right  side,  with 
some  enlargement,  and  shooting  pains  felt  in  the  same  region,  partic- 
ularly when  it  is  pressed,  with  pains  in  one  or  both  shoulders,  and 
under  the  shoulder  blades  ;  uncomfortable  sensations  when  lying  on 
the  left  side  ;  yellowness  of  the  skin,  eyes,  and  urine  ;  bowels  irregu- 
lar, loose,  or  costive ;  appetite  disturbed ;  sometimes  a  dry,  hacking 
cough ;  shortness  of  breath ;  tongue  whitish,  and  brown  or  yellow 
towards  the  root ;  a  bitter  and  bad  taste  in  the  morning.  The  urine 
deposits  a  sediment  on  standing.  There  is  generally  a  low  and  des- 
ponding state  of  mind,  with  irritability  and  peevishness  of  temper. 

The  skin  is  often  covered  with  yellow  spots,  and  with  a  branny 
substance.  The  various  symptoms  of  dyspepsia  are  often  present. 
The  nervous  system  is  generally  much  disturbed,  and  there  is  a  dis- 
inclination to  apply  the  mind.  There  is  frequently  a  great  dread  of 
imagined  evil,  supposed  to  be  impending. 

Treatment. —  This  does  not  require  to  be  as  active  as  that  for  the 
acute  form  of  the  disease. 

If  there  be  much  tenderness  of  the  liver,  begin  with  mustard  poul- 
tices, and  the  compound  pills  of  podophyllin,  or  the  compound  pilla 
of  leptandrin,  or  (36). 

I  have  abandoned  the  use  of  mercury  in  this  disease,  as  in  most 
others  ;  but  if  any  prefer  to  use  it,  the  blue  pill  (52)  will  be  found  tne 
most  useful  form. 

The  compound  tar  plaster  placed  over  the  liver,  in  bad  cases,  i» 
often  very  serviceable. 


LMUlilMIIMJWiWIIiHMIIIBiM^^  ' 


266 


DISEASES  OF  THE  ABDOMINAL  CAVITY.     - 


An  alterative  (138)  (146)  will  be  found  useful. 

The  daily  alkaline  sponge  bath  must  on  no  account  be  omitted 
Vigorous  friction  must  follow  it  Vigorous  constitutions  will  bear 
the  shower  bath ;  in  such  cases  it  may,  occasionally,  take  the  place  of 
the  sponge  bath. 

The  diet  must  be  simple,  yet  nourishing  and  wholesome,  —  and 
embracing  but  a  small  amount  of  fat,  —  as  this  is  composed  largely 
of  carbon,  and  the  liver  is  unable  to  remove  what  is  already  in  the 
blood. 

Especially  and  above  all,  out-door  exercise  must  be  taken  to  the 
full  amount  of  the  strength,  and  the  thoughts  be  occupied  with  cheer- 
ful subjects.  Let  the  hot  sun  be  avoided,  and  the  summer  exercise 
be  taken  in  the  cool  hours  of  the  day. 

The  recovery  from  this,  as  from  all  other  chronic  diseases,  must 
necessarily  be  slow. 

Acute  Inflammation  of  the  Spleen. — Splenitis. 

The  spleen  is  in  the  upper  part  of  the  belly,  on  the  left  side,  oppo- 
site the  liver.  It  is  subject  to  acute  inflammation,  which  is  known  by 
a  pain  just  under  the  short  ribs  on  the  left  side,  also  by  swelling,  sore- 
ness to  the  touch,  and  by  more  or  less  fever.  The  pain  often  shoots 
up  through  the  midriff  and  to  the  left  shoulder.  There  is  a  short,  dry 
cough  ;  a  feeling  of  tightness  about  the  heart ;  a  sickness  at  the  stom- 
ach, and  vomiting ;  and  a  discharge  frequently  of  black  blood  from 
the  bowels.  The  urine  is  scanty,  is  passed  with  some  difficulty,  and 
is  high  colored. 

This  disease  appears  most  frequently  in  hot  climates,  and  is  often 
connected  with  intermittent  fevers. 

Chronic  Inflammation  of  the  Spleen. 

Thvs  prevails  most  in  fever  and  ague  districts,  and  is  a  frequent 
result  of  chills  and  fever.  It  is  generally  very  stubborn,  often  lasting 
many  years. 

Symptoms.  —  A  feeling  of  weight,  tightness,  and  sometimes  pain  in 
the  left  side,  —  the  pain  being  increased  by  pressure,  or  an  attempt  to 
lie  on  the  left  side.  The  organ  sometimes  enlarges  very  much,  so 
that  it  can  be  felt  by  the  hand.  This  enlarged  mass  passes  under  the 
common  name  of  "  ague  cake."  There  are  sometimes  numbness, 
weakness  of  the  legs,  difficulty  of  breathing,  palpitation  of  the  heart, 
inability  to  exercise  much,  obstinate  constipation,  vomiting  of  food, 
piles,  dry  skin,  tongue  coated  white  or  red,  low  spirits,  and  occasion- 
ally dropsical  affections. 

During  the  chill  in  fever  and  ague,  the  spleen  becomes  enormously 
loaded  with  blood.  Surfeited  and  stretched  in  this  way  again  and 
again,  it  is  not  Htrange  that  the  organ  should  become  diseased. 

Treatment.  —  This  should  be  about  the  same  with  the  treatment  for 
acute  and  chronic  inflanunatiou  of  the  liver. 


be  omitted. 

)n3  will  bear 

the  place  of 

jsome,  —  and 
posed  largely 
ilready  in  the 

taken  to  the 
'd  with  cheer- 
imer  exercise 

liseases,  must 


>plenitis. 

ft  side,  oppo- 
1  is  known  by 
swelling,  sore- 
often  shoots 
is  a  short,  dry 
s  at  the  stom- 
;k  blood  from 
difficulty,  and 

s,  and  is  often 


en. 

is  a  frequent 
,  often  lasting 

Jtimes  pain  in 
an  attempt  to 
'ery  much,  so 
5ses  under  the 
es  numbness, 
I  of  the  heart, 
iting  of  food, 
ind  occasion- 

s  enormously 
ay  again  and 
leased. 

treatment  for 


DISEASi.     OF  THE  ABDOMINAL  CAVITY. 


267 


After  the  active  symptom' 
bath  may  be  used  once  or  , 

In  the  chronic  form  of     • 
pound  tar  plaster,  with    .luf 
iodine,  will  be  particularly 

Among  medicines,  mil' 


inflammation  are  subdued,  the  warm 

a  week. 

opase,  counter-irritation  with  the  com- 
1  poultices,  croton  oil,  or  tincture  of 
!ded. 
f  ammonia  (53)  has  a  high  reputation. 


To  keep  the  bowels  open,  ,  iophyllin,  quinine,  and  nux  vomica  (46), 
have  a  fine  ert'ect.  Iron  may  be  given  (73)  when  the  patient  is  blood- 
less and  pale. 

Jaundice. — Icterus, 

The  jaundice  is  a  very  common  disease,  and  to  be  known,  needs  only 
to  be  seen. 

Syniptoilis.  —  The  most  prominent  symptoms  are,  yellowness  of  the 
skin  and  whites  of  the  eyes,  saffron-colored  urine,  and  whitish  or  clay- 
colored  stools.  So  full  is  the  urine  of  bile,  that  a  piece  of  white  linen, 
dipped  in  it,  receives  a  bright  yellow  tinge. 

Beside  these  leading  symptoms,  there  are  impaired  appetite,  a  loatli- 
ing  of  food,  the  sense  of  a  load  at  the  pit  of  the  stomach,  sourness  of 
stomach,  sometimes  sickness  and  vomiting,  a  bitter  taste  in  the  mouth, 
disinclination  to  move  about,  sleepiness,  a  dull  pain  in  the  right  side, 
which  is  increased  by  pressure. 

The  entire  body  of  a  person  who  has  died  of  jaundice,  including 
bones,  muscles,  and  membranes,  j,re  found  to  be  full  of  bile,  and  colored 
yellow. 

Explanation.  —  The  bile  flows  into  the  upper  bowel,  a  little  below 
the  stomach,  through  a  duct  or  tube  about  as  large  as  a  goose-quill. 
This  little  tube  or  vessel  receives  the  bile  from  a  smaller  tube,  called 
the  hepatic  duct,  and  from  another  which  goes  to  the  gall-bladder, 
called  the  cystic  duct. 

These  little  tubes  sometimes  get  obstructed  or  plugged  up  by 
sticky,  thickened,  or  hardened  bile,  or  by  gall-stones,  formed  in  the  liver, 
and  the  bile  finding  no  outlet  through  its  natural  channels,  is  taken 
up  by  the  absorbents,  distributed  over  the  system,  and  produces  the  yel- 
lowness we  witness.  When  these  ducts  and  the  gall-bladder  are  filled  and 
fitretched  by  this  thickened  and  hardeued  bile,  they  become  tender 
and  sore.  Hence  the  sore  feeling  in  the  side  when  pressure  is 
mode. 

There  is  another  explanation  of  the  way  in  which  the  yellowness  of 
jaundice  is  produced,  and  it  matters  not  whether  it,  or  the  one  just 
j^iven,  be  adopted.  It  is  this  :  The  bile  is  formed  by  the  blood,  and 
not  by  the  liver.  The  ofiice  of  the  liver  is  to  draw  or  strain  off  the  bile 
from  the  blood.  And  when  this  organ  is  inflamed,  or  gets  sluggish  and 
will  not  work,  the  blood  is  not  relieved  of  its  yellow  freight.  The 
bile  accumulates  and  in  attempting  to  escape  through  other  channels,  it 
lodges  in  the  various  tissues,  particularly  in  the  skin. 

Treatment If  there  be  much  inactivity  of  the  liver,  the  treatment 

may  begin  with  an  emetic  (I)   (2)  (4). 


268 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


f    ^' 


An  infusion  of  thoroughwort,  drank  freely  every  day,  is  a  valuable 
remedy.  The  inner  bark  of  the  barberry  steeped  in  cider,  or  this  arti- 
cle compounded  with  others  (286)  (287)  will  be  found  excellent. 

The  diet  should  be  plain,  wholesome,  and  nourishing,  but  com- 
posed mostly  of  vegetable  articles,  particularly  green  vegetables  and 
berries  when  they  are  to  be  had. 

Cold  water  should  be  the  principal  drink ;  or  drink  and  medicine 
may  be  combined  in  the  shape  of  five  drops  of  muriatic  acid,  and 
three  drops  of  nitric  acid,  dissolved  in  a  tumbler  of  water  slightly 
sweetened.  This  is  generally  a  pleasant  drink,  and  will  assist  very 
much  in  the  cure. 

The  warm  bath  once  or  twice  a  week,  and  the  alkaline  sponge  bath 
every  day,  with  smart  friction,  must  not  be  omitted. 

When  jaundice  is  caused  by  the  passage  of  gall-stones  through  the 
bile  duct,  there  is  sometimes  terrible  pain  and  suflering,  —  the  stone, 
occasionally,  being  as  large  as  a  nutmeg,  and  forcing  its  way  through 
a  quill-sized  tube.  So  great  is  the  distress  that  the  patient  sometimes 
rolls  upon  the  floor  in  agony.  To  alleviate  this  pain,  large  doses  of 
opium,  la\idanum,  or  morphine,  are  required.  A  large  teaspoonful  of 
bicarbonate  of  soda  dissolved  in  a  tumblerful  of  hot  water  is  an  ex- 
cellent remedy  if  drank  at  a  single  draught.  It  relieves  the  acidity 
of  the  stomach,  and  acts  as  a  fomentation  to  the  internal  seat  of  the 
pain.  Mustard  poultices,  or  warm  fomentations,  over  the  seat  of  the 
pain,  are  required.     The  warm  bath  is  excellent. 

The  acid  bath,  made  by  .nixing  three  parts  of  muriatic  acid  with 
two  parts  of  nitric  acid,  and  adding  as  much  of  this  mixture  to  water 
as  will  make  it  about  as  sour  as  weak  vinegar,  is  valuable  in  jaundice. 
Only  a  quart  of  water  need  be  taken ;  and  the  solution  should  be 
applied  with  a  sponge.  It  is  of  the  right  strength,  if  it  produce  a 
sught  tingling  of  the  skin. 

Gall  Stones. — Biliary/  Calculi. 

These  are  concretions,  or  hardening  of  bile  into  masses  of  all  sizes 
from  that  of  mere  grains,  to  that  of  a  nutmeg.  Fig.  97  is  a  specimen 
of  them.  They  are  found  in  the  gall  bladder,  the  cystic 
duet,  the  hepatic  duct,  and  are  sometimes  precipitated 
from  the  bile  after  it  has  passed  into  the  bowels.  In  pass- 
ing through  the  ducts,  if  of  considerable  size,  they  produce 
intense  pain,  particularly  if  they  are  jagged  upon  their  ^^  ^ 
lurface.  M^L 

These  stones,  so  called,  are  composed,  chemically,  of^^^ 
cholesterine,  bile  pigment,  choleic  acid,  choleate  of  soda,  mucus,  earthy 
salts,  and  margarin  and  its  compounds.  A  nucleus  seems  to  be 
first  formed,  and  then  a  gradual  accumulation  takes  place  upon  its 
surface. 


Fra.  U7. 


4. 


Symptoms. — An  almost  constant  uneasiness  in  the  right  hypochon- 
driac region,  with  spasms  of  pain,  coming  on  suddenly,  and  lasting 
for  a  time  with  great  severity,  and  then  subsiding.    The  pain  is  caused 


18  a  valuable 

K  or  this  arti- 

[ccellent. 

ig,  but  coni- 

tgetablea  and 

uid  medicine 

ktic  acid,  and 

kater  slightly 

assist  very 

sponge  bath 

[s  through  the 

'i  —  the  stone, 

way  through 

nt  sometimes 

arge  doses  of 

easpoonful  of 

iter  is  an  ex- 

?s  the  acidity 

al  seat  of  the 

16  seat  of  the 

itic  acid  with 
(cture  to  water 
le  in  jaundice. 
Son  should  be 
it  produce  a 


ses  of  all  sizes 

is  a  specimen 

tic 

ed      *''»«^ 

83- 

ice 
eir 


<4. 


a. 


(k 


of 

11UCU8,  earthy 
seems  to  be 
lace  upon  its 


ht  hypochon- 
',  and  lasting 
ain  is  caused 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


26fa 


by  a  stone  being  suddenly  forced  into  the  duct  and  moving  forward  in 
it,  and  it  subsides  when  the  stone  either  stops,  or  gets  through  the  duct 
When  the  stone  reaches  the  bowels,  it  passes  oft  with  the  stools. 

The  patient  generally  has  a  pale,  sallow  complexion,  a  small,  feeble 
pulse,  and  often  suffers  from  nausea  and  vomiting,  and  from  restless- 
ness and  hurried  breathing. 

Treatment. —  To  reduce  the  spasm,  give  Dover's  powder  in  full 
doses,  or  chlorodine.  Also,  apply  mustard  over  the  right  hypochoii- 
(Irium  and  stomach,  and  follow  it  with  hot  fomentations  with  hops, 
or  use  wet  cups. 

If  the  stomach  is  irritable,  give  the  neutralizing  mixture  until  it 
moves  the  bowels.  A  warm  infusion  of  thoroughwort,  given  to  the 
extent  of  producing  vomiting,  will  sometimes  do  well,  and  lobelia 
enough  with  it  to  relax  the  duct  may  be  useful. 

To  relieve  the  acidity  on  which  the  formation  of  these  stones  so 
often  depends,  a  neutralizing  preparation  (338)  may  be  given  for  a 
long  time,  the  diet,  in  the  mean  time,  being  well  regulated.  The 
sponge  bath,  with  saleratus  and  water,  should  be  taken  daily,  followed 
by  brisk  rubbing ;  and  free  exercise  in  the  open  air  should  Ou  no 
account  be  omitted.  ^  '  .  .    <  , 

Acute  Inflammation  of  the  Stomach. — Gastritis. 

This  is  a  rare  disease.  It  is  generally  induced  by  irritating  and 
corrosive  substances  taken  into  the  stomach.  Poisons,  as  arsenic, 
aquafortis,  corrosive  sublimate,  and  the  like,  are  the  most  common 
causes  of  it.  Blows,  sudden  stoppage  of  sweat,  and  excessive  use 
of  ardent  spirits,  may  also  excite  it. 

Symptoms.  —  It  is  marked  by  burning  pain  in  the  stomach,  thirst, 
restlessness,  anxiety,  constant  vomiting,  prostration  of  strength,  a 
quick,  hard,  and  small  pulse,  incessant  retching,  a  sunken  counte- 
nance, hiccough,  cold  hands  and  feet,  and  a  damp  skin. 

Treatment.  —  If  the  inflammation  be  excited  by  poison,  the  reme- 
dies named  under  antidotes  for  poisons  must  be  first  employed. 

The  poison  being  neutralized  or  thrown  off,  the  inflammatory  con- 
dition must  be  combatted  with  the  remedies  usual  for  such  states. 
Mustard  poultices  to  the  feet,  along  the  spine;  and  particularly  over 
the  pit  of  the  stomac);),  will  be  among  the  first  things  to  be  employed, 
and  should  be  followed  by  hot  fomentations  of  stramonium  leaves  or 
hops,  —  both  the  fomentations  and  the  poultices  to  be  repeated  as  oc- 
casion may  require.  Dry  cupping  over  the  region  of  the  stomach  is 
useful. 

Drinks.  —  Cold  water,  bread-water,  rice-water,  arrow-root  gruel,  in- 
fusion of  slippery  elm  bark,  and  of  marshmallow.  These  should  be 
taken  in  very  small  quantities, —  say  a  teaspoonful  at  a  time,  —  about 
twenty  drops  of  tincture  of  aconite  root  bemg  added  to  half  a  tum- 
blerful. Lumps  of  ice  may  be  held  in  the  rnoath,  and  occasionally 
swallowed. 


270 


DISEASKS  OF  THK  ABDOMINAL  CAVITY. 


Injections.  —  Emetics  and  physic  are  not  proper,  but  iiijectioiia 
(248)  (2/33),  or  siitiply  soap  suds,  will  be  required. 

The  reiiK  dies  must  be  pursued  until  all  tenderness  has  disappeared 
from  the  pit  of  the  stomach. 

While  the  patient  is  recovering,  great  care  must  be  taken  not  to 
overload  the  stomach  with  food.  Arrow-root,  sago,  and  milk  are 
among  the  first  articles  to  be  allowed.  After  these,  will  come  grad- 
ually beef-tea,  chicken  broth,  soft-boiled  eggs,  and  beef-steak,  until  the 
whole  diet  can  be  restored. 


Chronic  Inflammation  of  the  Stomach. 

This  is  a  much  more  common  disease  than  the  preceding ;  indeed 
it  is  very  common.  Though  it  does  not  put  life  in  immediate  danger, 
it  perverts  the  feelings  of  the  stomach,  and  causes  many  of  the  symp- 
toms of  indigestion.  Dyspepsia,  however,  is  a  different  complaint, 
and  not  necessarily  connected  with  inflammation. 

Symptoms.  —  There  is  generally  pain  in  the  stomach,  which  is  in- 
creased by  the  presence  of  food,  and  by  external  pressure.  The  pain 
is  sometimes  felt  only  during  digestion.  The  fermentation  of  the 
food  in  the  stomach  generates  a  gas,  which  is  frequently  belched  up. 
This  is  what  is  meant  in  common  language  by  having  "  wind  in  the 
stomach,"  and  '•  belching  wind."  The  meals  are  frequently  vomited 
up ;  the  appetite  is  fickle,  sometimes  voracious,  and  again  nearly  ab- 
sent ;  the  thirst  is  likewise  variant ;  the  tongue  is  white  in  the  centre, 
and  red  at  the  sides  and  tip,  —  sometimes  smooth  and  red  all  over, 
like  a  slice  of  raw  beef.     The  urine  is  scanty  and  high-colored. 

The  disease  is  very  liable,  if  badly  managed,  to  lead  to  ulceration 
of  the  coats  of  the  stomach,  and  thence  to  a  fatal  end ;  for  an  ulcer 
may  penetrate  the  walls  of  the  stomach,  and  let  its  contents  into  the 
abdominal  cavity,  which  would  excite  an  immediately  fatal  inflamma- 
tion. 

Treatment.  —  If  there  be  much  tenderness,  we  may  apply  leeches 
over  the  stomach.  With  less  tenderness,  counter-irritation  will  an- 
swer,—  as  blisters,  croton  oil,  mustard  poultices,  the  compound  tar 
plaster,  or  dry  cups. 

The  skin  of  the  whole  surface  should  receive  special  attention. 
The  warm  or  the  cold  bath  should  be  used  often,  according  to  the 
strength  of  the  patient.  When  the  reaction  is  good,  a  cold  compress 
bound  upon  the  stomach  every  night,  will  do  much  to  bring  relief. 

The  diet  cannot  be  too  carefully  managed.  While  there  is  consid- 
erable tenderness,  the  nourishment  must  be  of  the  most  simple  and 
unirritating  kind,  —  consisting  of  little  more  than  the  most  bland 
nutritive  drinks ;  and  even  these  should  be  taken  in  small  quantities 
at  a  time.  Gum  arable  water,  rice-water,  barley-water,  arrow-root 
gruel,  tea,  and  toast  without  butter,  will  be  amply  sufficient  to  keep 
soul  and  body  together,  and  will,  in  two  or  three  weeks,  generally 
starve  the  enemy  out  of  his  quarters.  After  this,  a  more  nourishing 
diet  may  gradually  be  resumed. 


put   iiijectioiia 
Is  disappeared 

taken  not  to 

uid  milk  an; 

come  grad- 

peak,  until  the 

kCh. 

Mjng;  indeed 

sdiate  danger, 

of  the  aymp- 

nt  complaint, 

,  which  ia  in- 
re.     The  pain 
itation  of  the 
y  belched  up. 
"wind  in  the 
ently  vomited 
ain  nearly  ab- 
in  the  centre, 
red  all  over, 
colored, 
to  ulceration 
1 ;  for  an  ulcer 
itents  into  the 
ital  inflamma- 

apply  leeches 
ition  will  an- 
Jompound  tar 

ial  attentio/i. 
)rding  to  the 
old  compress 
ing  relief, 
ere  is  consid- 
t  simple  and 
most  bland 
ill  quantities 
r,  arrow-root 
lent  to  keep 
ks,  generally 
e  nourishing 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


J?7 


Indigestion.— Dyspepsia. 

Dyspepsia  is  a  disease  of  civilization.  Savages  know  nothing  of 
it.  It  is  the  costly  price  we  pay  for  luxuries.  All  civilized  nations 
Bufler  from  it,  more  or  less,,  but  none  so  much  as  the  people  of  the 
United  States.  It  is  here,  in  the  new  world,  that  the  disease  has  be- 
come domesticated,  and  we,  as  a  people,  who  have  threatened  to 
monopolize  its  miseries. 

Few  disorders  inflict  upon  their  victims  greater  suffering;  yet  it  is 
not  particularly  dangerous,  and  it  >j  '!ven  doubtful  whether  it  tend* 
very  much  to  shorten  life,  unless  the  kngth  of  life  be  judged  to  con- 
sist in  the  sum  of  happiness  enjoyed,  —  in  which  case,  few  complaints 
shorten  it  more. 

Symptoms.  —  These  vary  very  much  in  different  stages  of  the  dis- 
ease, and  in  different  persons.  In  general  the  complaint  begins  with 
a  sense  of  fulness,  tightness,  and  weight  in  the  stomach,  sooner  or 
later,  after  meals,  and  a  changeable,  (liminished,  or  lost  appetite. 
Occasionally,  the  appetite  is  craving,  and  when,  in  obedience  to  its 
promptings,  a  large  meal  is  taken,  there  is  pain  in  the  stomach,  wi^h 
general  distress  and  n'.'rvousness,  and  sometimes  vomiting.  Flatu- 
lency and  acidity  are  common,  with  sour  and  offensive  belching  of 
wind ;  and  very  often  there  is  a  water-brash,  or  vomiting  of  a  clear, 
glairy  fluid  when  the  stomach  is  empty.  Dizlness  is  a  prominent 
symptom.  There  is  a  great  deal  of  what  patients  call  an  "  all-gone  "■ 
feeling  at  the  pit  of  the  stomach,  —  a  weakness  so  great  at  that  par- 
ticular spot,  that  it  is  very  hard  to  sit  up  straight.  There  is  a  bad 
taste  in  the  mouth ;  the  tongue  is  covered  with  a  whitish  fur ;  there 
is  headache,  heartburn,  palpitation  at  times,  high-colored  urine,  and 
tenderness,  now  and  then,  at  the  pit  of  the  stomach.  The  bowels  are 
generally  irregular,  sometimes  very  costive,  at  other  times  loose,  when 
portions  of  food  are  passed  off  undigested. 

Nervous  Complication.  —  Such  are  the  symptoms  in  a  case  of  sim- 
ple disorder  of  the  stomach,  when  no  other  part  of  the  system  is 
materially  involved.  This  is  indig'estion,  well-marked,  and  distressing 
enough ;  but  it  is  only  a  part  of  what  is  understood  by  a  case  of 
modern  dyspepsia.  In  this,  either  the  indigestion,  in  its  course,  dis- 
turbs and  involves  the  nervous  system,  or  the  nerves  become  them- 
selves disordered,  and  produce  the  indigestion.  Sometimes  one  hap-, 
pens,  sometimes  the  other,  it  matters  not  which  ;  both  are  present,  — 
the  affection  of  the  stomach  and  of  the  nerves,  in  a  case  of  thorough 
dyspepsia.  To  make  out  a  full  case,  in  its  tormenting  completeness,  we 
must  add  to  the  above  symptoms,  great  depression  of  spirits,  amount- 
ing at  times  to  complete  hopelessness  and  despondency  ;  a  dread  and 
fear  of  some  impending  evil ;  a  lack  of  interest  in  passing  events ;  un- 
willingness to  see  company  or  to  move  about ;  an  irritable  and  fretful 
temper ;  a  desire  to  talk  of  one's  troubles,  and  nothing  else ;  a  sallow, 
haggard,  sunken,  and  sometimes  wild  exprep  Jon  of  countenance;  a 
'Iry,  wrinkled,  and  harsh  skin,  with  unrefreshing  sleep,  distarbed  by 


W 


272 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


all  sorts  of  annoyancfs  and  difficulties,  such  as  shipwrecks,  falls  down 
precipices,  and  nightmare. 

The  man  who  has  all  these  symptoms,  or  ai.y  considerable  portion 
of  them,  has  dyspepsia,  and  is  about  as  miserable  as  if  all  the  sorrows 
of  life  were  electrical  currents,  and  were  running  through  him  contin- 
ually. 

Causes  of  Dyspepsia.  —  To  healthy  digestion,  three  conditions  are 
•specially  necessary,  —  that  the  food  should  be  well  chewed  and 
mixed  with  saliva  before  it  is  swallowed ;  that  the  stomach  should 
pour  out  and  mix  with  it  the  right  amount  of  healthy  gastric  juice  ; 
and  that  it  should  be  well  churned  while  in  the  stomach. 

It  is  well  known  that  the  first  of  these  conditions,  a  thorough  chew- 
ing of  food  is  rare  in  this  country.  We  eat  too  fast ;  we  do  not  mcis- 
ticate  our  food  ;  we  boll  it  whole. 

This  is  the  first  cause  of  dyspepsia,  and  it  is  the  fruitful  mother  of 
causes.  It  furnishes  the  occasion  for  eating  too  much  ;  for  when  the 
food  is  swallowed  with  such  rapidity,  the  stomach  is  taken  by  sur- 
prise, as  it  were ;  it  cannot  secrete  gastric  juice  fast  enough  to  be 
difiused  through  the  fast-growing  mass ;  and  the  appetite  does  not 
decline  until  a  great  deal  too  much  is  taken.  The  coats  of  the  stom- 
ach, being  stretched  unnaturally,  do  not  pour  out  the  gastric  juice  at 


the  right  time,  or  as  much  of  it  as  is  wanted,  and  what  there  is,  is 
altered  in  quality. 

Moreover,  the  stomach  being  overburdened,  cannot  turn  over  and 
ahurn  its  contents  properly. 

To  fast  eating,  we  may  add,  high-seasoned  dishes,  too  stimulating 
for  the  stomach;  eating  between  meals,  and  at  unseasonable  hours, — 
particularly  at  bed-time  ;  excessive  use  of  strong  drinks  and  tobacco  ; 
habitually  sitting  up  late  at  night ;  inactive  habits  of  body  ;  and  ex- 
cessive use  of  the  mind. 

No  causes  of  dyspepsia  are  more  active  than  those  which  disturb 
and  fret  the  mind.  It  is  surprising  how  suddenly  any  mental  agita- 
tion will  put  an  end  to  the  appetite,  and  suspend  digestion.  And 
when  these  mental  disturbances  are  protracted,  when  care  becomes  a 
daily  and  hourly  companion,  dyspepsia  is  almost  sure  to  show  itsel£ 
Considering  the  numerous  causes  of  unpleasant  mental  excitement 
which  we  have  in  the  politics,  the  business,  the  ambition,  the  family 
jars,  etc.,  of  this  country,  it  is  a  wonder  that  dyspepsia  is  not  even  more 
prevalent.     It  is  hard  for  the  sensitive  to  escape. 

Urinary  Deposits.  —  Before  speaking  of  the  treatment  of  dyspepsia, 
it  will  be  proper  to  take  notice  of  certain  deposits  in  the  urine,  to 
which  persons  suffering  from  this  complaint  are  liable,  and  the  dis- 
covery of  which,  will,  in  many"  cases,  indicate  the  treatment. 

Many  dyspeptics  have  acid  urine,  which  is  loaded  with  crystals  of 
oxalate  of  lime.  These  persons  are  much  depressed  in  spirit,  and 
look  upon  the  dark  side  of  everything.  They  are  painfully  disturbed 
by  small  annoyances,  are  irritable  in  temper,  incapable  of  exerting 
themselves,  look  with  dread  upon  the  future,  and  generally  have  the 
dark  and  dingy  look  of  the  face,  which  indicates  functional  derange- 
ment of  the  liver. 


falls  down 

ible  portion 
the  sorrowH 
him  contin- 

^nditions  are 
shewed  and 
lach  should 

gastric  juice ; 

^rough  chew- 
do  not  mas- 

1  mother  of 
for  when  the 
aken  by  sur- 
nough  to  be 
tite  does  not 
of  the  stom- 
Lstric  juice  at 
Lt  there  is,  is 

irn  over  and 

)  stimulating 
able  hours, — 
and  tobacco ; 
ody ;  and  ex- 

ffhich  disturb 
mental  agita- 
jestion.  And 
ire  becomes  a 
3  show  itsel£ 
al  excitement 
m,  the  family 
not  even  more 


of  dyspepsia, 
the  urine,  to 
and  the  dis- 
tent 

ith  crystals  of 
in  spirit,  and 
illy  disturbed 
e  of  exerting 
rally  have  the 
on^  derange- 


DISEASE8  OF  THE  ABDOMINAL  CAVITY. 


27.M 


The  most  of  these  crystals  are  octahedral  in  forin,  and  in  the  field 
of  a  good  microscope,  arc  bciintiful  ohjcrts  for  inspection.  (Figs.  98 
iui'l  99.)  To  obtain  them,  take  a  portion  of  urine  passed  in  the 
morning  (urina  sang-uinis),  and  let  it  stand  till  a  deposit  takes  place. 
I'our  oil'  the  upper  portion  of  the  urine  ;  put  a  part  of  the  remainder 
in  a  watch  glass,  and  gently  heat  it  over  a  lamp.  The  heat  will  cause 
a  deposit  of  the  crystals. 


Flo.  99 


Fio.  99. 


Flo.  100. 


The  oxalate  of  lime  is  frequently  found  in  urine,  having  the  form 
of  dumb-bells.  When  examined  by  polarized  light,  they  ajjpear  beau- 
tifully colored  and  striated.     (Fig.  100.) 

The  urate  of  ammonia,  and  uric  acid  gravel,  are  likewise  found  in 
large  quantities,  in  the  urine  of  many  dyspeptics.  Some  ar'j  exhausted 
by  them,  and  reduced  almost  to  skeletons,  and  to  a  wretched  state  of 
health,  —  having  boils,  eruptions,  etn. 

To  find  the  urates,  put  a  little  of  the  urine  containing  the  deposit 
in  a  test  tube,  and  warm  it  gently  over  a  lamp.  Jf  the  deposit  readily 
dissolve,  it  is  probably  urate  of  ammonia  (Figs.  101  and  102),  and  may 
then  be  examined  under  the  microscope,  to  make  the  matter  sure. 


Fio.  101. 


Fio.  102. 


To  find  uric  or  lithic  acid,  let  morning  urine  stand  until  a  solid 
deposit  has  sunk  to  the  bottom ;  then  pour  off  the  liquid,  and  place 
some  of  the  solid  portion  upon  a  glass,  and  examine  it,  with  a  micro- 
scope, and  if  this  acid  be  present,  its  peculiar  crystaline  forms 
(Fig.  103)  will  be  discovered,  either  alone,  or  mixed  with  urate  of 
ammonia. 

In  those  cases  in  which  there  is  a  great  pro.stration  of  the  nervous 

35 


^4 

r] 


J2 


^ 


274 


1)ISP:A8E8  of  the  AUDOMINAL  CAVITY. 


Bystem,  with  a  Iohb  of  pcxuuI  power,  bud  feeling!,  in  the  head,  po:  hap« 
pain  and  weakneas  across  the  loinH,  and  a  tendency  to  eontiuinption, 
I-,,,.  iM.  w<*  iiuiy  Huspect  the  presence  of  tlio  triple; 

pliosphates  in  the  urine.  PlioHphoruH  is 
oni;  of  the  elements  of  the  i)r!iin  ;ind 
nerves,  and  when  there  is  a  constant  drain 
of  this  element  through  the  kidnc^/s,  the 
nervous  system  is  gradually  exImustecL 
To  find  the  triple  phosphates,  put  sonio 
morning  urine  in  a  glass  vessel,  and  let  it 
stand  till  a  sediment  has  gone  to  the  bot- 
tom. Put  Bcme  of  the  sediment  in  a  test 
tube,  apd  v  arm  it  gently  over  a  lamp. 
If  the  waruith  do  not  dissolve  the  deposit, 
add  to  it  a  little  acetic  acid ;  if  the  de- 
posit dissolve  in  the  acetic  acid,  it  proba- 
bly consists  of  earthy  phosphates.  This  is 
then  to  be  examined  luider  the  micro- 
scope to  ascertain  whether  it  is  the  phos- 
phate of  lime,  the  triple  phosphate,  or  a  mixture  of  both. 


Fio.  IM. 


Fio.  106. 


Fio.  106. 


JFlo.  107. 


Fig.  104  shows  us  the  prismatic  crystals  of  the  triple  phosphate. 
In  a  few  rare  cases,  these  are  penniforin  (Fig.  105).  Fig.  106  gives 
us  another  specimen  of  the  crystals  of  the 
triple  phosphates,  as  they  appear  under  the 
microscope,  mixed  with  amorphous  particles 
of  phosphate  of  lime.  If  an  excess  of  am- 
monia be  added  to  the  urine,  the  crystals 
become  star-like,  and  foliaceous,  as  in  Fig. 
107. 


Treatment  of  I)y.^pepsin.  —  As  there  are 
few  complaints  which  distress  the  patient 
more  than  dyspepsia,  so  there  are  few  which 
give  the  physician  rrore  trouble.  Generally 
our  art  has  failed  upon  it  because  too  much 
ha?  been  required  of  us.  We  have  not  merely  been  asked  to  cure 
the  disease,  but  to  do  it  while  the  patient  continues  the  indulgence  of 
his  appetite,  or  his  excessive  application  to  business  or  study.     It  has 


mmA 


(\d,  po:  liapH 

nsutnptioii, 

)f  the  triple 

losplioruM  irt 

brain    ;ui(l 

iiHtant  drain 

Iddnc^/s,  the 

i'xliaustt'(L 

,  put  nomo 

I,  and  h-t  it 

to  the  bot- 

II t  in  a  test 

v(T  a  lamp. 

the  deposit, 

;  if  the  dc' 

rid,  it  probtt' 

lies.     'I'his  i» 

the  niicro- 

t  is  the  phos- 


Fio.  108. 


)1(;  phospliate. 
Fig.  106  gives 


[0. 107. 


asked  to  cure 
indulgence  of 
study.     It  has 


DISKASKS  OF  TIIK  ABDOMINAL  CAVITY. 


27r» 


of  us,  that  with  medicine  we  slionld  contravene  the 
and  restore  health  while  the  causes  of  diseas(>  are  in 


been   cxpc  ted 
laws  of  nature, 
full  ac^tivity. 

This  complaint  is  oftc  brought  on  by  not  keeping  tl.  bowels 
open.  To  cure  it,  thcrcffore,  one  of  the  (irst  things  to  be  done  is  to 
remove  cosliveness  and  regulate  the  bowels. 

One  of  the  very  best  articles  1  know  of  to  remove  cons\;pation  is 
Mettauer's  Aperient.  I  have  ))lace(l  it  in  the  de|)artm(rnt  of  l*har- 
macy  ;  it  ought  to  be  in  the  Unired  States  Dispensatory.  Taken 
immediately  after  meals,  in  doses  of  a  teaspoonful,  it  corrects  acidity 
of  the  stomach,  it  gently  opens  the  bowels,  and  when  its  action  is 
over,  will  be  found  to  liave  diminished  the  costiveness,  rather  than  in^ 
creased  it,  as  most  kinds  of  physic  do.  It  is  excellent  in  the  bilious 
Ibrms  of  dyspepsia,  —  acting  finely  upon  the  liver,  —  particularly  if 
a  fi'w  drops  of  acpia  regia  in  water  be  taken  before  meals,  —  the  ape- 
rient being  taken  after. 

If  piles  exist,  this  mixture  will  be  objectionable  on  account  of  the 
aloes,  and  the  fluid  neutralizing  extract  may  take  its  place.  Sweet 
tincture  of  rhubarb  and  sody,  (37)  is  uometimes  preferable  to  the  ape- 
rient. 

Several  other  preparations  (;18)  (289)  (39)  (290)  will  be  found  use- 
ful to  remove  costiveness  and  d  ability  of  the  stomach. 

For  acidity,  beside  the  remedies  already  mentioned,  prepared  char- 
coal may  be  used,  in  teaspoonful  doses,  or  carbonate  of  magnesia,  or 
fluid  magnesia,  or  trisnitrate  of  bismuth.  A  good  remedy  is  pulver- 
ized guaiacum,  rhubarb,  prepared  charccral,  and  carbonate  of  mag- 
nesia, equal  parts ;  also  (28)  (37)  (38)  (42).  If  crystals  of  oxalate  of 
lime  be  found  in  the  urine,  give  :i  few  drops  of  aqua  regia,  in  water, 
three  times  a  day. 

llyg:ieuic  Trentnient.  —  The  diet  must  be  managed  with  great  pru- 
dence. Food  nmst  be  taken  in  such  quantities  only  as  the  stomach 
can  digest,  however  small  that  quantity  may  be ;  and  it  must  be  taken 
slowly,  and  wel!  chewed.  No  article  should  be  touched,  or  thought 
of,  which  disagrees  with  the  stomach.  Costiveness  may  frequently 
be  entirely  removed  by  eating  no  bread  except  that  made  from  un- 
bolted wheat  flour,  commonly  called  Graham  bread,  or  by  making 
one  of  the  three  daily  meals  of  boiled  cracked  wheat,  with  milk  or 
molasses.  If  the  triple  phosphates  be  found  in  the  urine,  there  is  a 
special  reason  why  the  unbolted  flour,  or  the  cracked  wheat  should 
be  used.  The  wheat  grain  abounds  in  phosphorus,  the  largest  por- 
tion of  which  is  in  the  bran,  and  this  is  much  needed  when  the  kid- 
neys are  robbing  the  brajn  of  its  phosphoric  element. 

Not  too  much  Brain-work.  —  It  is  important  that  the  brain  and 
nervous  system  should  be  relieved  of  the  burden  of  too  much  work, 
and  ihat  the  thoughts  should  be  turned  int  the  most  agreeable  chan- 
nels. If  the  patient  would  get  well,  the  disinclination  to  move  about, 
and  see  company  mnst  be  resisted.  In  many  cases,  dyspeptics  are 
like  sea-sick  persons,  —  feeling  as  though  they  would  rather  go  over- 
board than  move.     In  such  instances,  friends  must  not  be  harsh  with 


' 


»^r^ 


them,  and  frown  upon  their  listlessncss  as  if  it  were  a  fault ;  but 
rather  treat  them  atTectionately,  and  beguile  them  out  by  all  sorts  of 
pleasing  enticements.  Exercise  mvHt  be  hud,  every  day,  and  be  con- 
nected, if  possible,  with  an  object,  so  that  it  may  be  performed  cheer- 
fully. It  is  important  to  engage  the  mind  in  the  exercise ;  and  for  this 
purpose,  some  contested  game  is  very  useful,  as  playing  at  billiards, 
rolling  nine-pins,  pitching  quoits,  or,  whero  the  strength  will  permit, 
playing  ball. 

Cheerfulness.  —  Nothing  does  more  to  drive  away  dyspepsia  than  a 
cheerful,  lively,  and  even  mirthful  state  of  mind.  All  the  nervous  in- 
Huences  sent  from  the  brain  to  the  stomach  should  be  of  the  most 
agreeable  kind.  Some  people  think  it  vulgar  to  laugh.  Let  such 
stand  witTi  long  faces  in  life's  shadows,  if  they  choose.  As  a  general 
rule,  the  best  men  and  women  laugh  the  most.  Good,  round,  hearty, 
side-shaking  laughter,  is  health  for  everybody ;  for  the  dyspeptic,  it  is 
life. 

Dyspeptics  who  have  a  taste  for  it,  and  can  endure  the  expense, 
should  travel.  A  voyage  to  Europe,  and  a  year  spent  in  seeing  the 
wonders  of  the  old  world,  will  generally  cure  the  most  stubborn  case 
of  indigestion.  This,  however,  depends  upon  circumstances.  For 
those  having  the  finer  organizations  and  the  higher  natures,  extensive 
travelling  is  sometimes  indispensable.  The  narrow  circle  of  thoughts, 
associations,  and  things,  in  their  own  neighborhood,  do  not  fill  the 
compass  of  their  wants  ;  their  many-sided  faculties  need  to  be  drawn 
on  by  the  large  variety  to  be  found  only  in  travel.  Their  large  and 
impressible  natures  want  to  be  tilled  full  in  order  to  drive  out  moease, 
and  it  takes  a  world,  or  a  considerable  part  of  it,  to  fill  them.  The 
dyspepsia  of  such  natures  is  not  comprehended  by  the  multitude,  and 
even  physicians  are  often  amazed  that  their  narrow  prescriptions  do 
not  reach  it  .  .  , 

Heartburn. —  Cardialgia. 

This  is  a  gnawing  and  burning  pain  in  the  stomach,  attended  by 
disturbed  appetite.  It  is  generally  caused  by  great  acidity  of  the 
stomach,  and  is  a  symptom  of  dyspepsia,  and  often  "afllicts  pregnant 
women.  Whenever  too  much  food  is  taken,  it  is  liable  to  ferment, 
and  become  extremely  sour,  —  causing  heartburn.  In  such  cases, 
vomiting  often  occurs ;  and  what  is  thrown  up,  is  sour,  and  some- 
times bitter.  , 

Treatment. — Immediate  temporary  relief  may  be  obtained  by  swal- 
lowing a  teaspoonful  of  soda,  magnesia,  or  chalk,  in  a  tumbler  of  cold 
or  warm  water.  Fluid  magnesia,  or  lime  water,  will  answer  the 
same  purpose.  If  there  is  wind  in  the  stomach,  as  well  as  acidity,  a 
teaspoonful  of  the  aromatic  spirit  of  ammonia,  or  (135),  will  often 
still  the  uneasiness  in  a  moment. 

To  cure  the  complaint,  the  stomach  must  be  strengthened  by  the 
remedies  directed  for  dyspepsia. 


")»"'];' 


.m-M«!:, 


DISEASES  OF  THE  ABllOMINAL  CAVITY. 


277 


fault ;  but 
all  sorts  of 
Und  be  con- 
rned  cheer- 
and  for  this 
at  billiards, 
m\\  permit, 


psia  than  a 
jiervous  in- 
of  the  most 
Let  such 
A.S  a  general 
)and,  hearty, 
speptic,  it  is 

the  expense, 
n  seeing  the 
tubborn  case 
tances.  For 
res,  extensive 
:  of  thoughts, 
)  not  fill  the 
I  to  be  drawn 
sir  large  and 
e  out  dioease, 
them.  The 
lultitude,  and 
ascriptions  do 


,  attended  by 
Lcidity  of  the 
lets  pregnant 
(le  to  ferment, 
ii  such  cases, 
ur,  and  some- 

lined  by  swal- 
ambler  cf  cold 
11  answer  the 
11  as  acidity,  a 
}5),  will  often 

jthened  by  the 


Spasm  or  Cramp  in  the  Stomach. —  Gastrodynia. 

Though  generally  of  shorter  duration,  this  is  more  violent  than 
heartburn.  It  is  attended  by  a  sense  of  fulness,  by  anxiety,  and  by 
great  restlessness.  In  females,  hysterical  symptoms  are  often  coupled 
with  it.  Great  quantities  of  air  or  gas  arc  generally  expelled,  and  the 
pain  shoots  through  to  the  back  and  shoulders. 

Treatment.  —  A  strong  purgative  injection  (248)  will  often  bring 
immediate  relief.  The  sweet  tincture  of  rhubarb  and  soda  (37),  with 
a  few  drops  of  tincture  of  cayenne  mixed  with  it,  will  often  bring 
speedy  relief.  So  will  a  mustard  poultice  laid  upon  the  stomach. 
The  mustard  poultice  is  a  remedy  of  great  excellence,  in  many  cascii. 
It  deserves  to  be  called  the  poor  man's  friend. 

Water  Brash. — Pyrosis. 

Thip  consists  in  a  discharge  from  the  stomach,  generally  in  the 
morning,  of  a  thin,  glairy,  watery  fluid,  sometimes  insipid,  at  other 
times,  sweetish,  and  at  still  others,  sour.  A  burning  heat  or  pain  in 
the  stomach  attends,  and  seems  to  be  the  immediate  cause  of  the 
discharge.  The  discharge  appears  to  be  the  natural  mucus  of  the 
stomach,  which  is  poured  out  in  large  quantities  in  consequence  of  a 
kind  of  catarrh  of  its  mucous  lining.  The  amount  thrown  up  varies 
from  a  spoonful  to  a  pint  or  more. 

The  complaint  is  caused  by  a  poor  innutritious  diet,  or  by  whatever 
causes  the  bloo    to  beconre  thin  and  watery. 

Treatment.  —  Ten  or  fifteen  drops  of  water  of  ammonia,  in  half  a 
tumbler  of  water,  will  quiet  the  distress,  and  check  the  discharge. 
The  most  effectual  remedy  I  am  acquainted  with  for  breaking  up  the 
discharge,  is  the  trisnitrate  of  bismuth,  taken  at  meal  times,  in  from 
twenty  to  thirty-grain  doses,  three  times  a  day.  The  compound  pow- 
der of  kino  is  a  valuable  remedy.  The  compound  tincture  of  senna 
and  the  tincture  of  balsam  of  tolu,  in  equal  parts,  and  administered 
in  tablespoonful  doses,  are  sometimes  useful.  The  tincture  of  nux 
vomica  is  a  good  remedy. 

To  restore  the  blood,  some  of  the  various  preparations  of  iron  (74) 
(80)  (73)  (316)  will  be  required. 

The  diet  should  consist  of  easily-digested,  nutritious  food,  —  an 
aoups,  broths,  fresh  meat,  potatoes,  and  unbolted  wheat  bread.    . 

Vomiting. 

This  occurs  under  a  great  variety  of  circumstances.  It  may  be 
induced  by  acidity  of  the  stomach,  by  irritability  of  the  stomach,  by 
distress  of  mind,  by  injury  of  the  brain,  by  offensive  otlors,  and  by  all 
organic  diseases  of  the  stomach. 

Treatment — Generally,  it  is  cured  by  treating  the  disease  which 
induces  it.  But  in  many  cases,  it  persists  very  obstinately,  and  may 
become  the  chief  thing  to  be  attended  to.  In  such  cases,  it  may  re- 
quire a  sixth  or  quarter  of  a  grain  of  morphia  to  check  it    But  gen- 


'-* 


(.- 


. 


craily  some  aromatic,  as  ginger,  spearmint,  peppermint,  or  spice  tea, 
will  put  an  end  to  it.  Some  cordial  or  stimulant,  as  brandy,  cham- 
pagne, tincture  of  ginger,  paregoric,  elixir  solutis,  or  cherry  brandy, 
will  answer  atoII.  Strong  coffee,  without  sugar  or  milk,  will,  in  some 
cases,  act  like  a  charm.  If  it  is  dependent  on  acidity,  the  remedies 
are  given  under  "dyspepsia."  If  caused  by  irritability  of  stomach, 
a  pill  of  extract  of  belladonna  and  ipecac  (339)  will  do  well. 

While  vomiting,  the  patient  "should  lie  still  in  bed,  and  in  bad  casee^ 
a  mustard  poultice  should  be  placed  upon  the  stomach. 

The  vomiting  of  children  may  sometimes  be  stopped  by  wetting  a 
piece  of  cloth  with  laudanum,  and  laying  it  upon  the  pit  of  the  stomach. 

Seasickness.. 

This  is  the  great  terror  of  person?,  wlio,  for  the  first  time,  cross  the 
ocean.  It  is  said  that  dark  complexioned  persons  suffer  more  from  it 
than  others. 

If  it  cannot  be  entirely  prevented,  it  may  be  mitigated  by  lying  flat 
upon  the  back.  To  lie  on  deck,  in  the  open  air,  is  much  better  than 
lying  in  the  close  air  of  the  cabin,  or  state  room.  A  wineglass  of 
brandy,  or  from  ten  to  forty  drops  of  laudanum  will  relieve  the  sick- 
ness very  much.  P'or  a  child,  it  is  sometimes  sufficient  to  wet  a  cloth 
with  laudanum,  and  lay  it  upon  the  pit  of  the  stomach.  Morphine 
is  sometimes  even  better  than  laudanum.  Creosote,  one  drop  at  a 
dose,  made  into  a  pill,  is  excellent  Ten  drops  of  hartshorn,  in  half  a 
tumbler  of  water,  is  good  for  some.  But  the  best  known  remedy  is 
chloroform,  taken  in  doses  of  from  forty  to  eighty  drops,  suspended 
in  water  by  means  of  a  little  gum  arabic. 

Milk  Sickness.  ^ 

This  disease  prevails  in  the  West,  chiefly  in  the  neighborhood  of 
level,  heavily-timbered,  rather  wet  oak  land. 

The  cattle,  horses,  and  sheep,  which  range  in  these  lands,  are  fre- 
quently attacked  by  a  disease  which  the  people  call  the  trembles.  It 
is  supposed  to  be  produced  by  eating  some  plant  growing  upon  those 
lands,  as  cattle  which  feed  in  the  neighboring  regions  are  free  from 
it  until  they  find  their  way  into  these  low  grounds.  It  has  been  sug- 
gested that  the  offending  plant  may  be  the  poison  ivy  {rhus  toxicoden- 
dron). Be  this  as  it  may,  the  calves,  soon  after  sucking  cows  which 
have  run  in  these  grounds,  are  seized  with  trembling,  and  frequently 
die  of  the  disease.  Dogs  which  lap  the  miii.,  are  affected  in  a  similar 
manner.  Children  drinking  it,  leave  the  table  and  vomit.  Upon 
grown  persons  the  effects  are  more  severe,  but  not  so  sudden.  The 
eating  of  the  beef,  mutton,  or  veal,  of  affected  animals,  brings  on  the 
same  disease. 

Symptoms.  —  The  disease  sets  in  with  sickness  at  the  stomach, 
which  is  preceded  by  general  debility,  more  particularly  of  the  legs. 
There  is  nausea,  vomiting,  and  the  breath  is  so  offensive  and  i>eculi'>.r 
that  those  acquainted  with  the  complaint  immediately  recognir  it 
^rom  this  smelL 


DI8E  *  8E8  OF  THE  ABDOMINAL  CAVITY. 


279 


J  spice  tea, 
Idy,  cham- 
|y  brandy, 
|l,  in  some 
remedies 
stomach, 
11. 
■bad  case^ 

wetting  a 
stomach. 


I,  cross  the 
)re  from  it 

lying  flat 
etter  than 
iieglass  of 
3  the  sick- 
vet  a  cloth 
Morphine 
drop  at  a 
,  in  half  a 
1  remedy  is 
suspended 


borhood  of 

ds,  are  fre- 
embles.  It 
upon  those 

free  from 
)  been  sng- 

toxicoden' 
ows  which 
frequently 
n  a  similar 
lit.  Upon 
den.  The 
ngs  on  the 

i  stomach, 
(f  the  legs, 
id  peculJ'>.r 
ecogni'    it 


These  existing  for  weeks,  constitute,  in  some  cases,  the  whole  of 
the  symptoms.  In  other  cases  they  are  more  severe,  being  attended 
by  chills  and  flushes,  great  oppression  about  the  heart,  anxiety,  deep 
breathing,  heat  in  the  stomach  compared  to  fire  and  boiling  water, 
violent  retching  and  vomiting,  alarmmg  beatinga  of  the  heart,  and 
throbbings  of  the  large  vessels,  and  cold  extremities,  —  producing,  all 
together,  extreme  distress. 

In  most  cases,  the  vomiting  returns  every  hour  or  two,  attended  by 
great  burning  at  the  pit  of  the  stomach,  the  substance  thrown  up 
having  a  peculiar  bluish-green  color,  and  a  sour  smell.  As  soon  as 
Ibis  discharge  takes  place,  the  patient  falls  back  upon  the  pillow,  and 
lies  easy  until  another  turn  comes  round.  The  tongue  is  covered 
with  a  whitish  coat,  the  bowels  are  obstinately  costive,  and  the  pulse 
is  small  and  quick. 

Treatment.  —  It  is  believed  that  the  neutralizing  mixture,  given  in 
tablespoonful  doses  every  time  the  nausea  and  burning  sensation  are 
felt,  is  the  most  eftectual  remedy  yet  used.  It  relieves  the  acidity, 
and  seems  well  adapted  to  allay  the  irritation.  Some  antibilious 
physic  (40)  to  move  the  bowels  should  also  be  given. 

Beside  these  remedies,  a  mustard  poultice  should  be  put  upon  the 
stomach,  and  hot  bricks  to  the  feet,  and  the  patient  be  kept  still  for 
some  hours.  The  diet  she  '  I  be  very  mild,  only  toast  water,  rice 
water,  or  thin  gruel.  , 

Acute  Inflammation  of  the  Peritoneum. — Peritonitis. 

This  disease  affects  the  extensive  membrane  which  lines  the  whole 
inside  of  the  belly,  an  extension  of  which  forms  the  omentum  or 
apron.  It  is  an  inflammation  to  which  women  are  much  exposed 
after  confinement,  and  is  known,  in  such  cases,  as  child-bed  fever.  It 
is  common  among  men,  also,  and  is  a  grave  disease. 

Symptoms. —  Like  other  forms  of  fever  and  inflammation,  it  is  pre- 
ceded by  chills,  with  increased  heat  of  surface,  thirst,  full,  strong,  and 
frequent  pulse,  flushed  face,  and  red  eyes,  dry  tongue  with  red  edges, 
dry  skin,  restlessness,  short  quick  breathing,  nausea  and  vomiting. 

The  pain  is  increased  by  the  patient  sitting  or  standing  up, — the 
bowels  being  thus  pressed  against  the  inflamed  membrane.  Lying 
upon  either  side  is  painful  for  the  same  reason.  To  lie  flat  upon  the 
back,  with  the  feet  drawn  up,  is  the  only  endurable  position.  The 
patient  lies  shV/,  for  all  movements  give  pain. 

The  pam  in  this  disease  is  generally  sharp,  cutting,  and  pricking, 
but  is  not  always  equally  intense.  It  is  aggravated  by  the  passage  of 
wind  along  the  bowel,  by  which  the  inflamed  membrane  is  slightly 
stretched. 

When  the  disease  is  advancing  towards  a  fatal  termination,  the  belly 
becomes  greatly  swollen  and  tense, —  having  to  the  hand  a  peculiarly 
tight,  drum-head  feeling ;  the  pulse  is  rapid  and  feeble ;  the  counte- 
nance is  full  of  anxiety,  and  i^  pinched  and  ghastly ;  and  a  cold  sweat 
breaks  out. 


i^ 


280 


DISKASKS  OF  TIIK  ABDOMINAL  CAVITY. 


Treatmeut. —  Small  do»es  of  antimony,  lobelia,  or  ipecac,  to  pro- 
duce nausea,  and  a  moisture  upon  the  skin,  is  generally  among  the 
first  things  given.  The  tincture  of  veratrum  viride,  in  five  to  ten- 
drop  doses,  repeated  every  hour,  will  accomplish  the  same  thing  more 
effectually  than  any  other  known  article.  For  such  purposes,  I  give 
it  the  first  place  among  medicines.  A  large  poultice  of  white  bread, 
rye  meal,  or  flax-seed,  may  be  spread  over  the  belly ;  or  cloths  wet 
with  cold  water,  will  be  still  better,  if  the  patient  be  full-blooded,  and 
naturally  strong.  The  bowels  should  be  moved  at  once  by  some 
active  physic,  as  butternut,  salts,  magnesia,  castor  oil,  or  cream  of 
tartar  (20)  (17)  (18)  (27|,  or  by  podophyllin,  etc.  (40)  (41)  (31). 

The  drinks  should  be  lemonade,  soda  water,  tamarind  water,  current 
jelly  dissolved  in  water,  and  preparations  (298)  and  (299).  Indian 
meul  gruel,  toast-water,  barley  gruel,  and  the  like,  are  the  only  allow- 
able diet. 

Chronic  Inflammation  of  the  Feritonoum. 

When  the  acute  inflammation  of  the  peritoneal  membrane  is  not 
Bucceasfully  treated,  it  may  run  on  for  a  time,  and  then  subside  into  a 
lower  grade  of  inflammation,  called  chronic^  and  in  this  state  remain 
for  an  indefinite  time.  But  it  often  arises  independently  of  the  acute 
disease,  and  attac!:s  persons  of  both  sexes,  and  of  all  classes  and  ages. 
Scrofulous  children  have  it,  and,  wasting  away  under  it  to  mere  skel- 
etons, are  said  to  have  consumption  of  the  bowels. 

Symptoms.  —  These  are  sometimes  very  obscure,  and  the  advances 
of  the  disease  stealthy.  At  first,  there  may  be  only  a  little  soreness 
of  the  belly,  so  slight  as  not  lo  be  noticed  except  after  hard  work,  or 
upon  some  wrenching  motion.  Generally,  there  is  a  sense  of  fulness 
and  tension  of  the  belly,  although  it  may  riot  be  increased  in  size. 
After  a  time,  it  enlarges  a  little,  and  its  tension  or  tightness  increases, 
especially  towards  evening.  By  pressing  carefully  with  the  hand,  a 
deep-feeling  tension  may  be  detected,  giving  to  the  hand  a  sensa- 
tion as  of  a  tight  bandage  underneath,  with  the  skin  and  integu- 
ments sliding  loosely  over  it.  If  \va*'>r  has  been  poured  out  into  the 
abdominal  cavity,  its  fluctuation  nay  frequently  be  detected  by  press- 
ing upon  one  side  of  the  belly  w  th  the  palm  of  one  hand,  and  strik- 
ing the  other  side  with  the  ends  o    *he  fingers. 

As  the  disease  goes  on,  the  feai.  s  become  sharp  and  contracted, 
and  the  countenance  grows  pale  and  sallow.  Ckistivenesa  comes  on, 
Bometimes  chills  and  fever,  with  debility,  loss  of  flesh,  cough,  difficult 
breathing,  hectic,  and  swelling  of  the  legs. 

Treatment  —  Costveness,  if  present,  may  be  relieved  by  Mettauer** 
aperient,  or  the  neutralizing  mixture,  assisted  by  coarse  bread,  and 
boiled  cracked  wheat 

Daily  bathing  is  specially  necessary,  particularly  the  alkaline  sponge 
bath,  with  vigorous  friction  over  the  bowels.  The  warm  bath  once 
or  twice  a  week,  will  be  useful.     la  some  cases,  the  wet  towel  laid 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


281 


c,  to  pro- 
mong  the 
|ve  to  ten- 
hiiig  more 
ses,  I  give 
hite  bread, 
lotha  wet 
oded,  and 
by  some 
cream  of 
(31). 

ter,  current 
).  Indian 
Jnly  allow- 


in. 

rane  is  not 
•side  into  a 
ate  remain 
f  the  acute 
8  and  ages, 
mere  skel- 


e  advances 
tie  soreness 
rd  work,  or 
!  of  fulness 
ed  in  size. 
3  increases, 
he  hand,  a 
d  a  sensa- 
nd  integu- 
it  into  the 
d  by  press- 
and  Btrik- 

contracted, 
comes  on, 
![h,  difficult 

Mettauer's 
bread,  and 

ine  sponge 
bath  once 
towel  laid 


upon  the  bowels  over  night,  and  well  covered  by  flannels,  will  afford 
relief;  or  the  compound  tar  plaster  may  occasionally  be  used. 

If  there  be  diopsy  of  the  belly,  iodide  of  potassium  (138)  should 
be  taken  freely,  ana  the  skin  made  sore  over  the  inflamed  part,  by 
tincture  of  iodine,  well  rubbed  in,  once  a  day. 

If  the  patient  be  pale  and  bloodless,  give  iron,  quinine,  etc.  (74) 
(7f5),  aid  let  the  diet  be  nourishing;  and  if  nervous  symptoms  be 
con  nee.  ed  with  the  debility  and  paleness,  add  some  nerve  tonic  (93) 
(81)  (316).  .  ,     - 

Acute  Inflammation  of  the  Bowels. — Enteritis. 

Bt  inflammation  of  the  bowels  is  generally  understood  an  inflamed 
condition  of  the  mticous  membrane  which  lines  thevi ;  but  this,  most 
commonly,  is  only  a  part  of  the  disease ;  it  involves,  more  or  less, 
beside  this  mucous  lining,  the  whole  substance  of  the  bowel. 

Symptoms. —  The  disease  begins  with  a  cHj  11,  and  with  uneasiness 
and  slight  griping  pains,  which  increase  in  severity  until  they  are  in- 
tense and  burning.  Pressure  aggravates  the  pain,  which  is  most 
intense  about  the  navel,  but  extends  more  or  less  over  the  whole 
bowels. 

From  the  beginning  there  is  sicknees  at  the  stomach,  and  some- 
times vomiting ;  there  is  loss  of  strength,  costiveness,  great  anxiety, 
thirst,  heat  and  fever,  dry,  furred,  and  red  tongue,  and  but  little  urine, 
with  pain  in  passing  it.  The  matters  passed  from  the  bowels  are 
dark  and  fetid ;  and  the  whole  belly  is  tender  and  sore  to  the  touch. 
The  pulse  is  quick,  hard,  and  small. 

The  stomach  will  be  but  little  afTected,  comparatively,  when  the 
disease  is  at  some  distance  from  it  in  the  lower  portion  of  the  bowels. 
Indeed,  the  nearness  of  the  inflammation  to  the  stomach,  or  its  re- 
moteness from  it,  may  be  judged  pretty  correctly  by  the  degree  of 
disturbance  in  that  organ.  The  length  of  time  after  drink  and  medi- 
cines are  swallowed,  before  they  are  vomited  up,  is  a  pretty  good 
measure,  likewise,  of  the  distance  of  the  disease  from  the  stomach. 

How  to  Discriminate.  —  This  disease  is  liable  to  be  confounded 
with  colic,  and  with  inflammation  of  the  peritoneum.  It  is  important 
to  distinguish  it  from  colic,  particularly,  for  the  treatment  for  that 
would  aggravate  this.  In  this  disease,  the  pain  is  increased  by  pres- 
sure ;  in  colic,  it  is  not,  but  is  rather  relieved.  In  enteritis,  the  pain 
remits,  but  never  ceases  wholly,  as  it  does  in  colic.  In  enteritis, 
the  knees  are  drawn  up,  and  the  breathing  is  short ;  in  colic,  it  some- 
times gives  relief  to  stretch  the  feet  down,  and  the  breathing  is  not 
altered. 

To  distinguish  it  from  inflammation  of  the  peritoneum,  take  notice 
that  diarrhoea  is  much  more  common  than  in  this  latter  complaint 
while  the  pulse  is  not  as  quick,  nor  the  pain  as  severe. 

Treatment. —  This  should  be  very  much  the  same  as  that  recom- 
mended for  inflammation  of  the  peritoneum.     Perhaps  in  both  dis- 


V%ii  j' 


^JAftjrJ^A 


282 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


eases,  it  might  be  well  to  begin  with  covering  the  belly  all  over  with 
leeches.  Aa  for  taking  blood  from  the  arm,  in  large  quantitiea,  as 
recommended  in  moat  of  the  books,  I  cannot  think  it  necessary. 

The  tincture  of  veratrum  viride,  in  full  doses,  so  as  to  keep  up  a 
free  perspiration,  cold  compresses,  mustard  poultices,  hot  fomentations, 
poultices,  blisters,  soothing  and  quieting  injections,  and  demulcent 
drinks,  as  slippery  elm,  marshmallow,  flax-seed,  etc.,  if  judiciously  ap- 
plied, will  do  about  all  that  we  have  it  in  our  power  to  accomplish ; 
and  under  such  treatment,  the  patient  will  recover  faster,  and  get  up 
better,  than  when  blood  is  freely  drawn. 

In  this  disease  it  is  well  to  inquire  if  the  patient  has  a  hernia,  for  if 
so,  it  is  liable  to  become  strangulated  without  his  knowledge.  A' 
strangulation  of  the  gut  may  be  the  cause  of  the  disease.  When  this 
happens,  the  complaint  is  very  unmaiiageable.  The  bowel  may  pos- 
sibly, in  such  case,  be  disentangled  by  applying  a  large  dry  cup  ;  or, 
what  is  better,  a  number  of  small  ones ;  but  the  tenderness  of  the 
belly  makes  the  use  of  this  remedy  difficult. 

Chronic  Inflammation  of  the  Bowuls. 

Like  other  chronic  inflammations,  this  may  follow  the  acute  form, 
but  it  also  results  from  various  other  causes,  as  unripe  fruit,  taking 
cold,  drastic  physic,  and  improper  treatment  of  other  diseases. 

Symptoms.  —  Red  end  and  borders  of  the  tongue,  dull  pain  in  belly, 
increased  by  pressure  and  rough  motion,  abdomen  either  swelled  or 
flat,  skin  dry  and  husky,  feet  and  hands  cold,  small  frequent  pulse, 
thirst,  loss  of  flesh,  low  spirits,  urine  scanty  and  high-colored,  and 
dirty,  slimy  discharges  from  the  bowels,  from  one  to  four  times  a 
day. 

Treatment. —  To  begin  with,  blisters,  or  croton  oil,  or  mustard  poul- 
tices, or  dry  cups,  if  the  tenderness  is  not  great,  or  leeches  if  it  is. 

If  the  bowels  are  hot  and  feverish,  bind  a  cold  compress  upon  the 
belly  over  night,  —  covering  it  well  with  flannel.  The  warm  bath 
should  be  used  twice  a  week. 

The  diet  must  be  of  the  most  simple,  unirritating  kind, — beginning 
with  a  solution  of  gum  arable,  rice-water,  barley  water,  arrow-root  or 
sago  gruel,  and  gradually  rising,  as  the  symptoms  improve,  to  beef 
tea,  mutton  and  chicken  broth,  tender  beef  steak,  etc. 

When  the  strength  will  permit,  gentle  exercise  must  be  taken  in 
the  open  air,  but  not  on  horseback,  or  in  hard,  jolting  carriages. 

As  Soon  as  the  inflammation  is  subdued,  some  mild  laxative  (35) 
may  be  given,  in  connection  with  an  infusion  of  wild-cherry  barl^ 
geranium,  and  Solomon's  seal,  equal  parts. 

Wind  Colic— Flatulent  Colic. — Interalgia. 

This  is  a  severe  and  distressing  pain  in  the  bowels,  —  sometimes  a 
stoppage,  and  a  swelling  about  the  pit  of  the  stomach  and  the  navel. 
What  children  call  belly  ache  'u  a  miU  for;a  of  it.     The  wind  passing 


t, 


over  with 
|uaiititieH,  as 
jssary. 

keep  up  a 

^mentations, 

demulcent 

pciously  ap- 

laccomplish ; 

and  get  up 

hernia,  for  if 
[wledge.  A' 
When  thia 
'el  may  pos- 
dry  cup ;  or, 
rnes8  of  the 


S. 

acute  fotm, 
fruit,  taking 
!ases. 

lain  in  belly, 
r  swelled  or 
squent  pulse, 
•colored,  and 
four  times  a 

lustard  poul- 
8  if  it  is. 
688  upon  the 
warm  bath 

— beginning 
rrow-root  or 
ave,  to  beei^ 

be  taken  in 
iages. 

ixative  (35) 
cherry  bark, 


gta. 

lometimes  a 
i  the  navel, 
iiid  pasuing 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


28a 


from  one  portion  of  the  bowel  to  another,  causes  a  rumbling  noise. 
The  pain  is  not  increased  by  pressure ;  and  this  distinguishes  it  from 
the  pain  of  inflammation.  It  moves  about,  too,  from  place  to  place, 
and  is  much  relieved  by  the  escape  of  wind  up  or  down. 

The  complaint  may  be  caused  by  a  weakness  in  the  digestive  or. 
gans,  by  eating  indigestible  food,  or  unri|)e  fruit,  by  costiveness,  and 
by  tak-ng  cold.  Some  persona  always  have  the  colic  excited  by  eat- 
ing certain  kinds  of  fruit. 

Trefltment. —  When  the  complaint  is  caused  by  an  indigestible  sub- 
stance taken  into  the  stomach,  the  offending  matter  should  be  thrown 
otr  by  a  <  emetic  as  soon  as  possible.  If  this  does  not  bring  relief, 
let  it  be  followed  by  a  dose  of  salts,  salts  and  senna,  compound  infu- 
sion of  senna,  elixir  salutis,  elixir  pro.,  or  sweet  tincture  of  rhubarb. 
If  there  is  no  sickness  of  the  stomach,  a  little  essence  of  pepf^ermint 
or  spearmint  in  hot  water,  or  brandy,  gin,  or  whiskey,  in  hot  water, 
may  prove  sufficient  to  expel  the  wind,  and  relieve  the  pain.  Ginger 
and  hot  water  does  well  with  some.  If  there  be  costiveness,  and  the 
pain  is  obstinatt*,  let  the  bowels  be  unloaded  by  a  stimulating  injec- 
tion (248)  (249)  (250).  . 

I 

Ai:  -Swellings. —  Tympanites, 

It  is  quite  common  for  persons  in  delicate  health,  —  particulfly 
females,  —  to  have  their  j*omocIi  and  bowels  swell  up,  sometimes 
slowly,  sometimes  suddenly,  so  that  they  cannot  bring  their  clothes 
together.  They  do  not  know  what  to  make  of  it ;  it  sometimes 
alarms  them  ;  and  they  ask  their  medical  adviser  what  it  means. 

Explanation.  —  This  is  the  meaning  of  it.  It  is  neither  more  nor 
less,  in  many  cases,  than  the  air  within  the  muscles  and  membranes 
swelling  up  and  distending  them  in  consequence  of  their  being  in  a 
weakened  condition.  There  are  two  ways  in  which  the  flesh  may  be 
caused  to  bloat.  It  may  be  caused  by  placing  a  cupping  glass  over 
it,  and  taking  ofl  the  external  air.  When  this  is  done,  the  air  within 
seeks  to  fill  the  vacuum  above,  and  lifts  up  the  flesh.  So,  likewise,  if 
the  parts  are  weak,  and  lose  their  tone,  they  give  way,  and  let  more 
air  into  their  substance,  and  they  stret<;h  and  puff  up. 

But  these  swellings  may  occur  from  an  accumulation  of  air  within 
the  bowels,  and  also  within  the  abdominal  cavity.  This  latter  gives 
the  belly  a  peculiarly  hard  feel,  like  the  head  of  a  drunr,,  and  when  it 
is  pressed  upon  with  the  fingers,  no  indentation  remains. 

Treatment  —  If  the  air  be  in  the  intestinal  tube,  a  stimulating  in- 
jection may  bring  away  the  wind.  It  may  be  composed  of  one  pint 
of  infusion  of  peppermint,  one  gill  of  tincture  of  prickly  ash  berries, 
half  a  gill  of  tincture  of  castor,  and  a  teaspoonful  of  ginger.  The 
bowels  of  the  patient  should  be  rubbed  for  a  long  time ;  and  in  ail 
forms  of  the  complaint,  it  would  be  well  to  do  thia  every  day.  Some- 
times the  wind  may  be  drawn  off  by  inserting  into  the  rectum  a  long 
gum-elastic  tube. 


=.4 


284 


DISEASES  OF  THE  ABDOMINAL  CAVITY 


The  best  constitutional  remedies  are  tonics,  —  iron,  quinine,  mineral 
acids,  and  bitters,  (48)  (55)  (59)  (60)  (62)  (63)  (64)  (71)  (73). 

Exercise  in  the  open  air,  and  a  careful  regulation  of  the  diet  will 
do  much  towards  removing  these  troubles.  Costiveiiess  must  be  care- 
fully guarded  against. 

Bilious  Colic. 

This  is  a  dangerous  disease.  There  is  pain  of  a  griping,  twisting, 
tearing  kind,  —  what  the  ancients  called  atrocious  pain.  It  is  chiclly 
about  the  navel,  but  sometimes  tortures  the  whole  belly.  It  comes 
and  goes  in  paroxysms.  Sometimes  the  abdomen  is  drawn  in,  at 
other  tiTies  it  is  swelled  out,  and  stretched  like  a  drum-head.  At 
first  the  pain  is  relieved  by  pressure ;  after  a  time  the  belly  is  tender  to 
the  touch.  There  is  thirst  and  heat,  and  a  discharge  of  bilious  mat- 
ter from  the  stomach.  In  the  worst  cases,  the  pulse  is  small,  the  face 
pale,  the  features  shrunk,  and  the  whole  body  covered  with  cold 
sweat  While  the  head  is  hot,  the  feet  are  cold.  In  advanced  stages 
of  the  disease,  the  action  of  the  bowels  is  sometimes  reversed,  and 
the  fecal  matter  forced  up  through  the  mouth. 

Causes.  —  Costiveness,  irritating  substances  in  the  bowels,  thick, 
vitiated  bile,  long  exposure  to  cold,  torpidity  of  the  liver  and  ekiii, 
great  unnat  .lal  heat,  with  dampness,  etc. 

Treatment. —  Administer  an  active  purgative  injection  immediately 
(251)  (252).  Internally,  dioscorein,  camphor,  etc.  (340),  every  fifteeii 
minutes,  till  relief  is  obtained,  —  at  the  same  time  covering  the  whole 
belly  with  a  large  mustard  poultice.  A  strong  decoction  of  the  wild 
yam  root,  drank  freely,  is  a  medicine  of  some  value,  —  so  is  a  decoc- 
tion of  scullcap  and  high-cranberry  bark,  equal  parts.  This  latter 
article  is  excellent  in  spasmodic  affections,  on  which  account,  it  has 
gained  the  name  of  cramp  bark.  The  sickness  at  the  stomach  may 
be  allayed  frequently  by  effervescing  drafts,  to  which  twenty-five  or 
thirty  drops  of  laudanum  are  added,  ('roton  oil,  given  in  one-drop 
doses,  done  up  with  crumb  of  bread,  will  sometimes  succeed  well  as 
a  purgative  medicine ;  or  castor  oil  and  spirits  of  turpentine,  e(|ua) 
parts,  in  two  great  spoonful  doses,  may  be  tried  before  the  croton 
oil. 

The  warm  bath  is  worth  remembering,  and  trying,  too,  if  the 
means  are  at  hand.  Hot  fomentations  of  the  bowels  with  a  decoc- 
tion of  poppy  leaves,  stramonium  leaves,  hops,  w^ormwood,  boneset, 
or  peppermint  leave  ,  nhould  not  be  overlooked.  Bottles  filled  with 
hot  water,  or  hot  bricks  rolled  in  flannel,  should  be  placed  at  the  back 
and  feet,  to  promote  perspiration. 

Persons  subject  to  this  complaint,  may  derive  advantage  from  one 
pill  composed  of  extract  of  high  cranberry  bark,  etc.  (100),  taken  after 
each  meal  for  some  months.  At  the  same  time  a  reasonable  amount 
of  exercise  should  be  taken  out  of  doors,  and  a  sponge  bath,  with 
friction,  be  employed  daily.  Care  should  be  taken  not  to  be  often 
•xposed  to  the  hot  sun. 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


285 


Ine,  mineral 
J3). 

|e  diet  will 
ist  be  care- 


,  twisting, 

t  is  fhiclly 

It  comes 

awn  in,  at 

head.  At 
is  tender  to 
)iliou8  mat- 
ill,  the  face 

with  cold 
need  stages 
versed,  and 

wels,  thick, 
r  and  skin, 

mmediately 
!very  fifteen 
g  the  whole 

of  the  wild 
►  is  a  decoc- 

This  latter 
ount,  it  has 
amach  may 
enty-five  or 
in  one-drop 
;ed  well  as 
ntine,  e(|ual 

the  croton 

too,  if  the 
ith  a  decoc- 
)d,  boneset, 
filled  with 
at  the  back 

;e  from  one 
taken  after 
sle  amount 
bath,  with 
o  be  often 


Painters'  CJolic. —  CoUca  Pictonum. 

This  form  of  colic  is  caused  by  the  slow  introduction  of  lead  into 
tlie  system,  —  generally  the  carbonate  of  lead.  It  passes  under  the 
dilVerent  English  nameaof  pa'nters'  colic,  Devonshire  colic,  and  dry 
belly-ache.  The  first  of  these  iit  the  name  by  which  it  is  most  com- 
monly known,  from  its  frequent  occurrence  atnong  painters,  who  uso 
white  lead  (carbonate  of  lead)  a  great  deal  in  the  preparation  of  their 
lolors. 

Symptoms.  —  The  disease  generally  comes  on  in  a  very  gradual 
w  ly.  At  first,  the  appetite  is  impain.'d,  there  is  slight  nausea,  belch- 
ing of  wind,  languor,  very  obstinate  costivcness,  transient  pains,  with 

eeling  of  weight  and  tightness  in  the  belly,  and  a  disinclination  to 

,ike  any  exertion. 

By  degrees,  the  pain  in  the  bowels,  and  particularly  about  the  ns- 
vel,  becomes  more  severe,  and  has  a  hoisting  character.  The  belly 
becomes  hard,  drawn  in,  and  a  little  tender  to  pressure,  and  the  stom- 
ach very  irritable.  The  pam  occasionally  slacks  off  a  little ;  but 
never,  even  in  mild  cases,  entirely  stops,  as  in  other  kinds  of  colic. 

In  some  severe  cases,  the  pain  runs  up  to  the  chest,  and  down  the 
arms  ;  also  down  to  the  bladder,  causing  the  urine  to  be  passed  w'u.i 
pain  and  difficulty,  and  giving  a  sense  of  weight  and  bearing  down 
in  the  lower  belly.  During  the  severest  pains,  the  countenance  ia 
pale,  contracted,  and  full  of  sufTering ;  cold  sweats  break  out  upon 
the  face  and  limbs,  and  anxiety  and  agitation  seize  the  patient. 

When  the  disease  is  not  seasonably  removed,  it  degenerates  into 
the  chronic  form,  the  mental  and  physical  energies  become  torpid, 
the  circulation  in  the  small  vessels  inactive,  the  skin  dry,  harsh,  shriv- 
elled, pale,  sallow,  or  of  a  leaden  hue,  the  temper  irritable,  despond- 
ing and  gloomy,  and  the  body  wasted.  Beside  all  this,  the  muscles 
which  lift  up  the  lower  arm  become  palsied,  so  that,  when  the  arms 
are  raised,  the  hands  hang  down  in  a  helpless  condition.  In  some 
cases,  there  is  a  blue  line  along  the  edges  of  the  gums. 

Treatment  —  For  relieving  the  pain  and  opening  the  bowels,  the 
treatment  should  be  very  much  the  same  as  that  for  bilious  colic 
There  is  one  article,  however,  which  is  thought  to  have  some  special 
influence  in  curing  this  disease,  after  it  has  become  chronic;  it  is 
alum.  Fifteen  grains  of  alum,  two  of  aloes,  two  of  jalap,  and  four 
of  Dover's  powder,  may  be  mixed,  and  taken  for  a  dose  two  or  three 
times  a  day.  If  the  muscles  of  the  arm  be  palsied,  one  sixteenth  of 
a  grain  of  strychnine  may  be  added  to  the  above.  The  aromatic  sul- 
phuric acid,  taken  as  a  drink,  fifteen  drops  to  the  tumblerful  of  water, 
is  always  worthy  of  trial. 

The  use  of  the  electromagnetic  machine  may  be  tried  for  the  palsy; 
or  a  splint  applied  to  the  arm  and  hand,  with  vigorous  friction  applied 
once  or  twice  a  day,  will  sometimes  do  much  for  recovering  the  use 
of  the  muscles. 

But  the  best  remedy  for  i,lie  palsied  muscles  is  iodide  of  potassium 


:&>la2,^i£Sk> 


286 


DISKASES  OF  THE  AUDOMINAh  CAVIT , 


1 


*       • 


(140),  taken  freely.  The  sulphnret  of  potasHa,  one  ounce  dinsolved  in 
a  (jnart  of  water,  and  taken  in  tea^poonful  dosen,  three  time«  a  day,  in 
also  worth  a  trial.  The  all'eeled  arm  uhouid  be  Hoaked  an  hour,  oneo 
or  twice  a  day,  in  the  tsaniu  amount  of  this  latter  salt,  dissolved  in  a 
gallon  of  water. 

Ncaiis  of  Prevention. —  The  numerous  persons  who  work  in  lead, 
should  coml)  their  hair  with  a  fine  comb,  wash  their  hands  and  hue, 
and  rin.se  their  mouth  several  times  a  dav,  and  also  wash  the  whole 
person  with  soap  once  or  twice  a  week,  and  with  clear  water,  or  sal- 
eratus  and  water,  once  a  day.  Their  working  clothes  should  be  of  a 
kind  to  admit  of  being  washed  once  or  twice  a  week,  and  they  should 
\k'.  put  olV  for  others  when  out  of  the  workshop.  A  paper  cap  should 
be  worn  while  at  work.  The  food  of  the  workmen  should  not  be  ex- 
IMJsed  to  the  vapors  or  Hoating  particles  of  lead,  and  consequently 
should  not  be  carried  into  the  shop ;  and  when  much  of  the  poison  is 
Hoating  in  the  air  of  the  work  room,  it  is  a  good  plan  to  wear  a  mask 
to  j)revent  its  btdng  drawn  with  the  breath  into  the  throat  and  lungs. 

It  has  been  said  that  those  who  cat  fn.'ely  of  fat  meats,  butter,  and 
other  oily  substances,  are  not  attacked  by  the  disease,  though  exjx)sed 
to  the  poison.  I  know  not  what  protection  this  can  give,  unless  the 
skin  is  in  this  way  kept  more  oily,  which  prevents  the  absorption  of 
the  poison.  This  would  seem  to  afford  a  hint  in  favor  of  anointing 
the  whole  person  once  or  twice  a  weelt  with  sweet  oil. 

'        ,  CoBtivenesB.— Oonstipation. 

Few  disorders  are  more  common  than  costiveness.  By  this  term 
I  mean  a  sluggish  state  of  the  bowels,  which  causes  them  to  retain 
the  feces  longer  than  is  warranted  by  health.  In  this  complaint,  the 
discharges  from  the  bowels  are  not  always  less  frequent  than  they 
should  be,  but  they  are  less  in  quantity,  are  compacted  and  hard,  and 
are  passed  by  hard  straining,  and  sometimes  with  considerable  pain. 

Symptoms.  —  Headache,  dizziness,  feverishness,  bad  feelings  in  the 
head  not  easily  described,  loss  of  appetite,  sometimes  nausea,  but 
little  desire  to  go  to  stool,  a  weight  and  heaviness  about  the  lower 
part  of  the  belly,  and  a  sense  of  confinement  over  the  whole  body. 

Causes;  —  Sedentary  habits,  particularly  when  connected  with  close 
application  of  the  mind ;  astringent  articles  of  medicine ;  stimulating 
diet,  composed  chiefly  of  animal  food  ;  various  diseases,  particularly 
those  of  a  nervous  character,  and  especially,  a  neglect  to  evacuate 
the  bowels  at  proper  periods.  All  ^  hese  causes  tend  to  weaken  the 
bowels,  and  gradually  to  arrest  that  peculiar  undulatory  movement, 
or  worm-like  action,  called  the  peristaltic  motion  of  the  bowels.  It 
is  this  continual  contraction  of  the  muscular  fibres  of  the  intestines 
from  above  downward,  which  pushes  the  contents  steadily  along;  and 
whatever  weakens  the  force  of  this  vernicular  play  of  the  intestinal 
walls,  brings  on  constipation. 

Treatment.  —  One  of  the  first  things  to  be  done  is  to  establish  the 


TT 


DISEASES  OV  THK  ABOOMINAL  CAVITY. 


287 


lissolvcd  iti 
Ja  II  (lay,  is 
jhonr,  onco 
lulvL'd  ill  a 

k  in  lead, 
and  face, 
tlm  whole 
\U'r,  or  sal- 
Id  be  of  a 
ley  nhould 
ap  should 
not  be  t'x- 
HHequently 
(•  poiison  is 
-•ar  a  mask 
md  lungs, 
jutter,  and 
ih  ex|X)sed 
unless  the 
sorption  of 
"  anointing 


y  this  term 
1  to  retain 
iplaint,  the 
than  they 
I  hard,  and 
ible  pain. 

ngs  in  the 
ausea,  but 
the  lower 
le  body. 

with  close 
timulating 
articularly 
>  evacuate 
^•eaken  the 
novement, 
owels.     It 

intestines 
Jong;  and 

intestinal 

tablleh  the 


habit  of  attempting  to  evacuate  the  bowels  at  a  particular  hour  every 
day.  The  best  time  for  most  persons  is  soon  after  breakfast  in  the 
morning.  Whether  successful  or  not,  the  attempt  to  procure  an  evac- 
uation should  on  no  account  be  omitted.  This  regularity  will  often 
tlo  much  to  break  up  the  costive  habit. 

Diet.  —  To  this  should  be  added  a  careful  regulation  of  th.;  diet. 
The  quantity  of  food  taken  should  be  no  greater  than  can  be  easily 
digested.  Full  meals  which  distenci  the  stomach  and  cause  it  to  press 
upon  the  bowels  embarrass  their  movemepts.  Bread  made  from  fine 
wheat  Hour  is  an  abomination  in  this  disi'rdcr.  Eat  only  that  from 
unbolted  (lour.  Cracked  wheat,  prepared  as  directed  amon^;  dicrtetic 
preparations,  is  excellent  for  the  cure  of  costiveness.  Fresh  vegeta- 
bles, as  peas,  beans,  potatoes,  squashes,  and  ripe  fruits,  in  their  sea- 
son, are  all  wholesome,  and  tend  to  relieve  costiveness.  But  rich  pies, 
puddings,  cakes,  doughnuts,  and  ail  that  sort  of  trash,  increase  the 
disorder. 

Water  Injections,  etc.  —  One  of  the  best  remedies  is  wat«r,  cold  or 
tepid,  accordmg  to  the  condition  of  the  patient,  injected  into  the  bow- 
els with  the  dumestic  si/ringe.  The  best  syringes  for  this  purpose  are 
Mattson's,  and  Davidson's,  one  of  whi'ih  should  be  in  every  family. 
Water  used  externally,  in  the  form  of  the  sponge  bath,  is  also  useful. 

iHedicines. —  All  the  above  measures  having  failed  to  give  relief, 
take  Mettauer's  aperient,  or  the  neutralizing  mixture.  If  these  fail, 
podopiiyllin,  etc.  (36),  may  have  a  trial.  A  cold  decoction  of  thorough- 
wort,  drank  daily,  sometimes  has  an  excellent  effect.  It  must  be  re- 
membered that  medicines  may  make  matters  worse,  and  they  should 
be  used  cautiously. 

All  the  causes  of  the  disease  must  of  course  be  avoided. 

Files.— Hemorrhoids. 

There  are  few  complaints  more  common  than  the  piles,  and 
scarcely  any  which  cause  more  trouble  and  misery.  They  consist  in 
a  fulness  of  blood,  and  languid  circulation  in  the  lower  portion  of  the 
bwer  bowel  or  rectum.  In  consequence  of  this  congestion,  eithe:  the 
veins  of  the  gut  become  enlarged  or  varicose,  or  the  blood  gets  infil- 
trated into  the  cells  beneath  the  mucous  membrane,  and  collects  so 
as  to  form  bloody  tumors. 

These  tumors,  whicli  are  seldom  absent,  are  the  leading  features  of 
the  piles.  They  sometimes  appear  externally,  around  the  anus  ;  this 
is  external  piles.  At  other  times  they  are  within  the  bowel ;  the  com- 
plaint is  then  called  internal  piles.  They  are  called  bleeding  piles 
when  blood  is  discharged,  and  blind  piles  when  it  is  not. 

S^^mptoms.  —  Usually  there  is  a  sense  of  weight  and  weakness  in 
the  lower  part  of  the  back  and  loins,  with  a  painful  itching  about  the 
anus.  On  going  to  stool,  there  is  a  burning,  cutting  pain  experienced, 
which  is  followed  by  bearing  down  and  tenesmus.     If  it  be  bleeding 


i'tU 


f 


288 


DISEASES  OP  TIIK  ABDOMINAL  CAVITY. 


piles, 
There 


the  little  tutnors  will  blned  at  every  raotion  of  the  bowels, 
'here  are  frequently  dinagreeuble  HuiiHUtioiiii  in  the  head,  general  las- 
Hitude,  an  irritable  Htatu  uf  mind,  and  a  HcnHC  of  fulnesH  and  anxiety 
in  the  atomach.  The  pains  experieneed  range  all  the  way  from  the 
HiighteHt  twinges  up  to  the  most  terrible  sutFeriiigH,  which  appear  like 
tearing  the  body  asunder. 

CuUHes. —  Everything  that  irritates  the  lower  bowel,  and  cauwes  a 
determination  of  blood  to  the  part.     All  drastic  physic  has  thin  efleet, 

—  particularly  aloes,  which  acts  especially  upon  the  rectum.  Uabii- 
iial  costivenesH,  straining  at  stools,  riding  uuu-h  on  horselmtk,  Hitniig 
a  great  deal,  tight  lacing,  high-seasoned  food,  and  stimulation  gener- 
ally, lifting  and  canying  heavy  weights,  and  indurations  of  the  liver. 

Females  during  pregnancy  are  nmch  alllicted  with  piles,  which  are 
induced  by  the  costiveness  so  peculiar  to  their  condition,  and  by  the 
pressure  of  the  enlarged  womb  upon  the  veins  of  the  pelvis. 

Treatment. — This  should  be  medicinal  and  dietetic. 

Great  care  must  be  observed  not  to  push  medication  too  far.  Ac- 
tive purging  will  do  great  mischief.  Yet  costiveness  must  in  some 
way  be  corrected.  For  this  purpose,  no  remedy  that  I  have  ever 
tried  has  done  better  in  this  complaint  than  an  electuary  composed 
of  confection  of  senna,  flowers  of  sulphur  and  cream  of  tartar  (6), 
taken  in  doses  just  sufficif  nt  to  procure  one  natural  motion  of  the 
bowtls  each  day.  Pills  made  of  extract  of  thoroughwort  are  said  to 
do  well.  If  the  liver  be  in  a  congested  state,  take  some  of  the  arti- 
cles recommended  in  the  cl'ronic  inflammation  of  that  organ. 

For  the  local  treatment,  nothing  is  better  than  two  ounces  of  lard 
and  one  dram  of  the  flowers  of  sulphur  mixed,  and  rubbed  between 
two  plates  of  lead  until  they  are  well  blackened.  This  ointment  is 
not  only  soothing,  but  curative,  both  in  the  bleeding  and  blind  piles. 
An  ointment  of  almost  equal  excellence  may  be  made  from  one  hand- 
ful each  of  witch  hazel  bark,  white  oak  bark,  and  sweet-appletree 
bark,  boiled  together  in  one  pint  of  water  down  to  one  third  of  a  pint. 
Then  strain,  and  add  two  ounces  of  lard,  and  simmer  away  the  water, 

—  stirring  continually  before  and  after  removing  from  the  fire,  till  it 
cools. 

If  there  is  much  inflammation  and  distress,  an  emolient  and  sooth- 
ing poultice  should  be  applied,  composed  of  slippery  elm  bark  and 
stramonium  or  poke  leave «.  Steaming  the  parts  is  sometimes  useful, 
by  sitting  over  a  hot  decoction  of  hops,  stramonium,  and  poke. 

Piles  may  often  be  cured  by  the  use  of  the  domestic  syringe.  Dailr 
injections  of  cool  or  cold  water  will  do  much  to  strengthen  the  bowel, 
and  restore  the  dilated  veins  to  their  natural  condition. 

The  food  should  be  of  a  laxative  nature,  corn  bread,  rye  pudding, 
bread  of  unbolted  wheat  flour,  mealy  potatoes,  ripe  fruit,  pudding 
and  milk,  buckwheat  cakes,  broths,  and  a  little  tender  meat  once  a 
'lay.  ,    ,  -      - 


y    '    J 


DISRA8KS  OF  THK  AHUOMINAL  CAVITY. 


289 


le  bowels. 
Clio  ml  laa- 
lid  anxiety 
ly  fmiii  tlie 
appear  like 


(I  cauBns  a 

lliin  ertt'ct, 

II.     Habii- 

u  k,  Hitiiiig 

ion  m'lHT- 

llu'  liv^r. 

S  which  are 

and  by  the 

isj. 


)o  far.  Ac- 
tst  in  some 

'.  have  ever 

y  composed 

tartar  (6), 

otion  of  the 

are  said  to 

of  the  arti- 
san. 

aces  of  lard 
jed  between 
ointment  is 

blind  piles, 
n  one  hand- 
let-appletree 
rd  of  a  pint. 
y  the  water, 
lie  fire,  till  it 

t  and  scoth- 
m  bark  and 
;ime3  usefd, 
poke. 

iiige.  Daily 
n  the  bowel, 

•ye  pudding, 
lit,  pudding 
[leat  once  a 


Looseness  of  the  Bowels. — Dianhwa. 

Loo.hi;nk8«,  or  relax  of  the  boweln,  i.-^  manifcHted  by  frequent,  copi- 
ous, and  thin,  or  unusually  liipiid  discha-gcH.  The  oxcesHive  discharge 
may  be  caused  either  by  irritating  and  unwholesome  food,  by  iniluin- 
niation  and  ulcerat.  on  of  some  portion  of  the  bowels,  or  by  debility. 

Hyniptoms.  —  Rumbling  noise  in  the  bowels,  with  more  or  loj^s 
weight  and  bearing  down,  and  uneasiness  in  the  lower  part  of  the 
bowels.  This  pressing  down  and  uneasiness  are  relieved  as  soon  as 
the  evacuation  takes  place,  but  returns  when  another  is  near  at  hand, 
(iriping  is  generally  present,  the  strength  is  reduced,  and  the  skin  is 
pale,  dry,  and,  after  a  time,  sallow. 

Treatment. —  When  the  complaint  is  caused  by  irritating  food,  it 
will  generally  stop  as  soon  as  the  olTending  substance  is  removed,  and 
not  much  medicine  will  be  required. 

To  neutralize  any  acidity,  to  remove  wind,  allay  irritation,  and 
strengthen  the  stomach,  the  compound  Ryrnp  of  rheubarb  and  potassa 
is  well  adapted,  given  in  tablespoonful  doses,  every  hour,  till  it  oper- 
ates. A  little  paragoric  added  to  it  occasionally,  or  essence  of  pep- 
pcrmint,  or  spearmint,  may  aid  its  good  effects. 

If  nausea  and  vomiting  arc  present,  put  a  mustard  poultice  upon 
the  stomach,  and  give  a  few  drops  of  laudanum.  If  there  is  much 
griping,  givr  an  injection  (248),  with  twenty  drops  of  laudanum  in  it 
A  common  ^^  larrhoea  may  generally  be  arrested  at  once  by  prescrip- 
tions 159  or  1. 1,  in  teaspoonful  doses,  after  each  discharge. 

When  there  is  inflammation  and  ulceration  of  the  bowel,  the  treat- 
ment must  be  similar  to  that  for  dysentery, --fomentations  exter- 
nally, and  the  occasional  use  of  starch  injections,  mild  cathartics  (9) 
(10),  and  Dover's  powder  internally. 

Chronic  BiarrhoBa. 

The  acute  form  of  diarrhoea,  not  being  properly  managed,  often 
runs  on,  and  becomes  chronic,  and  is  at  times  exceedingly  difficult  to 
cure.  ' 

Symptoms.  —  Frequent  d'  harges,  generally  with  some  pain  and 
griping,  restlessness,  thirst,  poor  appetite,  debility,  loss  of  flesh,  dry, 
rough,  and  somewhat  saflow  skin,  and  tongue  dry  and  dark-colcre^. 
The  food  often  passes  through  the  bowels  pretty  much  in  the  condi- 
tion in  which  it  was  swallowed.  The  liver  is  generally  out  of  order, 
and  the  bowels  are  frequently  afflicted  with  a  low  grade  of  inflam- 
mation. .  - 

Treatment.  —  In  this  form  if  the  disease,  astringents  and  tonics  will 
generally  be  required.  Sometimes  a  teaspoonful  of  brandy,  in  a  little 
sweetened  water,  or  in  clear  water,  several  times  a  day,  will  effect  a 
cure.     Good  cherry  brandy  is  a  valuable  remedy ;  so  is  blackberry 


V'n- 


■  !■ 


brandy.  Many  of  the  worst  cases  have  been  cured  by  taking  no 
nourishment,  for  a  long  time,  except  milk,  with  a  little  lime  water 
in  it. 

When  the  liver  is  involved  in  the  complaint,  as  evinced  by  light- 
colored  stools,  leptandrin,  geranium,  etc.  (341),  may  be  given  with 
advantage. 

In  some  instances,  when  there  is  considerable  debility,  pills  of 
quinine,  catechu,  etc.  (342),  will  do  well. 

A  sponge  bath  must  be  taken  daily,  and  the  skin  be  well  rubbed 
after  it. 

J  Cholera  Morbus. 

The  above  name  is  given  to  a  disease  common  in  warm  weather, 
and  characterizeci  by  sudden  attacks  of  bilious  vomiting  and  purging, 
with  severe  pain  in  the  belly,  cramps,  and  general  fever  and  subse. 
quent  prostration.  The  great  amount  of  bile  secreted  and  discharged 
has  given  it  the  name  cholera,  from  choler,  bile. 

Symptoms.  —  The  disease  begins  by  sickness  and  distress  at  the 
stomach,  which  is  succeeded  by  violent  gripings,  with  vomiting  of 
thin,  dirty-yellowish,  whitish,  or  greenish  fluid,  with  discharges  from 
the  bowels  similar  to  that  vomited.  The  nausea  and  distress,  with 
some  few  exceptions,  continue  between  the  vomiting  and  purging, 
and  the  pain,  at  times,  is  intense.  The  pulse  is  rapid,  soon  becoming 
small  and  feeble,  the  tongue  dry,  the  urine  high-colored,  and  there  is 
much  thirst,  though  no  drink  can  be  retained  on  the  stomach.  It  is 
to  be  distinguished  from  diarrhoea  by  the  bilious  discharges. 

Treatment  —  Apply  a  large  mustard  poultice  over  the  stomach  and 
liver,  and  give  tblespoonful  doses  of  compound  powder  of  rhubarb 
and  potassa,  every  half  hour,  until  the  vomiting  and  nausea  are 
checked,  adding  to  each  dose  five  to  ten  drops  of  laudanum,  if  neces- 
sary. Perhaps  it  would  generally  be  best,  however,  to  give  liberal 
draughts  of  warm  water,  at  first,  or  flax-seed  tea,  that  all  the  solid  con- 
tents of  the  stomach  and  bowels  may  be  washed  out. 

A  t^aspoonful  of  laudanum  in  a  wineglassful  of  flax-seed  tea,  given 
as  an  injection,  every  two  hours,  will  sometimes  do  excellently  well ;  or 
a  tea  made  of  chamomile  flowers,  or  Colombo,  and  made  sour  by  a  few 
drops  of  nitric  or  sulphuric  acid,  and  given  internally,  will  sometimes 
succeed  better  than  most  other  things.  One  grain  of  morphine  and 
thirty  grains  of  bicarbonate  of  soda  dissolved  in  an  ounce  of  sweet 
tincture  of  rhubarb,  and  given  in  teaspoonful  doses,  every  half  hour 
will  often  have  a  fine  effect.     The  prescription  162  is  also  valuable. 

Hot  bricks  should  be  applied  to  the  feet,  and  warm  flannels,  or 
other  kinds  of  dry  heat,  to  the  whole  body. 

Asiatic  Cholera. 

Beside  the  above  name,  this  fearful  disease  has  been  called  epi- 
demic  cholera,  malignant  cholera,  spasmodic   cholera,  and  cholera 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


291 


taking  no 
lime  water 

ed  by  light- 
given  with 

ity,  pilU  of 

well  rubbed 


.rm  weather, 
ind  purging, 
■  and  subae- 
d  discharged 

stress  at  the 
vomiting  of 
iharges  from 
iiatress,  with 
ind  purging, 
on  becoming 
and  there  is 
imach.  It  is 
es. 

stomach  and 
r  of  rhubarb 
.  nausea  are 
am,  if  neces- 
>  give  liberal 
the  solid  con- 

jed  tea.  given 
3ntly  well ;  or 
30ur  by  a  few 
ill  sometimes 
norphine  and 
nee  of  sweet 
ery  half  hour 
o  valuable, 
n  flannels,  or 


sn  called  epi- 
and  cholera 


asphyxia.  It  first  attracted  notice  in  Bengal,  in  1817,  whence  it 
spread  westward  throngh  Europe,  and  in  June,  1832,  it  reached  Que- 
bec, on  this  continent. 

Sjniptoiiis.  —  First  Utage,  —  1  he  first,  premonitory  stage,  is  marked 
by  dcningeinent  of  the  digestive  organs,  rumbling  in  the  bowels,  pain 
in  the  loins  .or  knees,  twitchings  of  the  calves  of  the  legs,  impaired 
appetite,  thirst,  and  esf)ecially,  a  slight  diarrhfea ;  and  these  symp- 
toms continue  from  a  few  hours  to  several  days.  I  should  add  to 
these  symptoms  what  is  said  to  have  been  recently  discovered,  namely, 
that  for  several  days  before  the  attack,  the  pulse  is  down  to  forty  or 
fifty  beats  in  a  minute.  This,  if  it  prove  to  be  reliable,  is  a  very  valu- 
able symptom. 

Second  Stage^  —  This  stage  is  marked  by  vomiting  and  purging  a 
thin,  colorless  f\s\d,  looking  almost  exactly  like  rice  water ;  by  severe 
cramps  in  the  calves  of  the  legs,  which  soon  attack  the  bowels  and 
stomach.  These  cramps  are  excessively  painful,  and  draw  the  mus- 
cles into  knots.  The  tongue  is  pale  and  moist ;  the  pulse  feeble, 
though  sometimes  full  and  firm  ;  the  breathing  hurried,  with  distress 
about  the  heart ;  great  thirst ;  a  feeling  of  internal  warmish  ;  and  the 
secretion  of  urine  entirely  stopped. 

Thes'  thin,  colorless  discharges  by  vomiting  and  purging,  are  the 
serum  watery  portion  of  the  blood,  which  oozes  through  the  sides 
of  the  blood-vessels,  and  runs  off"  rapidly,  leaving  the  crassamentum, 
or  red,  solid  part  of  the  blood,  stranded  upon  the  inner  surfaces  of  the 
arteries  and  veins.  When  so  much  of  this  is  discharged  that  the 
blood  cannot  circulate  freely,  the  patient  sinks  into  the 

Third  Stage,  which  is  characterized  by  great  prostration ;  pulse 
hardly  perceptible ;  skin  cold  and  clammy ;  face  blue  or  purple,  and 
eyes  much  sunken ;  hands  dark-colored  and  sodden,  looking  like  a 
washerwoman's ;  breathing  short  and  laborious ;  a  sense  of  great  heat 
in  the  stomach ;  and  intense  thirst  Recoveries  from  this  stage  sel- 
dom take  place.    ,      ..   •  ,  -•      , 

Treatment.  —  In  the  first  stage,  the  diarrhoea  should  receive  the 
most  prompt  attention.  From  five  to  ten  drops  of  laudanum,  re- 
peated a  few  times,  every  three  hours,  will  generally  put  a  stop  to  it. 
Morphine  (162)  is  also  a  suitable  remedy.  The  compound  syrup  of 
rhubarb  and  potassa,  with  some  other  articles  (343),  in  tablespoon  ful 
doses,  every  hour,  till  it  operates  gently,  is  worth  a  trial.  The  diet 
should  of  course  be  very  carefully  regulated  at  such  a  time,  tliough 
not  particularly  changed,  except  to  leave  off  any  indigestible  article 
which  is  known  to  be  injurious,  and  to  be  made  a  little  more  sparing 
than  in  a  time  of  perfect  health. 

When  the  second  stage  hf^s  s^t  in,  or  the  stage  of  vomiting,  purg- 
ing, and  cramps,  the  treatment  must  be  energetic.  The  sinking  pow- 
ers must  be  sustained  by  chloroform,  opium,  and  ammonia  (119),  or 
by  camphor,  opium,  and  cayenne  (344),  giving  one  pill  every  hour. 
Brandy  may  also  be  given  freely. 


The  warmth  of  the  surface  must  be  promoted  by  all  possible  means, 
hot  bricks  and  bottles,  tincture  of  cayenne,  friction,  etc. 

In  the  third  stage,  the  remedies  recommended  above  are  to  be  pur- 
sued with  increased  energy,  particularly  the  stimulants,  and  the  efforts 
to  promote  the  warmth  of  the  surface. 


Dysentery.— Bloody  Flux. — Colitis. 

This  is  an  inflammation  of  the  mucous  membrane  lining  the  lower 
or  large  bowels.  The  small  bowels  begin  at  the  stomach,  and  are 
eight  or  ten  yards  long ;  being  largest  near  the  stomach,  and  dimin- 
i:jhing  in  size  as  they  approach  their  termination  at  the  cascum.  The 
lower  or  large  bowels  are  two  or  three  times  as  large  as  the  small 
ones,  and  from  their  junction  with  the  latter,  they  ettend  about  six 
feet  to  the  outlet,  or  anus.  The  large  bowels  are  composed  of  the 
caecum,  the  colon,  a:id  the  rectum.  The  rectum  is  about  one  foot  in 
length. 

In  most  cases  of  dysentery,  the  rectum,  and  about  half  the  adjoin- 
ing portion  of  the  colon,  experience  the  chief  force  of  the  inflamma- 
tion. Sometimes  the  whole  of  the  colon  and  caecum  are  affected. 
Soi..otime8  the  mucous  membrane  lining  these  ia  ulcerated,  and,  be- 
coming wholly  disorganized,  passes  off  in  shreds. 

Symptoms. —  The  disease  comes  on  with  loss  of  appetite,  costive- 
ness,  lassitude,  shivering,  heat  of  skin,  a:  A  quick  pulse.  These  are 
followed  by  griping  pain  in  the  bowels,  and  a  constant  desire  to  pass 
their  contents.  In  general  the  passages  are  small,  composed  of  mucus 
mixed  with  blood.  These  passages  are  attended  and  followed  by 
severe  gripings  and  inclination  to  strain,  learnedly  called  tormina,  and 
tenesmus.  They  are  sometimes,  in  the  early  stages,  attended  by  nau- 
sea and  vomiting.  The  natural  feces,  which  do  not  pass  off  much, 
are  small  in  quantity,  and  formed  into  round,  compact  balls,  or  irreg- 
ular, hardened  lumps.  This  tenesmus,  or  great  desire  to  strain,  will 
continue,  perhaps  increase,  for  several  tiays,  —  the  discharges  being 
mostly  blood  in  some  cases,  and  chiefly  mucus  in  others.  Having, 
generally,  but  little  odor,  at  '"'rst,  these  discharges  become,  as  the  dis- 
ease advances,  exceedingly  o..ensive. 

Canseii.  —  Dysentery  is  very  frequently  caused  by  sudden  changes 
from  hot  to  cold,  by  which  sweating  is  suddenly  checked,  and  the 
blood  repelled  from  the  surface.  Hot  climates,  and  dry,  hot  weather 
are  predisposing  causes.  All  green,  unripe,  and  unwholesome  food ; 
and  all  indigestible  food  of  every  sort,  may  induce  it. 

Treatment.  —  In  mild  cases,  give  a  tablespoonful  of  cabtoi  oil  and 
two  teaspoonfuls  of  paragoric,  mixed,  once  a  day.  Sometimes,  in 
place  of  the  above,  a  dose  of  rochelle  powder,  dissolved  in  water,  with 
thirty  or  forty  drops  of  laudanum,  may  be  taken.  A  moderate  quan- 
tity of  flax-seed  or  slippery  elm  tea,  may  be  taken  as  a  drink,  and  the 
bowels  be  well  emptied  by  an  injection  of  starch. 

When  there  is  much  pain  in  the  bowels,  a  mustard  poultice  laid 


sible  means, 

|e  to  be  pur- 
the  efforta 


ig  the  lower 
ch,  and  are 
and  dimin- 
cum.  The 
9  the  small 
id  about  six 
posed  of  the 
t  one  foot  in 

the  adjoin- 
le  inflamma- 
are  affected, 
ted,  and,  be- 

stite,  costive- 
These  are 
lesire  to  pass 
sed  of  mucus 
followed  by 
tormina,  and 
ided  by  nau- 
ss  off  much, 
lalis,  or  irreg- 
0  strain,  will 
liarges  being 
rs.  Having, 
e,  as  the  dis- 


den  changes 
ked,  and  the 
hot  weather 
iesome  food ; 


ihtoi  oil  and 
jmetimes,  in 
1  water,  with 
derate  quan- 
rink,  and  the 

poultice  {aid 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


29ii 


upon  them,  will  have  a  good  effect  The  starch  injections  should,  in 
such  case,  have  half  a  teaspoonful  of  laudanum  mixed  with  it.  The 
compound  syrup  of  rhubarb  and  potassa  will  often  act  favorably,  given 
in  tablcspoonful  doses. 

If  there  is  reason  to  suppose  the  liver  is  affected,  give  podophyliin, 
etc.  (46). 

The  patient  should  not  be  allowed  to  sit  up,  and  must  be  kept  very 
still,  and  be  allowed  only  a  very  scanty  diet,  as  flour  porridge,  well 
boiled,  rice  water,  etc. 

Chronic  Dysentery. 

Whkn  dysentery  "runs  on"  for  some  time,  it  may  become 
chronic.  •  , 

Symptoms.  —  Looseness  of  bowels,  —  the  discharges  being  un- 
healthy, more  or  less  bloody,  attended  by  bearing  down,  or  a  desire 
to  strain,  and  being  in  nunriber  from  two  to  forty  a  day.  There  is 
great  debility,  the  pulse  is  weak  and  quick,  the  tongue  slightly  furred, 
the  appetite  lost,  the  face  pale  and  sallow,  and  the  skin  dry  and  parched. 
Sometimes  the  relax  alternates  with  costiveness. 

Treatment.  —  In  this  form  of  the  complaint,  astringents  will  be 
necessary  (159)  (161)  (162)  {S46\  (346)  (347). 

Injections  may  be  used,  if  jssary,  composed  of  nitrate  of  sil- 
ver, fifteen  grains  to  the  ouncv  water,  or  an  infusion  of  golden  seal, 
with  a  little  tincture  of  prickly-ash  berries  added  to  it. 

The  diet  must  be  very  light,  easy  of  digestion,  and  nutritious-  In 
some  cases,  it  should  be  composed  chiefly  of  wheat  flour  porridge,  or 
boiled  milk  and  boiled  rice.  In  other  cases,  a  little  tender  beef  steak 
should  be  taken  once  a  day. 

;, .  Worms. — Vermes. 

The  intestinal  canal  is  subject  to  various  disturbances  from  the 
presence  of  worms.  Of  these  troublesome  tenants,  there  are  three 
principal  varieties. 

The  Ascaris,  or  pinruform,  called  also  maw  or  thread  worm,  is  a 
small,  white,  thread-like  worm  from  half  an  inch  to  an  inch  in  length. 
These  worms  live,  in  great  numbers,  in  the  rectum,  where  they  excite 
great  irritation  and  itching. 

The  Lumbrlcus,  or  ascaris  lumbricoides,  is  a  round  worm,  about  an 
eighth  of  an  inch  in  thickness,  and  from  an  eighth  to  a  quarter  of  a 
yard  in  length.  Its  color  varies  from  a  milky  whiteness  to  a  deep 
red.     It  generally  occupies  the  small  bowels. 

The  Tmia  Solamun,  or  fape'tcorm,  is  a  flat  worm,  with  four  suckers 
at  the  head,  is  from  a  few  feet  to  some  hundreds  in  length,  and  full  of 
joints.  It  dwells  in  the  small  bowels,  and  feeds  on  the  chyle  as  it 
comes  along,  before  it  is  absorbed  by  the  lacteals.     lu  this  way,  it 


Jt   !' 


■*■!    ■ 
■ft 


it: 


# 


1^- 


201 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


robs  the  body  of  nourishment,  and  produces  great  loss  of  flesh,  and 
an  enormous  appetite. 

Symptoms.  —  In  the  grown  person  the  symptoms  of  worms  are 
quite  obscure,  except  an  intolerable  itching  within  the  anus,  which 
generally  indicates  pin-worms. 

In  children  worms  are  indicated  by  palenei<s,  itching  of  the  nose, 
grinding  of  the  teeth  and  starting  in  sleep,  irregular  appetite,  bad 
breath,  swelled  upper  lip,  picking  of  the  nose,  hard  swelled  belly,  and 
one  cheek  constantly  flushed. 

Treatment.  —  For  expelling  worms  various  articles  have  been  used. 
Among  these  spirits  of  turpentine  (155)  has  a  high  reputation.  The 
following  preparation  does  well :  Spirits  of  turpentine,  half  an  ounce  ; 


half  an  ounce;  castor  oil,  one  ounce:  worm-seed 


essence  oi  anine, 
oil,  one  ounce.  Mix.  The  dose  for  a.  child  one  or  two  years  old,  is 
ten  to  twenty  drops,  every  two  or  three  hours.  In  two  or  three  days, 
a  brisk  physio  should  be  given.  The  worm  powder  is  quite  success- 
ful. 

One  of  the  most  popular  remedies  is  the  pink-root.  It  should  be 
united  with  a  purgative.  The  following  is  a  good  preparation :  Pink- 
root  and  senna,  each  half  an  ounce ;  bitartrate  of  potassa,  one  dram ; 
pulverized  jalap,  half  a  dram  ;  cardamom  seeds,  half  a  dram  ;  extract 
of  liquorice,  two  drams.  Mix,  and  add  half  a  pint  of  boiling  water. 
Let  the  whole  steep  an  hour.  Give  a  tablespoonful  or  two,  occasion- 
ally, till  the  worms  are  expelled. 

An  injection  composed  of  quassia  (66),  or  aloes  (22),  or  of  simple 
sweet  oil,  is  very  effectual  in  removing  pin-worms  from  the  lower 
bowel.  So  is  an  injection  composed  of  the  red  iodide  of  mercury, 
one  grain ;  iodide  of  potassium,  half  a  grain ;  and  two  pints  of 
water. 

Most  of  the  above  preparations  are  thought  to  be  successful  in  ex- 
pelling all  kinds  of  worms ;  but  for  the  tape-worm,  no  other  remedy 
has  yet  shown  itself  as  effectual  as  pumpkin-seeds.  The  seeds  should 
be  well  bruised,  and  steeped  in  water.  This  should  be  drank  freely 
for  several  days,  if  need  be.  It  is  believed  to  be  a  sure  remedy,  even 
in  cases  of  several  years'  standing. 

In  all  cases  of  worms,  the  diet  should  be  carefully  chosen,  and  be 
connected  with  proper  exercise,  pure  air,  frequent  bathing,  and  all 
those  measures  which  tend  to  improve  the  general  health. 

After  the  expulsion  of  the  worms,  tonics  should  always  be  taken 
to  strengthen  the  bowels,  that  the  same  evil  may  not  return. 


Acute  Inflammation  of  the  Kidneys. — Nephritis. 

Before  speaking  of  this  disease,  I  wish  to  give  the  reader  a  general 
idea  of  a  kidney,  and  shall  do  so  by  the  use  of  two  cuts. 

Fig.  108  presents  the  external  surface  of  the  right  kidney,  with  its 
renal  capsule  mounted  on  top  ;  t,  being  its  upper  edge  ;  /,  A,  superior 
and  inferior  branches  of  the  emulgent  artery  ;  c,  d,  e,  three  branches 
of  the  eitiulgent  vein  ;  a,  the  pelvis  of  the  ureter ;  b,  the  ureter. 


flesh,  and 

iTortns  are 
Inus,  which 

If  the  nose, 
[petite,  bad 
belly,  and 

been  used, 
tion.     The 
an  ounce ; 
worm-seed 
ears  old,  is 
three  days, 
ite  success- 
should  be 
ion:  Pink- 
one  dram ; 
tn ;  extract 
iling  water. 
D,  occasion- 

ir  of  simple 
I  the  lower 
of  mercury, 
o  pints  of 

;ssful  in  ex- 
her  remedy 
eeds  should 
Irank  freely 
medy,  even 

)en,  and  be 
t)g,  and  all 

s  be  taken 

n. 

phritis. 
it  a  general 

ev,  with  its 
A,  superior 
e  branches 
reter. 


DISEASKS  OP  THE  ABDOMINAL  CAVITY. 


295 


Fig.  109  is  the  same  kidney  laid  open ;  1,  being  the  supra  renal 
capsule  ;  2,  the  vascular  portion  ;  3,  3,  the  tuberlar  portion,  consisting 
of  cones ;  4,  4,  two  of  the  calices  receiving  the  apex  of  their  corres- 
ponding cones  i  5,  5,  5,  the  three  infundibula ;  6,  the  pelvis ;  and  7, 
the  ureter. 


rio.ioe. 


rxi.109. 


The  kidneys  are  glands,  and  their  oflice  is  to  draw  or  strain  off 
from  the  body  those  effete  or  worn-out  particles,  or  products  of  decay 
which  contain  nitrogen.,  while  the  liver  takes  away  those  carbonaceous 
matters  which  have  no  nitrogen.  These  useless  substances  which  go 
out  through  the  kidneys  are  generally  in  the  form  of  urea.  In  carry- 
ing off  these  matters,  the  kidneys  may  have  more  to  do  than  properly 
belongs  to  them ;  and  may  be  so  stimulated,  or  irritated,  or  injured 
in  some  way,  as  to  become  inflamed.  .    , 

Symptoms. — Like  most  other  inflammatory  diseases,  it  begins  with 
cold  chills  and  rigors,  especially  in  the  back  and  loins,  followed  by 
fever  and  pain.  The  pain  frequently  extends  to  the  bladder,  the  loins, 
and  the  thighs,  and  is  of  a  severe,  lancinating  kind,  —  though  some- 
times obtuse.  Pressure,  motion,  straining,  or  taking  a  full  breath,  add 
to  its  pungency.  The  urine  is  scanty,  high-colored,  sometimes  bloody, 
and  can  only  be  passed  drop  by  drop.  In  the  loins  there  is  a  sense 
of  heat,  gnawing,  and  constriction ;  the  bowels  are  either  constipated, 
or  relaxed  by  diarrhoea.  A  numbness  of  the  thigh,  and  drawing  up 
of  the  testicle  on  the  affected  side,  are  marked  and  peculiar  symptom* 
In  some  cases,  there  are  nausea,  vomiting,  oppression  at  the  stomach, 
faintness,  hiccough,  drum-head  distention,  and  rumbling  of  the  bowels. 
The  skin  is  hot  and  dry,  the  pulse  hard  and  frequent. 

Causes.  —  The  use  of  cantharides,  oil  of  turpentine,  and  other  di- 
uretics, taking  cold,  violent  exercise,  mechanical  injuries,  the  transla- 
tion of  rheumatism  or  gout,  the  striking  in  of  skin  eruptions,  and 
gravelly  formations  in  the  kidneys  or  ureters. 


29« 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


DistiHctions.  —  This  disease  is  to  be  distinguished  from  colic  by 
the  pain  being  increased  bv  pressure,  and  by  the  frequent  but  diffioult 
discharge  of  red  urine ;  irora  lumbago^  from  its  being  confined  fre- 
quently to  one  side,  and  also  by  the  urinary  troubles,  and  by  the 
nausea  and  vomiting ;  and  frrtm  all  other  diseases,  by  the  numbness 
of  the  thigh,  and  the  drawing  up  of  the  testicles. 

Terniiiiatiuiis  of  tlie  DIseiise.  —  It  runs  a  rapid  course,  and  may 
terminate  by  resolution,  or  by  suppuration.  When  the  latter  happens, 
•t  is  indicated  hy  the  decline  of  the  more  violent  symptoms,  a  throb- 
bing and  a  senfce  of  weight,  with  chills,  followed  by  flushes  of  heat, 
and  sweating.  The  matter  formed,  generally  small  in  quantity,  may 
pass  into  the  cavity  of  the  kidney,  and  thence  through  the  bladder  to 
a  natural  outlet  with  the  urine. 

Treatment  —  Either  put  the  feet  into  a  hot  mustard  bath,  or  put 
mustnrd  drafts  upon  them.  At  the  same  time  apply  a  large  mustard 
pou!  ntx)n  the  small  of  the  back,  and  follow  it  up  with  hot  fomen- 
tati.  stramonium  leaves  and  hops,  or  stramonium  and  worm- 

woou         msy. 

Let  perspiration  be  induced  as  soon  as  possible  by  five  to  ten  ten. 
drop  doses  of  tincture  of  veratrum  viride,  repeated  every  hour,  or  by 
teaspoonful  doses  of  the  compound  tincture  of  Virginia  snake-root, 
given  every  half  hour. 

If  costiveness  exist,  the  bowels  must  be  opened  by  epsom  salts. 
Cream  of  tartar,  or  salts  of  tartar ;  or  by  copious  injections  of  warm 
water,  containing  a  few  drops  of  the  tincture  of  arnica  leaves.  Such 
injections  not  only  unload  the  bowels,  but  act  as  a  local  bath,  by  lying 
in  the  bowel  near  the  inflamed  kidneys. 

The  drinks  must  be  mucilaginous  and  diuretic.  The  marshmal- 
low  root  and  peach  leaves,  slippery-elm  bark,  flax-seed,  mullein,  elder 
blows,  haircap-moss,  and  cleavers,  are  all  valuable.  If  the  disease  is 
caused  by  gravel,  twenty  drops  of  liquor  potassee,  largely  dilated 
with  flax-seed  and  upland-cranberry  tea,  and  taken  freely  as  a  drink, 
is  excellent. 

Chronic  Inflammation  of  the  Kidneys. 

This  is  frequently  the  result  of  the  acute  form  of  the  disease,  but  ii 
also  produced  by  injuries,  and  other  causes. 

Symptoms.  —  A  weakness  in  the  small  of  the  back,  and  a  dull, 
heavy  pain  in  the  kidneys.  The  urine  is  passed  often,  and  in  small 
quantities.  It  is  alkaline,  —  sometimes  white  and  milky,  —  and  has 
in  it  deposits  of  phosphate  of  lime,  and  triple  phosphates. 

Treatment.  —  Infusions  of  pipsissewa,  uva  ursi,  trailing  arbutus, 
wild  carrot,  queen  of  the  meadow,  buchu  leaves,  or  foxglove  are  use- 
ful diuretics,  and  may  be  taken  with  advantage. 

The  bowels  must  be  kept  open  with  some  gentle  physic  (18),  if 
{hey  are  costive  ;  and  the  alkaline  sponge  bath,  with  friction,  be  used 
daily. 


x\ 


^T" 


colic  by 
at  difficult 
iifined  fre- 
nd  by  the 
numbness 


and  may 
T  happens, 
8,  a  throb- 
;s  of  ht>at, 
ntity,  may 
bladder  to 

ith,  or  put 
'e  mustard 
lot  fomen- 
ind  worm- 
to  ten  ten. 
our,  or  by 
jnake-root, 

>som  Baits, 
s  of  warm 
res.  Such 
h,  by  lying 

marshmal- 
lUein,  elder 
disease  is 
jly  dilated 
as  a  drink, 


I. 

sase,  but  is 

nd  a  dull, 
i  in  small 
—  and  has 


g  arbutus, 
e  are  use* 

3ic  (18),  if 
>n,  be  used 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


297 


An  eruption  may  be  brought  out  upon  the  small  of  the  back  by 
rubbing  on  a  few  drops  of  croton  oil ;  or,  if  the  patient  prefer  it,  a 
mustard  poultice  may  be  applied  two  or  three  times  a  week. 

The  food  should  be  nutritious,  and  easily  digested,  and  a  little  exer- 
cise be  taken  daily  in  the  open  air. 

Acute  Inflammation  of  the  Bladder. — Cystitis. 

This  disease  affects  the  lining  membrane  of  the  bladder,  —  some- 
times its  muscular  substance.  It  may  attack  the  upper  portion,  the 
middle,  or  the  neck  of  this  organ.     It  runs  a  rapid  course. 

Symptoms.  —  Burning,  piercing,  and  throbbing  pain  in  the  region 
of  the  bladder.  The  pain  extends  to  the  perineum,  and  in  some 
cases,  to  the  testicles  and  thighs,  and  is  much  inc.eased  by  pressure. 
The  perineum,  the  sjmce  between  the  fundament  and  testicles,  feels 
sore  to  the  touch.  The  desire  to  pass  urine  is  incessant,  but  the 
efl'ort  to  do  so  is  mainly  ineffectual.  The  water  passes  off  drop  by 
drop,  with  great  pain,  or  is  entirely  stopped,  —  causing  enlargement 
of  the  bladder,  and  great  distress.  Mucus  from  the  inflamed  lining 
of  the  bladder  passes  off  with  the  water.  Nausea,  vomiting,  and 
great  anxiety  are  common.  The  bowels  are  bound,  and  when  the 
disease  is  on  the  side  next  the  lower  bowel,  there  is  a  desire  to  empty 
the  bowels ;  and  if  the  inflammation  be  in  the  neck,  there  is  great 
pain  in  the  perineum,  and  frequently  an  entire  retention  of  tne  water. 
The  pulse  is  full,  hard,  and  frequent,  the  skin  hot  and  dry,  the  thirst 
urgent,  and  the  patient  restless  and  dejected. 

Causes. —  This  disease  may  be  produced  by  taking  cantharides  and 
turpentine ;  by  irritating  substances  forced  into  the  bladder  with  a 
syringe,  or  by  pushing  bougies  or  catheters  into  it ;  by  gravel  stones 
in  the  bladder;  by  retained  urine;  by  external  injuries;  by  gonor- 
rhoea ;  and  by  cold  applied  to  the  feet,  or  to  the  lower  portion  of  the 
abdomen. 

Treatment. —  If  the  urine  be  retained,  it  is  of  the  utmost  impor- 
tance that  it  be  early  drawn  off  with  the  catheter,  lest  a  distention  of 
the  bladder  bring  on  mortification.  Great  care  is  required  not  to  pro- 
duce irritation  by  any  roughness  in  introducing  the  instrument. 

Leeches  should  be  applied  upon  the  lower  part  of  the  bowels,  the 
perineum,  and  around  the  anus.  When  these  are  removed,  warm 
poultices  should  be  applied.  Cold  compresses  will  often  do  as  well. 
The  bow^els  must  be  opened  with  epaom  salts.  Injections  of  warm 
water,  with  a  few  drops  of  tincture  of  arnica  leaves,  will  act  finely  as 
a  local  bath,  —  the  water  being  retained  as  long  as  possible. 

The  tincture  of  veratrum  viride  will  be  required  in  five  to  ten-drop 
doses,  or  the  compound  tincture  of  Virginia  snake-root,  to  induce 
perspiration.  Dover's  powders  may  sometimes  be  used  for  the  same 
purpose. 

Drinks  must  be  taken  very  sparingly.  A  small  amount  of  cold  in- 
fusion of  slippery  elm  bark,  or  marshmallow  and  peach  leaves,  or 


296 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


cleavers.     This  mucilaginous  drink  must  be  the  beginning  and  the 
end  of  the  diet  during  the  activo  stage  of  the  disease. 

Chronic  Inflammation  of  the  Bladder. — Cystirrhcea. 

This  is  much  more  common  than  the  active  form  of  the  diseane. 
It  often  arises  from  the  same  causes  which  produce  acute  inflamma- 
tion of  the  bladder. 

It  often  passes  under  the  title  of  "  catarrh  of  the  bladder."  It  is 
a  chronic  inflammation  of  the  mucous  lining  of  the  bladder,  and  ia  a 
very  common  and  troublesome  aflection  among  old  people. 

Symptoms.  —  Slight  lancinating  pains,  with  a  feeling  of  heat  in  the 
region  of  the  bladder,  and  a  sense  of  weight  and  tenderness  in  the 
perineum  ;  frequent  and  tormenting  desire  to  pass  water,  with  occa- 
sional spasmodic  action  of  the  bladder.  The  urine  is  loaded  with 
tenacious  mucous,  just  as  the  expectoration  has  large  quantities  of 
mucus  in  it  when  there  is  inflammation  of  the  membrane  lining  the 
windpipe  and  bronchial  tubes.  When  the  water  has  stood  a  while, 
this  mucus  settles  at  the  bottom  of  the  vessel,  leaving  the  fluid  clear 
above.  Great  quantities  of  this  are  sometimes  passed,  —  amounting 
even  to  pints  in  a  day.  The  triple  phosphates  of  magnesia  and  am- 
monia are  often  found  in  the  water. 

Frequently  there  are  derangements  of  the  appetite  and  digestive 
functions,  a  white  or  brown  fur  upon  the  tongue,  a  harsh,  dry  skin, 
with  thirst  and  general  debility,  —  especially  in  the  back  and  loins. 
Sometimes  there  is  a  little  fever. 

Treatment.  —  To  reduce  the  inflammation,  apply  leeches,  or  mus- 
tard, or  croton  oil,  or  a  cold  compress  every  night 

As  a  diuretic,  give  an  infusion  of  buchu,  uva  ursi,  trailing  arbutus, 
quecM  of  the  meadow,  etc.  Tincture  of  veratrum  viride  and  sweet 
^irits  of  nitre  (125)  is  a  good  remedy.  The  compound  infusion  of 
trailing  arbutus  is  well  recommended.  So  is  the  compound  balsam 
of  sulphur.    An  infusion  of  the  pods  of  beans  has  been  well  spoken  of. 

An  injection  into  the  bladder,  once  a  day,  of  a  tepid  infusion  of 
golden  seal  root,  with  much  care,  may  be  of  great  service ;  or  an 
infusion  of  equal  parts  of  golden  seal,  witch  hazel,  and  stramonium, 
It  may  be  done  with  a  gum-elastic  catheter,  and  a  small  syringe. 

The  bowels  must  be  kept  open  with  the  neutralizing  mixtute,  or 
some  other  mild  physic ;  and  the  skin  bathed  with  saleratus  and 
water  once  a  day,  and  rubbed  well  with  a  coarse  towel. 

Should  there  be  any  scrofulous,  or  gouty,  or  rheumatic  condition  of 
the  system,  the  remedies  for  those  complaints  may  be  used  in  addition 
to  the  above. 

Disease  of  the  Snpra-Renal  Capsules.^ 

The  supra-renal  capsules  are  small  bodies  situated  above  the  kid- 
neys.    (Fig.  109,  1.)     Their  office  is  not  well  understood.     It  has 


T^ 


ig  and  the 


stirrhcea. 

the  diseaHc. 
Innainina- 

der."     It  is 
er,  and  is  a 


heat  in  the 
iu'83  in  the 

with  occa- 
oaded  with 
uaiitities  of 
ining  the 
)od  a  while, 
e  fluid  clear 
•amounting 
ia  and  am< 

id  digestive 
ah,  dry  skin, 
c  and  loins. 


168,  or  mus- 
ing arbutus, 

I  and  sweet 
infusion  of 

und  balsam 

II  spoken  of. 
infusion  of 

vice ;  or  an 
tramoniuni, 
yringe. 
mixtuie,  or 
leratus  and 

condition  of 
in  addition 


S. 

Dve  the  kid- 
3d.     It  has 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


29U 


been  found  of  late  that  they  are  subject  to  a  disorder,  having  peculiar 
symptoms.     This  is  a  new  disease. 

Symptoms.  —  The  most  marked  symptom  is  a  peculiar  change  in 
the  color  of  the  skin,  called  "bronzing."  This  bronzing  process  be- 
gins in  patches  on  thof«e  jiarta  ex|)os«Hl  to  the  sun,  and  to  friction, 
as  the  neck,  the  backs  of  the  hands,  the  fronts  of  the  thighs,  and  the 
arms.  These  patches  look,  in  color,  like  spots  upon  a  bronze  statue, 
deprived  of  their  gloss. 

Another  marked  symptom  is  a  peculiar  debilUy,  which  comes  on 
without  any  apparent  cause,  —  there  being,  generally,  no  evidence  of 
organic  disease,  and  no  loss  of  flesh,  —  and  is  attended  with  faint- 
iiigs,  loss  of  energy  both  of  body  and  mind,  a  pciculiar  flabbiness  of 
flesh,  and  an  early  death,  apparently  from  sheer  weakness. 

The  blood  bt'comes  early  d«!praved,  and  loses  its  coloring  matter, 
as  shown  by  the  paleness  of  the  skin  where  there  is  no  bronzing. 

The  pulse  is  generally  very  soft  and  compressible.  The  stomach  is 
irritable,  the  appetite  gone;  there  is  nausea,  and  sometimes  vomiting, 
with  pain  and  a  sense  of  sinking  at  the  pit  of  the  stomach.  Fre- 
quently there  is  costiveness,  sometimes  {l>arrh(jea,  and  pains  in  the 
back  and  loins.  In  some  cases  there  are  epileptic  fits,  failure  of 
memory,  change  of  temper,  or  a  numbness  of  the  fingers,  legs,  etc. 

Tretltment. —  The  disease  is  a  peculiarly  fatal  one.  As  no  mode 
of  treatment  has  yet  proved  successful,  it  is  well  to  observe  caution 
in  prescribing. 

The  treatment  prescribed  for  chronic  inflammation  of  the  kidneys, 
would  perhaps  be  as  safe  as  any  that  could  at  present  be  proposed- 

Blight's  Disease  of  the  Kidneys. — Albuminuria. 

This  peculiar  disease  was  first  explained  to  the  profession  in  1837, 
by  Dr.  Bright,  of  England,  whose  name  it  took.  It  consists  of  a  dis- 
order of  the  kidneys,  —  probably  a  congestion  and  an  obstructed  cir- 
culation in  them,  Irom  which  arise  two  most  important  effects ;  first, 
albumen,  an  essential  alimentary  constituent  of  the  blood,  is  secreted 
and  passed  off,  in  larger  or  smaller  quantities,  in  the  urine ;  and  sec- 
ondly, urea,  the  worn-out  matters  in  the  blood  which  the  kidneys  are 
made  expressly  to  carry  off,  is  permitted  to  remain.  If  the  urine  of 
a  person  having  Bright's  disease  be  examined,  therefore,  albumen, 
which  should  not  be  there,  will  be  found,  and  urea,  a  natural  constitu- 
ent, will  be  absent 

Method  of  Examination.  —  To  discover  albumen  in  urine  suspected 
to  contain  it,  place  a  little  in  a  test  tube,  and  boil  it  over  a  spirit 
lamp.  If  albumen  be  present  only  in  minute  quantity,  it  may  cause 
only  a  delicate  opalescence ;  if  in  larger  quantity,  it  may  separate  in 
curdy  flakes,  and  fall  to  the  bottom  as  a  more  or  less  abundant  white 
precipitate.     If  very  abundant,  the  liquid  may  become  nearly  solid. 

The  albumen  is  the  same  as  the  white  of  an  egg,  and  the  boiling  has 
the  same  efiect  in  whitening  and  hardening  it,  as  upon  that  substance. 


-i 


ff'i''^ 


8U0 


DISEASES  OF  THE  ABDOMINAL  CAVITT. 


Fia  110. 


Albumen  in  Homctimcs  found  in  the  urine  in  ii  coagulated  state, 
and  having  tlie  shape  of  tubes  or  worms.  (Fig.  110.)  This  is  quite 
common  in  Bright's  disease.  The  deposit  seems 
to  be  made  up  of  fibrous  casts  of  the  uriniferous 
tubes  of  the  kidneys. 

SyiiiptoniN. —  The  two  unnatural  conditions 
mentioned  above,  give  rise  to  the  symptoms  jf 
Bright's  disease.  One  of  them,  however,  is  it- 
self the  most  constant  and  characteriHtic  symp- 
tom of  the  disease,  namely,  the  presence  of  al- 
bumen. This,  too,  being  one  of  the  nutritive 
construents  of  the  blood,  its  abstraction  thins 
the  serous  portion  of  the  blood,  and  causes  it  to  filter  out  of  its  vessels 
into  the  cells,  —  causing  dropsy  of  the  cells,  usually  called  cellulat 
dropsy,  or  anasarca.  This  general  dropsy  begins  frequently  in  the 
face,  and  spreads  rapidly  over  the  whole  body  and  limbs.  In  addi. 
tion  to  this,  there  are  pains  in  the  back  and  loins,  a  gradual  failing  of 
strength,  and  a  derangement  of  digestion.  The  skin  becomes  dry, 
with  a  pale  and  bloodless  appearance,  and  there  are  frequently  thirst, 
nausea,  and  vomiting.  The  urine  frequently  has  fat,  blood,  epithelial 
scales,  mucus,  blood  discs,  fibrous  casts  of  the  uriniferous  tubes,  and 
saline  sediments ;  and  is  generally  lighter  by  weight  than  in  health, 
and  less  in  quantity,  and  is  apt  to  be  red,  brown,  or  dingy  in  color. 

The  retention  of  urea  in  the  blood  acts  as  a  poison,  and  cause.s, 
toward  the  latter  end  of  the  disease,  when  accumulated  in  large  quan- 
tity, drowsiness,  convulsions,  and  apoplexy. 

A  frequent  desire  to  make  water,  with  a  shifting  back  and  forth 
of  the  bowels  between  costiveness  and  diarrhoea,  are  common  symj)- 
toms. 


Treatment.  —  The  results  of  treatment  in  this  disease  are  often  un- 
satisfactory. Yet  if  taken  in  season,  investigated  with  proper  caro, 
and  treated  with  due  diligence,  much  may  be  done  for  its  cure.  It  ia 
one  of  those  harassing  complaints,  which  physicians  in  family  prac- 
tice seldom  have  the  patience  to  investigate  and  manage  with  suffi- 
cient care. 

Let  the  healthy  and  active  condition  of  all  the  vessels  of  the  skin 
be  the  first  object  aimed  at.  This  will  relieve  the  laboring  and  falter- 
ing kidneys  of  a  portion  of  their  burden.  The  alkaline  sponge  bath 
with  vigorous  friction  every  day,  will  secure  this  object. 

In  the. next  place,  the  skin  being  put  in  a  working  condition,  should 
be  made  to  work  by  some  inv^rnal  diaphoretic,  —  as  the  tincture  of 
veratrum  viride,  in  doses  o(  from  five  to  ten  drops,  or  the  compound 
tincture  of  Virginia  snake-root,  in  teaspoonful  doses. 

The  kidney  may  be  still  further  relieved,  especially  when  there  is 
considerable  tendernesa,  and  other  signs  of  inflammation,  by  cupping, 
leeching,  mustard  pouHices,  and  croton  oil. 

The  bowels  should  be  regulated  by  some  gentle  physic,  as  cream  of 
tartar  dissolved  in  flax-seed  tea,  or  rochelle  powders,  or  epsom  salts, 
the  lenitive  electuary,  or  the  white  liquid  physic.     In  some  cases, 


\e-Ji.M^;i,1r:/±Ji^ 


■f.^K      nil  M 


itod  state, 
iis  is  quite 


its  vesselii 
'<!  cellular 

tly  in  the 
lu  addi. 

failing  of 
omes  dry, 
ntly  thirst, 

epithelial 
tubes,  and 

in  health, 
in  color, 
nd  causes, 
arge  quan- 

:  and  forth 
mon  8ynij3- 

e  often  un- 
roper  caro, 
jure.  It  ia 
imily  prac- 
with  sufli- 

jf  the  skin 
and  falter- 
onge  bath 

ion,  should 
incture  of 
compound 

n  there  is 
f  cupping, 

cream  of 
som  salts, 
nvt  cases, 


DISEASES  OF  TIIB  ABDOMINAL  CAVITY. 


301 


podophyllin  and  leptandrin  (40),  or  tl'^  compound  powder  of  jalap 
(41),  are  useful. 

When  there  is  dropsy  of  the  ccIIk,  elatcrium  may  bo  used  ns  phvsio 
(31),  or  the  kidney  may  be  jogged  by  digitalis  {i'M)  (129),  its  eflecta 
being  carefully  watched.  Cider,  freely  drank,  has  been  found  useful 
in  some  cases. 

To  restore  the  blood,  iron  (73)  (93)  (74)  (75)  (72)  (71)  is  the  essen- 
tial article.  When  there  is  considerable  debility,  some  of  the  vegeta- 
ble bitters,  as  quinine,  quassia,  gentian,  Colombo,  etc.,  may  be  used 
daily. 

Coffee,  and  all  indigestible  articles  of  food,  as  rich  pastrieti,  new 
bread,  high-seasoned  meat,  and  fats  umst  be  avoided,  —  in  a  word, 
nothing  nuist  be  taken,  either  in  kind  or  quantity,  which  the  stomach 
I    cannot  easily  digest. 

Diabetes. 

This  disease  is  a  kind  diarrhoea  of  the  kidneys.  The  amount  of 
urine  secreted  and  discharged  is  large,  sometimes  enormous  in  quan- 
tity, —  amounting  even  to  several  gallons  in  twenty-four  hours. 
Everything  taken  into  the  stomach  seems  to  run  off  by  the  kidneys. 
The  food  and  drink  being  mostly  converted  into  urine,  do  but  little 
good.  The  kidneys  having  got  into  an  exalted  state  of  action,  do  too 
much.,  — just  as  the  mucous  membrane  of  the  air  tubes  does  in  bron- 
chitis. 

Nature  of  the  Urine. — Not  only  is  there  too  much  urine  discharged, 
but,  instead  of  being  lighter  than  healthy  urine,  as  in  Bright's  disease, 
it  is  heavier,  and  instead  of  holding  albumen  in  solution,  it  contains 
grape  sugar.  % 

To  Detect  8ii|[^r. — Put  a  little  of  the  suspected  urine  in  a  test  tube, 
—  add  to  it  a  drop  or  two  of  solution  of  sulphate  of  copper,  which 
will  give  the  fluid  a  pale  blue  tint.  Now  add  liquor  potassa  in  excess; 
if  sugar  be  present,  this  will  throw  down  a  pale  blue  precipitate  (hy- 
drated  oxide  of  copper),  which  will  immediately  re-dissolve,  forming 
a  purplish  blue  liquid.  Boil  this  over  a  lamp ;  if  there  be  sugar,  a 
reddish  or  yellowish-brown  precipitate  (sub-oxide  of  copper)  will  be 
thrown  down ;  if  no  sugar,  a  black  precipitate  (common  oxide  of 
copper)  will  fall  to  the  bottom. 

Another  Test.  —  Place  a  little  urine  in  a  test  tube ;  add  to  it  half 
its  volume  of  liquor  potassa,  and  boil  five  minutes.  If  there  be  sugar 
present,  the  liquid  will  take  a  .brownish  or  bistre  tint 

Growth  of  Tonila  as  a  Test — Place  a  portion  of  sacharine  urine 
in  a  warm  place,  and  a  scum  will  soon  rise,  as  if  a  little  flour  had 
been  dusted  on  it.  This,  when  examined  under  the  microscope, 
proves  to  be  minute  oval  bodies.  These  expand  and  dilate  the  vesi- 
cle containing  them,  into  the  for  n  of  a  tube.  They  still  continue  to 
enlarge,  and  project  from  the  parent  bladder,  like  buds.     The  whole 


11 


,^ 


302 


DIBEASr.n  OF  THE  AnnOMTNAL  CAVITY. 


Fio.  111. 


Uirn  rcHcmhloH  a  jointed  fungoid  growth  (Fig.  Ill),  which  finally 
hrciikn  u|t,  iind  fulftt  to  the  bottom,  as  a  copioua  dcpoai'  of  oval  veai* 
ch'H  or  H|)on'!*. 

Other  Syiii|ifoiiiN.  —  Groat  thirnt,  craving  ap- 
potiti',  dry  Hkin,  a  wnwo  of  w«'ight  and  uncnHi- 
M('H8  in  the  Mtoniach  after  eating,  dry  and  paniied 
mouth,  white  and  foul  or  el<>an  and  red  tongiii;, 
waiting  of  florth,  languor  and  avcrBion  to  exer- 
cise, debility,  pain  and  weakncBH  in  the  ioinx, 
coHtlvenesB,  Iohh  of  the  sexual  feeling,  and  cold 
feet.  As  the  diseaw!  draws  towards  a  fatal  end, 
the  gums  become  spongy,  the  breath  fetid, 
Bometimea  smelling  liiic  urme. 

Treatment. —  The  skin  should  have  about  the  same  treatment  as 
that  recommended  in  Bright's  disease.  Also,  the  same  counter-irrita- 
tion over  the  kidneys.  The  bowels  must  be  kept  oocn  by  some  gentle 
physic  (13)  (12)  (15). 

Tonics. —  These  will  be  required  to  restore  the  tone  of  the  system, 
particularly  iron,  —  same  preparations  as  recommended  in  Pright'a 
disease. 

Astrinipents  to  check  the  flow  of  urine  will  be  needed.  Alum,  in 
three-grain  doses,  three  times  a  day,  or  sugar  of  lead,  or  white  vitriol, 
or  clear  opium,  will  be  serviceable.  Creosote,  in  one  or  two-drop 
doses,  and  tincture  of  cantharides,  have  each  cured  cases. 

One  scruple  of  Peruvian  bark,  one  scruple  of  wild  cranberry  leaves, 
powdered,  and  half  a  grain  of  opium,  mixed  and  taken  three  times  a 
day,  is  a  good  remedy. 

All  articles  which  contain  sugar  and  starch  must  be  forbidden 
in  the  diet.  Bread  and  potatoes  contain  a  large  amount  of  starcli ; 
and  beets,  parsnips,  and  some  other  vegetables,  have  sugar.  It  is  best 
to  confine  the  patient  almost  entirely  to  tender,  fresh  meats  ;  and  the 
drink,  notwithstanding  the  great  thirst,  must  be  restricted  to  a  very 
small  quantity. 

Bleeding  from  the  Eidnejs,  etc. — Hematuria. 

By  this  I  mean  a  discharge  of  blood  from  the  urinary  passage.  It 
may  come  from  the  kidneys,  the  ureters,  the  bladder,  or  the  urethra. 

Symptoms.  —  The  passage  of  the  blood  is  preceded  by  pain  in  the 
region  of  the  bladder  or  kidneys,  and  accompanied  by  faintness. 
There  is  generally  heat  and  distress  in  the  loins,  and  tenderness 
upon  pressure  in  the  region  of  the  bladder  or  kidneys,  according  to 
the  place  from  which  the  blood  comes. 

It  is  sometimes  difficult  to  decide  whether  the  coloring  matter  in 
the  urine  is  really  blood.  In  such  cases,  the  microscope  will  generally 
detect  the  blood  corpuscles,  if  present.  They  commonly  appear  as  in 
Fig.  1 12,  —  having  a  yellov  color,  and  pretty  uniform  size. 


i.iUiJifAK- 


i<  li  fiiiiilly 
ovttl  vcai- 

111. 


liatincnt  as 
iiitcr-irrita- 
omc  gi'iille 

tlie  system, 
in  Plight's 

Alum,  in 
hite  vitriol, 
ir  two-drop 

lerry  leaves, 
ree  times  a 

;  forbi'dden 
t  of  starcli ; 
.  It  ia  best 
9 ;  and  the 
d  to  a  very 


turia. 

lassage.     It 
B  urethra. 

pain  in  the 

J  faintness. 

tenderness 

jcording  to 


I  matter  \n 

II  generally 
ppear  as  in 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


30.') 


Tre atnientt  ^ — This  must  of  conr«o  vary  nocordinj<  to  th(^  naturo  of 
th(>  cii.tc,  iiiui  the  immediate  ciiuse  |)r(Mliiring  it.  Wiiere  active  bleed- 
iiig  exists,  the  patient  must  liave  absolute  rest  ri<i.  ua. 

in  bed,  with  applications  of  cold  to  the  hips  and 
loins.  If  the  patient  be  strong  and  full  of  blood, 
wet  cups  or  leeches  nuiy  i)C!  applied  over  the 
kidneys,  or  the  bladder.  In  such  cases,  to<i,  the 
bowels  nmst  be  freely  moved  with  some  prepar- 
ation of  salts  (14)  (IH)  (:>())  CJ,",). 

Sugar  of  lead  is  a  valuable  remedy  ;  but  it 
should  be  given  in  lar<3[e  doses  for  a  short  time, 
rather  than  in  small  do^es  for  a  long  time.     It  is 
best  taken  in  form  of  solution  (34n),  two  great  spoonfuls  every  two 
hours,  until  Bvc  or  six  doses  are  taken. 

But  the  beai,  remedy  is  gallic  acid.  It  seems  to  have  extraordinary 
power  in  this  complaint.  It  should  be  given  in  five-grain  doses, 
mixed  with  a  teaspoonfui  of  mucilage  of  gum  arabic,  and  ten  drops 
of  tincture  of  henbane. 

Suppression  of  Urine. — Ischuria  Renalis. 

This  disease  is,  in  one  respect,  just  the  opposite  of  diabetes. 
While  immense  quantities  of  urine  are  secreted  in  that,  none  is  se- 
ereted  in  this.  In  that,  the  kidneys  do  too  much ;  in  this,  they  do 
nothing. 

This  complaint  is  sometimes  called  paralysis  of  the  kidneys.  It 
usually  occurs  in  old  persons,  and  those  inclined  to  corpulency. 

Symptoms.  —  The  patient  makes  no  water ;  and  if  the  c^.theter  be 
applied,  none  will  be  found  in  the  bladder.  The  patient  feels  unwell, 
restless,  anxious,  with  a  slight  pain  in  the  loins  and  bowels,  perhaps ; 
but  on  the  whole  not  illness  enough  to  give  any  very  good  account 
of  it.  After  a  little  time,  nausea  comes  on,  and  perhaps  vomiting, 
and  soon  drowsiness,  wanderings  of  mind,  incoherent  talk,  hiccough, 
stupefaction,  and  death.  These  head  symptoms  are  caused  by  the 
shutting  up,  in  the  kidneys,  the  natural  outlet  of  urea,  of  an  excre- 
inentitious  matter,  which  acts  as  a  poison  to  the  nervous  system. 
Before  death,  the  perspiration  has  a  strong  smell  of  urine. 

Treatment.  —  The  cause  cf  this  complaint  not  being  known,  the 
treatment  must  necessarily  be  a  little  uncertain.  We  cannot  go 
amiss,  however,  in  placing  the  patient  immediately  in  a  warm  bath 
for  fifteen  or  twenty  minutes.  Then  app'  ivet  cups  over  the  kidneys, 
and  follow  these  either  by  mustard  poultices,  or  by  hot  fomentrtions. 

Let  the  bowels  be  opened  by  the  compound  powder  of  jalap,  or  by 
elaterium  (31).  Epsom  salts  or  cream  of  tartar  might  in  some  cases 
be  substituted  for  the  above.  A  stimulating  injection  is  also  desira- 
ble (246).  ~  ,  .  V 

Diuretics,  as  sweet  spirits  of  nitre,  digitalis,  queen  of  the  meadow  and 
peach  leaves,  equal  parts,  and  marshmallow,  are  of  course  called  for. 


■)>ii 


■>r^ 


p/'i") 


804 


DISEASES  OF  THE  ABnOMINAL  CAVITY. 


Much  of  the  poisonous  matter  retained  may  be  got  out  through  the 
skin,  by  a  free  use  of  the  compound  tincture  of  Virginia  snake-root 
or  tincture  of  veratrum  viride  in  full  doses. 

Although  the  symptoms,  in  the  earlier  stages  of  this  complaint, 
may  not  attract  much  attention,  or  be  thought  worthy  of  notice,  yet 
the  treatment  should  be  prompt  and  energetic,  as  a  fatal  termination 
is  Bometimea  reached  in  the  brief  space  of  forty-eight  hours. 


I'  •- 


i„ 


Retention  of  Urina. 

This  disorder  is  often  confounded  with  suppression  of  the  urine, 
but  it  is  different  in  every  respect.  In  suppression,  the  urine  is  not 
formed  by  the.  kidneys  ;  in  retention,  it  is  formed,  and,  in  some  cases, 
poured  into  the  bladder,  but  is  retained  on  account  of  some  inability 
to  pass  it 

Ischuria. — This  is  one  of  the  forms  of  retention.  In  this  complaint, 
the  urine  has  passed  from  the  kidneys  to  the  bladder,  but  from  some 
cause,  generally  palsy  of  the  muscles  of  the  bladder,  it  cannot  be 
passed  off  In  this  case,  there  is  no  pain,  but  the  stream  of  water 
flows  off  with  slower  and  slower  pate,  —  the  patient  having  to  stand 
a  long  time,  and  muke  tiresome,  efforts  with  the  abdominal  muscles 
to  get  the  bl-jdd«ii-  emptied.  As  the  quantity  discharged  diminishes, 
the  desire  to  urinate  .grows  more  uigent.  Pressure  juat  above  the 
puoes,  gives  pain,  and  the  bladder  feels  und?r  the  hand  like  a  large 
hard  tumor. 

Dysiiriia.->-In  this  form  of  the  complaint,  the  water  is  passed  to 
8on;e  extent,  bat  with  pain  and  heat  along  the  water-pipe.  This  is 
generady  caused  by  some  inflammation  along  the  urethra. 

Strangury.  In  this,  the  water  is  only  passed,  drop  by  drop,  and 
with  great  burning,  scalding,  and  tenesmus  in  the  neck  of  the  bladder, 
^hen  there  is  considerable  inflammation,  the  skin  becomes  hot,  the 
pulse  hard  and  quick,  and  the  tongue  covered  with  a  white  fur. 

Causes. —  These  several  forms  of  the  complaint  are  caused  by  palsy 
of  the  bladder,  gonorrhoea,  inflammation  in  the  neck  of  the  bladder 
or  the  water-pipe,  mechanical  injuries  of  the  bladder  in  child-bearing, 
or  otherwise,  by  tumors  pressing  upon  it,  by  irritation  from  gravel  or 
stone  within  its  cavity,  by  stricture  or  partial  closing  up  of  the  nrethra, 
by  disease  of  the  prostate  gland,  by  taking  spirits  of  turpentine  or 
cantharides,  or  by  the  absorption  of  this  latter  article  when  used  as  a 
blister. 

Treatment.  —  It  is  obviously  necessary  in  this  complaint,  that  treat- 
ment, in  order  to  be  of  any  avail,  should  be  prompt ;  for  when  the 
retention  is  complete,  the  bladder  will  burst  in  from  two  to  five  days, 
and  cause  the  death  of  the  patient. 

The  treatment  must  vary  according  to  the  cause  of  .he  retention. 

If  it  be  caused  by  palsy  of  the  bladder,  the  common  flexible  cathe- 
ter must  be  used  daily  until  the  muscular  fibres  reco/er  their  lost 


".?'■".'  11  ■JWglllj.P 


hrough  the 
snake-root 

complaint, 
notice,  yet 
erminadon 


the  urine, 
line  is  not 
3ome  cases, 
16  inability 

complaint, 
from  some 
cannot  be 
tn  of  water 
ng  to  stand 
lai  muscles 
diminishes, 
t  above  the 
like  a  large 

9  passed  to 
pe.     This  ia 

y  drop,  and 
the  bladder, 
nes  hot,  the 
e  fur. 

led  by  palsy 
the  bladder 
lild-bearing, 
m  gravel  or 
the  nrethra, 
irpentine  or 
m  used  as  a 


t,  that  treat- 
ir  when  the 
to  five  days, 

retention, 
jxible  cathe- 
iv  their  lost 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


302 


power.  When  much  irritation  is  caused  by  introducing  it,  it  is  better 
not  to  withdraw  it,  but  to  close  its  external  orifice  with  a  small  plug* 
which  the  patient  can  remove  as  often  as  necessary  to  let  off  the 
urine.  To  remove  the  paralysis,  the  electro-magnetic  machine  is 
worth  a  trial,  —  the  current  being  passed  through  the  bladder.  At 
the  same  time  let  the  patient  take  strychnia  (85)  (86)  (83)  (95). 
Cantharides,  in  the  form  of  tincture,  or  in  connection  with  strychnia 
(291),  is  often  useful. 

If  the  retention  be  caused  by  infiammation  of  the  neck  of  the  blad* 
der,  leeches  should  be  applied  to  th^  perineum,  and  three  or  four  drops 
of  croton  oil  may  be  rubbed  ou  just  above  the  pubes  to  bring  out  an 
eruption.  Warm  fomentations  will  also  be  serviceable,  and  warm 
hip  baths.  Cooling  diuretics,  as  infusions  of  marshmallow,  cleavers, 
pumpkin  seeds,  buchu,  sweet  spirits  of  nitre,  etc.,  must  not  be  omitted 

Inability  to  Hold  the  Urine. — Enuresis. 

This  complaint,  generally  called  incontinence  of  urine,  is  quite 
common  among  children.  In  some  cases  the  child  has  no  ability  to 
hold  its  water  at  any  time;  but  generally  it  is  only  passed  off  invol- 
untarily at  night  while  in  bed.  In  adult  lif?  it  is  less  frequently  met 
with,  except  among  the  old. 

Canses.  —  Irritation  of  the  roots  of  the  spinal  nerves  which  go  to 
the  bladder,  mechanical  injuries  of  the  bladder,  palsy  of  the  bladdfsr, 
particularly  in  old  people,  debility  of  the  neck  of  the  bladder,  a  gen- 
eral weakness  of  the  nervous  system,  worms  in  the  bowels,  piles, 
whites,  gravel  or  stones  in  the  bladder,  etc. 

Treatment.  —  As  a  general  rule,  the  change  of  constitution  which 
occurs  at  purberty  cures  this  complaint.  But  as  this  does  not  always 
happen,  it  is  important  that  parents  do  everything  in  their  power  to 
break  it  up  early,  lest  it  become  an  affliction  for  Ufe. 

Children  who  suffer  from  this  disorder  are  apt  to  drink  largely. 
This  habit  should  be  restrained.  But  little  drink  should  be  allowed, 
\thatever  the  desire  for  it.  Care  should  be  taken  that  the  child  make 
water  before  going  to  bed,  —  also  that  it  be  roused  at  a  late  hour  for 
the  same  purpose. 

The  skin  should  be  washed  all  over,  every  day,  with  cool  or  cold 
water,  and  vigorously  rubbed  with  a  coarse  towel.  This  will  cause 
the  excess  of  fluids  to  pass  off  through  the  skin,  and  lessen  the  action 
of  the  kidneys. 

In  some  instances  chiltren  urinate  in  bed  through  carelessness, — 
being  half  conscious  of  what  is  occurring,  but  not  caring  enough  to 
rouse  themselves.  In  such  cases,  they  are  often  cured  by  some  de- 
cided correction,  —  the  impending  act  of  passing  water,  connecting 
itself  in  their  minds  with  the  correction,  and  recalling  them  instantly 
to  full  consciousness.  Of  conrse  this  mode  of  relief  should  be  resorted 
to  with  great  judgment  and  caution. 

When  the  complaint  proceeds  from  debility  or  relaxation  of  the 
neck  of  the  bladder,  the  compound  infusion  of  trailing  arbutus,  and 

39 


#^^ 


306 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


the  isinglass  custard  found  among  dietetic  preparations,  may  be  used 
freely.  The  tincture  of  cantharides,  from  ten  to  forty  drops  to  chil- 
dren, may  be  given,  and  increased  gradually  to  a  hundred,  or  until  slight 
difficulty  is  felt  in  passing  the  water.  Then  stop,  and  give  the  articles 
mentioned  above.  Spirits  of  turpentine  is  useful  to  some  extent, 
given  also  in  small  doses,  and  continued  for  some  time. 

If  the  disorder  be  caused  by  irritation  of  the  spinal  nerves,  cold 
wat«r  douched  upon  the  back,  or  croton  oil  rubbed  along  the  spine, 
or  a  warm  stimulating  or  irritating  plaster  upon  the  lower  part  of  tho 
back,  will  be  reouired.  The  electro-magnetic  machine  may  do  well 
in  ^ome  cases. 

Urinary  Deposits.— Gravel.— Stone. 

Unnatural  deposits  in  urine  are  to  be  regarded  simply  aa  evi- 
dences of  changes  which  disease  is  making  in  the  body.  As  such 
they  are  valuable,  —  more  valuable,  in  many  cases,  than  any  or  all 
other  symptoms  we  can  study,  and  most  valuable  from  the  ease  with 
which  they  may  be  investigated.  Yet,  but  very  few  physicians,  com- 
paratively, pay  any  special  attention  to  them,  or  make  any  effort  to 
acquire  the  small  amount  of  knowledge  needed  for  their  detection. 

Sources  of  the  Urine.  —  The  urinary  secretion  has  three  sources. 
The  largest  bulk  of  it  comes  from  the  superabundance  of  drink  taken 
into  the  stomach.  This  is  shown  from  the  free  flow  of  pale  urine 
after  taking  copious  drafts  of  water  or  other  fluids.  Such  quantities 
of  water  as  are  often  drank,  would  embarrass  the  functions  of  animal 
life,  were  it  not  pumped  off"  by  the  kidneys. 

A  second  source  of  supply  for  the  urinary  secretion,  is  to  be  found 
in  the  elements  of  imperfectly  digested  food,  and  also  some  abnormal 
elements  arising  from  incomplete  assimilation.  Oxalic  acid  is  a 
specimen  of  the  latter,  being  sometimes  largely  excreted,  in  dyspep- 
sia, soon  after  a  meal. 

The  third  source  of  urine  is  found  in  those  old  and  worn-out  atoms 
of  the  system,  which  can  serve  no  further  useful  purpose  in  the  ani- 
mal economy,  and  which  cannot  he  got  rid  of  by  the  lungs  or  skin. 
It  is  only,  however,  one  portion  of  the  dead  tissue,  namely,  that  which 
is  rich  in  nitrogen,  which  goes  out  through  the  renal  strainer, — an- 
other portion,  which  has  a  preponderance  of  inflammable  elements, 
carbon,  hydrogen,  and  perhaps  sulphur,  takes  the  outward  channel 
through  the  liver,  as  bile. 

Characteristics  of  Urine. — Henlthy  urine  has  a  light  amber  color,  is 
transparent,  and  has  different  degrees  of  density,  —  its  specific  gravity 
varying  from  1.003  to  1.030.  It  has  an  aromatic,  violet-like  smell, 
ana  a  bitter,  disagreeable  taste,  like  salts. 

That  which  is  passed  a  little  time  after  drinking  largely,  is  pale, 
and  has  a  low  specific  gravity,  varying  from  1.003  to  1.009,  and  is 
called  urina  potus.  That  passed  soon  after  the  digestion  of  a  full 
meal,  is  called  uritm  chyli,  or  urina  cibi;  it  has  a  specific  gravity  from 
\.030  to  1.030.     That  which  is  secreted  from  the  bloody  and  is  passed 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


307 


ay  be  used 
)ps  to  cliil- 
until  slight 
the  articlea 
ime  extent, 

lerves,  cold 
;  the  spine, 
part  of  the 
aay  do  well 


iply  as  evi- 
'.  As  such 
I  any  or  all 
16  ease  with 
icians,  com- 
my  effort  to 
ietection. 

iree  sources, 
drink  taken 
f  pale  urine 
:h  quantities 
ns  of  animal 

to  be  found 

ne  abnormal 

acid  is  a 

in  dyspep- 


ic 


rn-out  atoms 
in  the  ani- 
iings  or  skin. 
|r,  that  which 
rainer, — an- 
)le  elements, 
rard  channel 

nber  color,  is 
ecific  gravity 
et-like  smell, 

rgely,  is  pale, 
1.009,  and  is 
ion  of  a  full 
gravity  from 
nd  is  passed 


before  eating  or  drinking  in  the  morning,  is  called  vrina  sanguinis ;  and 
has  a  specific  gravity  from  1.015  to  1.025.  This  is  the  best  specimen 
of  the  average  density  and  nature  of  healthy  urine. 

Healthy  urine  contains  urea,  uric  acid,  sulphuric  acid,  phosphoric 
acid,  lime,  magnesia,  phosphate  of  soda,  etc.  It  is  only  when  these 
are  discovered  in  excess,  that  they  indicate  disease. 

Examination  of  IJrine.  —  Let  a  piece  of  blue  litmus  paper  be  first 
dipped  in  the  urine ;  if  it  be  acid,  the  color  of  the  paper  will  be 
changed  to  red,  or  reddish-brown.  Should  the  blue  color  remain  un- 
changed, then  use  yellow  tumeric  or  reddened  litmus  paper ;  if  the 
urine  is  alkaline,  the  tumeric  will  become  brown,  and  the  reddened 
litmus  will  be  changed  to  blue.  If  the  color  in  both  cases  remains 
unaltered,  the  urine  is  neutral ;  that  is,  neither  acid  nor  alkaline. 

This  being  done,  let  the  specific  gravity  be  taken.  This  is  easily 
done  by  the  urinometer  (Fig.  113).  This  instrument  is  known  also 
by  the  names  hydrometer,  and  gravimeter.  It  is  generally  fio.  u3. 
made  of  glass.  When  placed  in  distilled  water,  it  will  sink 
to  a  certain  point ;  and  as  all  bodies  immersed  in  fluid  dis- 
place a  bulk  equal  to  themselves,  it  follows  that  in  a  fluid 
denser  than  water,  the  instrument  will  not  sink  so  deep.  The 
space  above  the  large  bulb  is  marked  off  into  degrees  corres- 
ponding to  different  densities.  When  this  instrument  is  im- 
mersed in  urine,  and  has  come  to  rest,  the  number  on  the 
graduated  scale,  which  stands  at  the  surface  of  the  liquid, 
when  added  to  1000,  will  represent  the  specific  gravity  of  the 
fluid.  If,  for  example,  the  surface  of  the  liquid  corresponds 
with  9  on  the  scale,  the  specific  gravity  of  the  urine  will  be 
1.009;  if  at  25,  it  will  be  1.025. 

By  attending  to  the  specific  gravity  of  the  urine,  the  phy- 
sician may  often  gain  important  information  respc  cing  his  patient, 
as  it  may  be  made  to  show  him  how  much  solid  matter  is  daily  car- 
ried out  of  the  body  through  the  kidneys.  This,  at  the  bed-side,  may 
often  give  useful  hints  in  regard  to  treatment. 

The  following  table,  constructed  by  Dr.  Golding  Bird,  shows  at  a 
glance  the  amount  of  solid  matter  iu  1000  grains  of  urine  of  different 
dejisities : 


8pe<iao 
<iravity. 

SoUdt.  Water. 

Speoiflo 
Oravlty. 

SoUdc.^  Wtter. 

ECS?.;  solid. 

W«ter. 

Speoiflo 
GVivlty. 

Solidii. 

Wafer. 

1001 

2.3S  997.67 

1011 

25.68  974.87 

1021 

48.93 

951.07 

1081 

72.23 

927.77 

1002 

4.66  995.341 

1012 

27.96  972.04 

1022 

5t.26 

948.74 

1032 

74.56 

925.44 

IOC'S 

6.091993.01, 

1013 

80.29  969.71 

1023 

4,    19 

946.41 

1033 

76.89  92.S.  11 

1004 

9.32.990.68 

1014 

32.62  967.38 

1024 

55.92 

944.18 

1034 

79.22  920.78 

1005 

11.65 

988.85 

1015 

34.95  965.05 

1025 

58.25 

941.75 

1035 

81.55  918.45 

lOOG 

18.98 

986.02 

1016 

37.23  962.72 

1026 

60.50 

939.42 

10.36 

83.88 

916.12 

1007 

16.31 

988.69 

1017 

39.61  960.39 

1027 

62.91 

937.09 

1087 

86.21 

913.79 

1003 

18.64  1981.86 

1018 

41.94  958.06 

1028 

65.24 

934.76 

1038 

88.54 

911.46 

1001) 

20.97  979.03 

1019 

44.27  955.78 

1029 

67.57 

932.48 

1039 

93.87 

909.13 

1010 

23.80  976.70 

1020 

46.60  953.40 

1030  '69.90 

930.10 

1040 

93  20 

906.80 

Tlie  mode  of  using  the  above  table  is  this.     Having  learned  the 
density  of  the  urine  passed  in  twenty-four  hours  by  means  of  the 


'iitii 


■  "!l 


^^ 


urinometer  (Fig.  113),  a  glance  at  the  table  will  show  ''le  proportion 
of  solid  matter  and  water  in  1000  grains  of  the  urim;.  Then,  by 
weighing  the  whole  quantity  of  urine  passed  in  twenty-four  hours,  the 
weight  of  solids  drained  off  by  the  kidneys,  may  be  determined  by  the 
simple  rule  of  proportion.  >  ;•     • 

Symptoms  of  Gravel.  —  A  sudden  attack  of  pain  in  the  region  of 
the  kidneys,  so  acute  and  severe,  frequently,  as  to  cause  fainting,  and 
even  convulsions.  The  paia  runs  down  to  the  groin  and  thigh,  caus- 
ing a  numbness  on  the  affected  side,  and  a  drawing  up  of  the  testiclCi 
The  pain  is  excessive  at  times,  and  then  remits.  Finally  it  stop:?  sud- 
denly. 

Leading  from  the  kidneys  to  the  bladder  are  two  small  tubes  about 
the  size  of  a  goose-quill,  called  ureters,  —  being  the  appointed  chan- 
nels of  the  urine.  The  pain,  of  which  I  have  spoken,  is  caused,  gen- 
erally, by  the  passage  of  a  stone  along  one  of  these  small  tubes.  If 
Uie-'stone  happen  to  be  a  little  too  large  for  the  tube,  or  uneven  or 
r''!Ted  upon  its  surface  so  as  to  bruise  and  tear  the  delicate  lining 
I),  the  ureter,  severe  pain  is  the  result.  The  pain  is  intense  when  the 
stone  moves  along ;  remits  when  it  stops ;  and  suddenly  ceases  alto- 
gether, when  it  gets  through,  and  drops  into  the  bladder. 

Sometimes  there  is  no  pain,  the  gravel  being  so  fine  as  to  pass 
through  the  ureters  very  easily.  It  then  passes  through  the  u. .  thra 
also,  and  is  found  as  a  sediment  of  the  urine  at  the  bottom  of  the 
vessel 

These  urinary  deposits  are  various,  and  quite  unlike  each  other  in 
kind.  They  indicate  different  states  of  health,  and  require  to  be 
spoken  of  separately. 


'  Uric-Acid  Gravel. 

This  form  of  deposit  passes  indifTerently  under  the  name  of  uric 


acj  .1 


gravel,  or  lithic  acid  gravel.  The  person  who  is  in  the  habit  of 
passing  this  kind  of  deposit  largely,  is  said  to  have  the  lithic  or  uric 
acid  diathesis  or  condition. 


Fia.  114. 


Fio.  115. 


The  urine  of  persons  in  this  state  lets  fall  after  it  has  stood  awhile, 
a  reddish  sediment,  like  brickdust.  This  consists  chiefly  of  urate  of 
ammonia  (Fig.  114  and  115),  tinged  with  certain  coloring  matters. 


'  'V"t  "I'*''  '"'     ■   ■'!' 


■•^^WWlWMllWWM 


proportion 
Then,  by 
ir  hours,  the 
lined  by  the 

region  of 

tinting,  and 

thigh,  cau8> 

he  testicle. 

t  stopF)  bud- 

:ube8  aboat 
>inted  chan- 
caused,  gen- 
l  tubes.  If 
>r  uneven  or 
licate  lining 
86  when  the 

ceases  alto- 

:  as  to  pass 
1  the  u.  i.hra 
jttoin  of  the 

ach  other  in 
jquire  to  be 


lame  of  vric 
the  habit  of 
lithic  or  uric 


tood  awhile, 

of  urate  of 

Ing  matters. 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


309 


FlO.  116. 


This  coloring  substance  may  be  more  or  less  abundant,  and  give  to 
the  deposit  various  shades,  as  dirty -white,  yellow,  pink,  and  red    The 

pure  uric  acLd  sometimes  appears  as  fine 
sand,  or  large  crystals  (Fig.  116).  The 
urine  is  of  a  dark  cojiju'r  color,  about  like 
brown  sherry,  and  is  more  scanty  than  in 
health.  It  is  al  highly  acid,  giving  to 
litmus  paper  a  deeper  shade  of  red. 

Persons  who  pass  this  kind  of  gravel 
largely,  are  apt  to  be  troubled  with  in- 
flammatory complaints;  with  acidity  of 
stomach  and  heartburn  ;  and  some  of 
them  with  gout  and  rheumatism. 

Placed  under  a  blowpipe,  uric  acid  is 
decomposed,  and  gives  out  an  odor  like 
that  of  burnt  feathers,  combined  with  the 
oil  of  bitter  almonds.  It  is  dissolved  by 
liquor  potassa,  from  which  muriatic  and 
nitric  acids  precipitate  it ;  and  by  sulphu- 
ric acid,  from  which  it  is  precipitated  by  water.  Acetic,  nitric,  and 
muriatic  acids,  alcohol,  ether,  and  water,  do  not  dissolve  it. 


Causes. —  Uric  acid  is  the  form  in  which  nitrogen  and  the  effete 
compounds  which  contain  it  are  got  out  of  the  body.  It  is  the  result 
of  the  decomposition  of  the  tissues  of  the  body.  Its  gravelly  particles 
are  the  sands  of  life  daily  washed  out  of  us,  —  reminding  us  always 
that  we  are  wasting  away.  Whatever  causes  the  body  to  waste  rap- 
idly, produces  it  in  excess.  We  find  it,  therefore,  in  the  urine  of 
those  who  suflTer  from  gout,  rheumatism,  dyspepsia,  fevers,  debility 
of  the  genital  organs,  straining  of  the  loins,  etc.,  which  produce  loss 
of  flesh. 

Treatment — The  remedies  for  this  uric  acid  gravel  are  the  alkalies, 
bicarbonate  of  potash,  bicarbonate  of  soda  and  magnesia.  The  first 
named  is  generally  the  best.  It  may  be  used  in  the  form  of  the  neu- 
tralizing extract,  —  especially  if  there  be  costiveness.  If  the  bowels 
do  not  need  physic,  let  the  potash  be  taken  in  the  shape  of  lye  made 
from  hard-wood  ashes  (300).  Fluid  magnesia  is  an  excellent  remedy; 
•o  is  liquor  potassa,  taken  in  twenty  or  thirty-drop  doses.  The  urine 
must  be  watched,  and  these  remedies  discontinued  when  it  becomes 
alkaline. 

At  the  same  time  the  stomach  should  be  supported  by  some  bitter 
tonic,  as  the  infusion  of  quassia,  gentian,  columbo,  Peruvian  bark,  etc 

Iron  is,  in  many  cases,  not  to  be  overlooked.  If  the  patient  be 
pale  and  bloodless,  some  of  the  preparations  of  this  metal  will  be 
needed  (61)  (73)  (74). 

Acids  must  be  carefully  avoided,  both  in  food  and  drink. 

The  diet  must  be  plain,  digestible  and  nourishing,  and  quite  mod- 
erate in  amount.    The  quality  is  of  less  consequence  than  the  quaaUily. 

Exercise  is  of  great  consequence,  and  must  be  regular,  and,  if  pos- 
sible, in  the  open  air. 


""W 


a'U 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


The  skin  must  receive  daily  attention  in  the  shape  of  an  alkaline 
sponge  bath,  with  friction.  This  will  throw  upon  the  skin  much  of 
tlie  labor  done  by  the  kidneys. 

Phosphatio  Deposits. 

These  deposit?  are  indicated  by  a  state  of  the  urine  just  the  oppo< 
site  of  that  which  contains  the  uric  acid  gravel.  They  are  contained 
in  urine  which  is  either  alkaline  when  passed,  or  becomes  so  very  soon 
by  standing. 

As  the  urine  cools,  a  white  sand  falls  to  the  bottom,  and  frequently 
a  film  forms  upon  the  surface  of  the  water.  Looking  at  this  film  in 
different  lights,  you  may  see  in  it  the  several  colors  of  the  rainbow. 
Skim  off  this  pellicle,  place  it  upon  paper,  and  let  it  dry ;  and  you 
may  then  see  the  little  shining  crystals.  This  urine  quickly  grows 
putrid  and  offensive.  Sometimes  it  smells  strongly  of  ammonia. 
The  more  phosphates  it  contains,  the  sooner  it  becomes  alkaline. 

These  deposits  are  generally  the  triple  phosphates.  Healthy  urine 
contains  the  phosphate  of  magnesia  in  a  state  of  solution.  Under 
some  circumstances,  the  urea  of  the  urine  is  decomposed  in  the  kid- 
neys, and  ammonia  is  disengaged.  This  combines  with  the  phosphate 
of  magnesia,  and  forms  the  triple  salt  of  the  phosphate  of  ammonia 
and  magnesia,  which  is  not  soluble. 

Symptoms.  —  A  sallow  complexion,  a  languid,  spiritless  state  of 
mind,  and  an  exhausted,  debilitated  condition  of  body.  The  urine  is 
pale,  rather  copious,  slightly  turbid,  has  a  low  specific  gravity,  and 
smells  unhealthy,  having  sometimes  the  faint  odor  of  weak  broth. 
There  is  generally  derangement  of  the  digestive  organs,  windy  stom- 
ach and  bowels,  nausea,  constipation,  or  diarrhoea,  stools  of  various 
colors,  and  sometimes,  in  diarrhcca,  resembling  yeast,  and  an  aching 
pain  and  weakness  in  the  loins. 

Causes.  —  These  deposits  are  produced  by  great  debility  of  the 
constitution,  by  injuries  of  the  spine,  dyspepsia,  defective  assimula- 
tion  of  food,  bad  diet,  irritation  of  the  neck  of  the  bladder,  and  or- 
ganic disease  of  the  kidneys.  But  they  are  caused  more  especially  by 
whatever  wears  and  exhausts  the  nervous  system,  as  heavy  cares,  de- 
pression of  spirits,  sedentary  habits,  great  mental  exertions,  mastur- 
bation, and  venereal  excesses. 

Treatment. —  These  deposits  being  connected  with  great  debility, 
care  must  be  taken  not  to  make  the  matter  worse  by  taking  active 
purgatives,  by  extreme  fasting,  or  by  any  means  which  will  increase 
the  weakness. 

On  the  contrary,  the  strength  must  be  supported  by  all  the  means 
that  can  be  commanded.  With  this  view,  the  citrate  of  iron  Pb) 
may  be  taken.  Morphia  combined  with  iron  (80),  to  allay  irritability, 
and  impart  strength  at  the  same  time,  may  be  used.  The  valerianate 
of  iron  (93)  is  excellent  for  the  same  purpose. 

Connected  with  a  state  of  urine  just  the  opposite  to  that  which 


.^_^^hi 


in  alkaline 
In  much  of 


the  oppo< 
contained 
very  soon 

frequently 
his  film  in 
rainbow, 
and  you 
3kly  grows 
ammonia, 
aline. 

althy  urine 
n.     Under 
in  the  kid- 
phosphate 
ammonia 

fs  state  of 
'he  urine  is 
ravity,  and 
reak  broth, 
indy  stom- 
of  various 
an  aching 

lity  of  the 
i  assimula- 
er,  and  or- 
pecially  by 
r  cares,  de- 
ls, mastur- 


it  debility, 
nng  active 
11  increase 

the  means 

iron  P5) 

irritability, 

valerianate 

hat  which 


DISEASES  OF  THE  ABDOMmAL  CAVITY. 


811 


holds  the  uric  acid  deposits,  this  form  of  gravel  calls  for  the  opposite 
remedies.  Instead  of  the  alkalies,  the  acids  are  wanted.  The  nitric 
and  muriatic  acids,  with  a  vegetable  tonic  (76),  may  be  used.  Opium 
is  spoken  of  in  high  terms,  and  is  thought  by  some  to  have  great 
power  in  turning  alkaline  urine  acid.  The  compound  balsam  of  sul- 
phur is  highly  spoken  of,  and  the  compound  infusion  of  trailing  arbu- 
tua  is  also  mentioned  with  approbation. 

It  is  all-important  to  throw  off  care,  and  to  give  the  mind  a  chance 
to  rise  up  with  all  the  elasticity  it  has.  To  bring  this  about,  journey> 
and  amusements  are  useful.  The  society  of  lively,  laughing,  witty 
friends  will  do  a  great  deal  to  give  the  spirits  a  rebound,  and  the 
whole  health  an  upward  movement.  Such  persons  are  a  blessing  to 
the  world ;  and  he  who  reckons  a  few  of  them  among  his  friends  will 
live  the  longer  for  it 

The  skin  should  have  the  benefit  of  the  daily  tonic  effect  of  a 
sponge  bath,  with  water  at  first  t«pid,  and  afterwards  cool ;  and  exer- 
cIho,  out  of  doors,  should  be  habitual,  and  connected,  as  much  as  pos- 
sible, with  objects  of  pleasure. 

The  drinking  of  hard  water  is  highly  injurious;  and  if  none  other 
can  be  had,  it  should  be  distilled,  and  then  spread  out  to  the  atmos- 
phere, in  shallow  vessels,  that  it  may  recover  its  pleasant  taste  by 
reabsorbing  air  and  carbonic  acid. 

Oxalic  Deposits. 

Oxalate  of  lime  in  the  urine  is  the  cause  of  this  kind  of  gravel 
It  appears  in  the  form  of  dumb-bells,  and  octahedral  crystals.  (Figs. 
117,  118,  and  119.) 


Fio.  U7. 


Fia.US. 


Fio. Ill 


The  urine  has  a  specific  gravity  of  1.015  to  1.025,  and  is  generally 
of  a  dark  amber  color,  and  clear,  and  bright;  it  is  generally  acid, 
though  occasionally  alkaline  or  neutral.  Urea  is  generally  found  in 
it,  and  epithelial  cells  (Fig.  120).  Unlike  the  uric  and  phosphatic 
urines,  it  is  quite  free  from  sediments,  except,  as  often  happens,  there 
is  a  large  amount  of  urea  in  it,  in  connection  with  the  oxalate  of 
lime. 

When  the  urate  of  ammonia  is  combined  with  the  oxalate  of  lime, 
it  often  happens  that  the  latter  has  to  be  dissolved  with  a  little  liquor 
potassa,  before  the  former  can  be  seen  with  the  microscope. 


Fio 


Symptoms.  —  Great  dcpresHion  of  spiritB,  excitable  state  of  the  ner- 
vous  system,  painful  susceptibility  to  external  impressions,  dyspeptic 
symptoms,  and  disturbances  of  the  liver,  a  fear 
and  dread  of  consumption,  emaciation,  inability 
to  make  exertion,  —  the  smallest  exertion  caus- 
ing fatigue,  —  in  men  a  deficient  sexual  power, 
a  pnin  and  weight  across  the  loins,  and  some 
irritability  of  tlie  bladder. 


Ciiuses. —  These  deposits  an;  supposed  to  re- 
sult, like  most  other  derangements  connected 
with  loss  of  flesh,  in  too  great  a  degree  of  oxi- 
dation. Vegetables  produce  oxalic  acid  by  just 
the  opposite  process,  namely,  deoxidation. 

Whatever  depresses  the  vital  powers,  may  generate  this  deposit » 
as  mental  depression,  overwork  of  the  brain,  burdensome  cares,  idle- 
ness of  mind  or  body,  masturbation,  debaucheries,  intemperanci;,  vene- 
real excesses,  and  injuries  of  the  spine. 

This  deposit  may  also  be  produced  by  certain  articles  of  diet,  which 
contain  the  oxalic  acid.  Among  these  may  be  named  the  rhubarb 
plant,  which  in  summer  is  largely  used  for  tarts  ;  and  sorrel. 

Treatment. —  The  treatment  for  these  deposits  should  be  very  much 
like  that  for  the  phosphatic  The  stomac  i  and  liver  should  receive 
some  special  attention.  A  pill  of  leptandrin,  podophyllin,  etc.  (.39), 
may  be  used  with  advantage.  The  preparation  of  nitric  and  hydro- 
chloric acids  (76)  must  generally  be  taken  for  some  time.  In  cases 
of  great  irritability,  the  sulphate  of  zinc  (82)  does  well. 

The  diet  should  be  plain,  digestible,  and  nourishing,  —  all  articles 
containing  the  oxalic  acid  being  rejected,  as  the  rhubarb  plant,  sorrel, 
tomatoes,  onions,  etc. 

For  the  rest,  follow  the  directions  for  the  treatment  of  phosphatic 
deposits. 

Urate  of  Ammonia  Deposits. 

The  urine  which  contains  these  deposits  is  generally  pale,  and  of 
low  specific  gravity,  about  1.012.  It  becomes  opaque  on  coolings 
from  the  deposition  of  a  nearly  white  urate  of  ammonia.  Instead  of 
falling  down  readily,  this  forms  ropy  masses  in  the  fluid,  and  looki> 
like  mucus  or  pus,  or  something  between  the  two.  Its  real  nature  is 
discovered  by  applying  a  little  heat,  which  quickly  dissipates  it. 

Microscopic  Characters. — Place  a  drop  of  this  turbid  urine  between 
two  slips  of  glass,  and  examine  it  closely  with  a  microscope ;  you 
will  see  myriads  of  minute  globules  adhering  together  in  linear 
masses.  Now  place  a  drop  of  the  turbid  urine  in  a  watch-glass,  and 
gently  warm  it ;  as  soon  as  it  has  become  clear,  add  a  drop  of  hydro- 
chloric acid  to  it^  and  when  it  is  cold,  examine  it  with  the  microscope. 
The  muddiness  will  be  gone,  and  you  will  now  see  lozenges,  or  thick 
coh?rvig  prisms  of  uric  acid  (Fig.  121).     The  exj^anation  of  this  iiH 


>f  the  nor- 
HyBpeptic 


8  deposit  t 
cares,  idle- 
inc(!,  veiie- 

Jiet,  which 
le  rhubarb 


very  much 
lid  receive 
,  etc.  (39), 
nd  hydro- 
In  cases 

all  articles 
ant,  sorrel, 

phosphatic 


de,  and  of 
n  coolings 
Instead  of 
and  lookb 
1  nature  is 

!B  it. 

e  between 
;ope ;  you 

in  linear 
glass,  and 

of  hydro- 
icroscope. 
s,  or  thick 
uf  this  its 


DISEASES  OF  THE  ABUOMIlfAL  CAVITT. 


813 


that  the  hydrtxihloric  acid  combinea  with  the  ammonia,  forming  muri< 
ate  of  ammonia  in  solution,  and  liberating  the  uric  acid  crystals. 


Fio.m. 


Flo.  122. 


TTrate  of  soda  (Fig.  122)  is  sometimes  found  in  urine,  which  Aas 
similar  chemical  reactions  with  urate  of  ammonia. 

Jausies.  —  These  deposits  are  generally  produced  by  some  overeat- 
ing, or  derangement  of  the  skin. 
The  treatment  is  the  same  as  that  for  uric  acid  gravel. 

Hipparic  Acid  Deposits. 

These  deposits  appear  in  the  healthy  urine  of  the  cow  and  the  horse ; 
and  also  in  that  of  human  beings,  but  in  such  small  quantities  as  to 
be  scarcely  appreciable. 

They  sometimes,  however   appear  in  unhealthy  proportions;  but 
they  never  show  themselves  as  a  sediment,  until  after  the  addition  of 
a  stronger  acid.     The  urine  containing  them  is 
Fio.  128.  generally  slightly  acid  or  neutral,  —  sometimes 

alkaline,  —  having  a  low  specific  gravity,  from 
1.006  to  1.008.  The  triple  phosphates  are  often 
found  ill  it. 

To  detect  these  desposits,  fill  a  large  watch- 
glass  with  urine,  and  evaporate  it  over  a  lamp  to 
a  few  drops.  Then  add  to  it  about  half  its  bulk 
of  hydrochloric  acid,  and  set  it  aside.  The 
addition  of  the  acid  produces  a  bright  pink 
color,  and  an  odor  like  new  hay.  After  a  few 
hours,  if  the  hippuric  acid  be  present,  its  peculiar  crystals  will  be 
■een.     (Fig.  123.) 

Ciiuse.  —  In  man,  this  deposit  is  supposed  to  depend  on  the  ab- 
sence of  food  having  a  good  share  of  nitrogen.  The  urine  of  vege- 
table eat?rs  contains  it  in  largest  quantities. 

Treatment.  —  The  only  treatment  required  is  a  diet  composed  in 
good  proportion  of  animal  food,  a  proper  attention  to  the  skin  by 
bathing,  etc.,  and  when  debility  exists,  tonic  medicines,  as  iron  and 
bitters,  with  out-door  exercise  enough  to  keep  the  muscles  in  working 
order. 


814 


DISEASES  OF  TUE  ABDOMINAL  CAVITT. 


Oystine  Deposits. 

Thebe  do  not  occur  in  healthy  urine,  and  rarely  as  an  element  in 
diseuaed  action.     They  contain  twenty-six  per  cent  of  sulphur. 

Urine  which  contains  cystine  in  of  a  pale  yellow  color,  and  has  a 
low  specific  eravity.  It  frequently  has  an  oily  appearance,  and  its 
smell  is  peculiar,  resembling  that  of  sweet  brier.  Soinetinies  its  o<U» 
is  fetid,  like  putrid  cabbage.  On  being  kept  for  a  short  time,  it  has 
its  surface  covered  with  a  pellicle  which  looks  oily,  and  consiHts  of  a 
mixture  of  crystals  of  cystine,  and  the  phosphate  of  aminonia  and 
magnesia.  I 

'1  he  cystine  deposit  appears  to  be  diffused  through  the  urine,  which 
is  always  turbid  when  boiled.  It  is  a  white  or  fawn-colon-d  powdc^r, 
and  falls  to  the  bottom  as  a  wndment.  It  undergoes  no  change  by 
warming  the  urine,  and  this  distinguishes  it  from  white  urate  of  am- 
monia. It  is  not  soluble  in  diluted  hydrochloric  or  strong  acetic  acid, 
which  distinguishes  it  again  from  the  earthy  phosphates. 

To  test  this  deposit,  add  liquor  ammonia  to  a  portion  of  it,  and 
shake  them.  If  the  deposit  be  cystine,  it  will  dissolve  readily.  A.llo\v 
a  few  drops  of  the  solution  to  evaporate  on  a  slip  of  glass,  and  the 
six-sided  tables  of  cystine  will  remain,  which  may  be  examined  under 
the  microscope.     (Fig.  124.) 


Fia.m. 


Tm.'m. 


rio.U8. 


It  is  to  be  remembered  that  occasionally  the  chloride  of  sodium  or 
common  salt  crystalizes  in  octahedral  forms  (Fig.  125),  which,  in 
some  positions,  may  look  very  much  like  cystine.  The  ready  solu- 
bility of  the  chloride  in  water,  and  the  absence  of  all  color  when  they 
are  examined  by  polarized  light,  will  prevent  mistaking  these  crystals 
for  cystine.  If  urine  containing  common  salt  be  quickly  evaporated 
on  a  slip  of  glass,  and  be  then  examined,  instead  of  the  octahedrons, 
we  find  crosslets  and  daggers.     (Fig.  126.) 

Causes. —  An  excess  of  sulphur  in  the  tissues,  a  scrofulous  consti- 
tution, and  hereditary  predisposition,  with  defective  oxidation,  and 
torpidity  of  the  liver.  It  is  often  found  in  the  urine  of  girls  who  have 
the  green  sickness. 

Treatment. —  The  great  object  is  to  improve  the  general  health, 
which  is  to  be  done  by  attending  to  the  skin,  and  the  administration 


•■■■ig'iiii 


element  in 

hur. 

and  iiafl  a 
r)C€,  and  ita 
nes  itM  od(T 
time,  it  has 
inHiHtH  of  a 

inunia  and 

I 

iirine,  which 

r'd  powder, 

change  by 
irate  of  ain- 
acetic  acid, 

n  of  it,  and 
Jiiy.  A.II0W 
am,  and  the 
nined  under 


ro-iaa. 


)f  sodium  or 
>),  which,  in 
!  ready  solu* 
)r  when  they 
hese  crystals 
y  evaporated 
octahedrons, 

1I0U8  consti- 
idation,  and 
rls  who  have 


aeral  health, 
Iminidtratioii 


DIRRARE8  OK  TF!K  ABDOMINAL  CAVITY. 


816 


of  iron  and  bitters,  and  also  altcrativcfi.  The  syrup  of  i(Mlidc  of  iron 
is  a  valuable  remedy.  Podophyllin  and  leptandrin  (34)  are  wanted 
to  rogiUate  the  liver.     The  nitro-iiiuriatic  acid  (7())  Hhoiild  be  tried. 

The  daily  sponge  bath,  and  daily  exerciHC,  att  in  utuat  chronic  com- 
plaints,  must  01:  no  account  be  neglected. 

Stone.— Calculus. 

It  often  happens  that  the  proper  treatment  for  removing  urinary 
deposits  is  not  adopted  in  seasoi:.  In  such  cases,  gravelly  particles, 
fniding  a  lodgment  for  a  time,  in  the  kidneys  or  bladder,  are  apt  to 
draw  other  particles  to  themselves,  which  become  fastened  to  them, 
and  form  a  layer  quite  round  them.  Ovjt  this,  other  layers  form  in 
succession,  until  a  stone  is  produced  so  large  that  it  cannot  p::.<s  off. 
These  grow  to  various  sizes,  —  being  sometimes  so  large  as  to  fill  the 
bladder. 

Uric  Acid  Calculus. —  The  most  common  of  these  formations  is  the 
uric  acid  calculus.  It  is  generally  smooth  or  slightly  tubcrculated  on 
the  surface,  and  varies  in  color  from  a  pale  yellowish-fawn,  to  a  red- 
dish-brown. When  sawn  through  the  centre,  its  layers  will  be  found 
tolerably  regiilar,  but  of  different  thickness.     (Fig.  127.) 

To  test  it,  place  a  small  fragment  upon  platinum  foil  under  the 
blowpipe.  If  uric  acil,  it  blackens,  and  gives  out  an  odor  like  burnt 
feathers  mixed  with  the  oil  of  bitter  almonds. 


Fio.  127. 


Fia.  UB. 


Fio.  139. 


Mixed  Calculus.  —  These  calculi  are  frequently  composed  of  tw^o  or 
more  different  kinds  of  matter  arranged  in  irregular  layers.  Fig.  128 
irf  a  mixed  calculus,  —  the  dark  layers  being  oxalate  of  lime,  the  light 
ones,  uric  acid. 

In  testing  such,  fragments  of  each  ingredient  should  be  separately 
examined. 

Urate  of  Ammonia  Calculus.  —  We  occasionally  meet  with  a  cal* 
cuius  composed  of  the  urate  of  ammonia.  These  calculi,  when  found, 
are  generally  small  in  size,  smooth  or  slightly  tuberculated  upon  the 
surface  (Fig.  129),  and  of  a  pale  slate  or  clay  color.  When  heated 
before  the  blowpipe,  it  gradually  disappears. 

Phosphate  of  Lime  Calculus. —  This  has  a  smooth  polished  surface, 
and  quite  regular  layers,  which  separate  easily  when  the  calculus  ii 
cut  asunder.     It  has  a  pale  fawn  or  stone  color.     (Fig.  130.) 


m 


316 


DISEASES  OP  Tire  AIIDOMINAL  CAVITT. 


It  chars  before  the  blowpifx*,  nnd  gradnnlly  becomes  whlti  as  the 
carbon  burns  away.  Dilut(*d  nitric  or  hydrochloric  acid  dissolves  A 
without  effervescence. 

Oxulute  of  Lime  CtUrulwi.  —  This  is  frequently  met  with  uncom- 
binrd  wifh  othtirH,  but  more  gciu'rally  its  nucleus  is  iiri(!  iicid  t)r  urate 
of  lime.  It  cununonly  lm»  u  brown,  dark  olive,  or  dirty-purple  color. 
Its  surface  is  irnrguhir  and  somewhat  rough.  li:  looks  like  the  fruit 
of  the  nmlberry,  and  is  known  as  the  mulberry  calnnliis,     (Fig.  I>31.) 

It  dissolves,  without  cHcrvescence,  in  diluted  nit  ic  or  hydrochloric 
acid.  When  thus  dissolved,  the  addition  of  a  little  uunnonia  v«ii 
cause  it  to  fall  to  the  bottom  us  a  white  precipitate.  ^ 


rio.  UQ. 


Fio.  lat 


Fio.  183. 


Fusible  CalcnluH.  —  This  is  a  mixture  of  phosphate  of  lirne,  and  the 
phosphate  of  ammonia  and  magnesia.  It  is  the  most  common  of 
all  the  calculi,  except  the  uric  acid.  It  has  an  oval,  irregular  form 
(Fig.  132),  and  is  white,  soft,  and  friable,  like  chalk.  Sometimes  it  is 
hard. 

It  may  be  known  by  the  readiness  with  which  it  melts  down  before 
the  blowpipe,  without  being  consumed.  -  .        • 

Causes.  —  The  causes  of  the  different  kinds  of  gravel  have  been 
already  explained.  Generally  stones  of  the  bladder  are  formed  in  the 
kidney,  ind  descending  through  the  ureters  into  the  bladder,  are  pro 
vented  from  passing  out  through  the  water-pipe  by  an  enlarged  pros- 
trate gland.  Remaining  in  the  bladder,  they  soon  get  encrusted  over 
by  other  matters  in  the  urine,  and  grow  by  accretion  to  be  stones. 

Symptoms. — When  a  stone  in  the  bladder  reaches  a  certain  size, 
especially  if  it  is  rough,  it  always  produces  suffering.  A  dull,  annoy- 
ing pain  is  felt  at  the  end  of  the  penis.  The  desire  to  make  water  is 
frequent,  and  there  is  a  sense  of  weight  in  the  perineum.  Sometimes 
the  stream  of  urine  is  suddenly  stopped  by  the  stone  falling  on  the 
orifice  of  the  urethra.  As  the  bladder  becomes  nearly  emptied,  it 
embraces  the  stone,  and  the  pain  is  increased.  Jolting  in  a  carriage 
causes  great  pain.  Mucus  passes  off  with  the  urine,  and  sometimes 
blood.  After  a  time,  the  appetite  fails,  hectic  sets  in,  albumen  ap- 
pears in  the  urine,  and  the  patient  sinks  under  inflammation  of  the 
bladder. 

These  symptoms  being  found  in  diseases  of  the  kidneys  and  blad- 
der, no  one  is  authorized  to  pronounce  upon  the  existence  of  stone, 
until  the  stone  has  been  touched  by  a  metalic  sound  introduced  into 
the  bladder. 


:';.'X«-2y.-' 


1 


hit)  as  the 
dissolves  .t 


rh  unrom- 
•iti  i)r  uriUf 
iirpic  color. 
tli«!  In  I  it 

Fig.  \'.n.) 

y<li()cliioiic 
iiioiiia  \vtil 


Tio.  laa. 


nc,  and  the 
tommon  of 
■gnlar  form 
etimes  it  is 

own  before 


have  been 
rmed  in  the 
er,  are  pro 
arged  pros- 
rusted  over 
stones. 

ertain  size, 
lull,  annoy- 
ke  water  is 
Sometimes 
ing  on  the 
emptied,  it 
a  carriage 
sometimes 
)umen  ap- 
bion  of  the 

and  blad- 
e  of  stone, 
luced  into 


DISEA8KS  OF  TIIK  ABDOMINAL  CAVITV. 


317 


Treatiuent.  —  The  only  etTectual  treatment  is  a  choice  betwee.i  two 
operations,  —  lUhotrily  and  Uthotiymy. 

The  former  consititH  in  introducing  an  inHtrnmrnt,  a  kind  of  forceps. 
Into  the  bladder,  through  the  urethra,  taking  hold  of  tlie  stone,  and 
('ru»>hing  it.  The  preparatory  tr«'atnicnt  consists  in  correcting  the  un- 
healthy state  of  the  urine,  and  the  fnupicnt  introduction  of  bougies  or 
xounds  to  enlarge  the  watcr-pi|)e  for  the  easy  entrance  of  the;  crush- 
ing forceps.  The  after  treatment  consists  in  diluent  drinks  to  increase 
flic  urine,  injections  of  warm  water  to  wash  out  the  fragments,  with 
hip  baths,  soothing  injections,  and  leeches  or  cupping  upon  the  peri- 
ricum. 

liithotoiny  consists  in  making  an  incision  into  the  bladder  through 
the  perineum,  and  taking  out  the  stone  or  stones  whole. 

Dropsy  of  the  Belly. — Ascites. 

This  is  a  collection  of  water  in  the  cavity  of  the  belly ;  sometimes 
the  fluid  is  outside  of  the  peritoneum,  and  next  to  the  muscles. 

Symptoms.  —  An  enlargement  of  the  belly,  with  a  sense  of  disten- 
sion and  weight,  —  particularly  on  the  side  on  which  the  patient  lies. 
When  the  collection  of  water  is  large,  the  breathing  becomes  short 
and  difRcult,  and  the  swelling  is  uniform  over  the  whole  abdomen. 

In  some  instances  the  fluctuation  of  the  water  may  be  distinctly 
heard  when  the  patient  moves  about,  —  just  as  we  may  hea'  the 
water  in  a  half-Riled  barrel  when  it  is  rolled  over.  This  sound  o'l  the 
fluid,  when  heard,  distinguishes  the  complaint  from  pregnancy,  and 
from  the  drum-head  state  of  the  bowelo.  This  fluctuation  may  some- 
times be  produced  by  pressing  upon  one  side  of  the  belly  while  the 
patient  is  standing  or  sitting,  and  striking  the  other  side  with  the  ends 
of  the  fingers  of  the  other  hand. 

In  some  cases,  there  is  loss  of  appetite,  dry  skin,  costiveness,  scanty 
urine,  oppression  of  the  chest,  cough,  colic  pains,  and  variable  pulse. 

Causes.  —  A  frequent  cause  of  this  complaint  is  chronic  inflamma- 
tion of  the  serous  membrane  which  lines  the  abdomen,  —  I  mean  the 
peritoneum.  It  may  also  be  produced  by  scarlet  fever,  fever  and 
ague,  disease  of  the  heart,  particularly  dilatation  of  the  right  cavities,- 
and  diseases  of  the  liver,  particularly  the  shrivelled,  hobnail  condition 
of  the  liver,  —  in  short,  whatever  causes  a  pressure  upon  the  portal 
veins,  and  obstructs  the  venous  blood  returning  from  the  intestines. 

Treatment. —  The  remedies  for  this  disease  are  mainly  diuretics 
and  purgatives.  The  bowels  may  sometimes  be  reduced  in  a  few 
days  from  an  enormous  size,  by  medicines  which  excite  the  action  of 
the  kidneys.  Digitalis,  combined  with  acetate  of  potash,  etc.  (130), 
forms  an  excellent  preparation.  The  patient  should  have  as  a  con- 
stant drink,  a  strong  infusion  made  from  two  parts  of  hair-cap  moss, 
and  one  each  of  juniper  berries  and  dwarf  elder  bark ;  also  an  infu- 
sion of  queen  of  the  meadow. 

The  purgatives  used  iu  ibis  complaint  are  those  which  produce 


iM 


-j__^i>v^_^-.„ir 


318 


DISEASES  OP  THE  ABDOMINAL  CAVITY. 


watery  stools.  One  of  the  best  of  these  is  elaterium.  It  will  some- 
times carry  off  the  water  with  great  rapidity ;  combined  with  some 
active  cathartics  (31),  it  will  have  all  its  good  effects  without  the 
griping  it  is  apt  to  occasion  alone. 

Cream  of  tartar,  taken  in  large  doses,  every  day,  will  sometimes  do 
well.     Epsom  salta  produces  wat«ry  stools,  and  is  a  good  remedy. 

For  promoting  absorption  of  the  fluid,  the  iodide  of  potassium, 
taken  in  from  three  to  ten-grain  doses,  three  times  a  day,  is  a  valua- 
ble medicine  in  many  cases.  The  compound  infusion  of  parsley  is 
said  to  be  still  better. 

The  skin  must  receive  careful  attention.  The  alkaline  sponge  bath, 
with  friction,  will  increase  the  transpiration  of  fluid  through  that 
organ.  Exercise  does  much  to  keep  up  an  active  circulation,  and  to 
lessen  dropsical  effusions. 

The  strictest  temperance,  both  in  eating  and  drinking,  must  be 
observed.  A  light  and  nourishing  diet,  with  water,  tea,  and  the 
diuretics  named  above  for  drinks ;  beyond  these  the  patient  must 
not  go. 

A  kneading  and  shampooing  of  the  bowels  once  a  day  has  an  ex- 
cellent effect ;  it  gives  activity  to  the  circulation  in  obstructed  veins. 
A  bandage  tied  close  around  the  bowels,  and  tightened  as  the  water 
diminishes,  has  an  effect  upon  the  sluggish  vessels  similar  to  that  of 
the  laced  stocking  in  varicose  veins  of  the  legs.  It  lessens  the  liabil- 
ity of  a  return  of  the  complaint. 

Dropsy  *•     the  Cells.— General  Dropsy. — Anasarca. 

Just  under  the  skin  is  a  membrane  composed  chiefly  of  cells,  called 
the  cellular  membrane.  When  a  considerable  part,  or  the  whole  of 
these  cells  are  filled  w^ith  a  watery  fluid,  we  call  the  complaint  o«fl- 
sarca,  or  cell  dropsy.  If,  beside  this,  there  is  a  collection  of  water  in 
the  large  cavities,  we  give  it  the  name  of  general  dropsy. 

Symptoms.  —  The  disease  generally  begins  with  a  swelling  around 
the  ankle  and  leg,  which  is  more  visible  at  night  after  standing  and 
walking,  and  is  less  perceptible  in  the  morning  in  consequence  of  the 
horizontal  position  of  the  night  To  the  touch  of  another  personj 
dropsical  feet  and  legs  feel  a  little  colder  than  natural;  and  when  hard 
pressed  with  +he  finger,  a  pit  will  be  sunk  in  the  flesh,  which  remains 
some  time  before  it  fills  up.  As  the  diseaL-;e  advances,  the  skin  of  the 
legs  becomes  smooth,  shining,  and  sometimes  even  cracks  open  to  let 
out  the  water.  The  limbs,  and  indeed  the  whole  person  become  stiflj 
heavy,  and  clumsy. 

As  the  disease  advances,  and  ascends  to  the  belly  and  chest,  there 
is  shortness  of  breath,  a  sense  of  suffocation  on  moving  or  lying 
down,  a  tightness  and  distress  across  the  epigastrium,  thirst,  dryness 
of  skin,  wakefulness,  loss  of  appetite,  scanty  and  deep-colored  urine, 
and  a  slow  fever. 

Causes.  —  General  dropsy  is  caused  by  whatever  weakens  the  gen- 
eral system,  and  by  such  circumstances  as  obstruct  the  circulation  in 


■\ 


will  some- 
with  some 
ithout  the 

letimes  do 

emedy. 

potassium, 
rt  a  valua- 
parsley  is 

oiige  bath, 
■ough  that 
on,  and  to 

f,  must  be 
1,  and  the 
tient  must 

las  an  ex- 
icted  veins, 
the  water 
'  to  that  of 
i  the  liabil- 


nasarca. 

jells,  called 
e  whole  of 
plaint  ana- 
>f  water  in 

ng  around 
inding  and 
;nce  of  the 
ler  person; 
when  hard 
;h  remains 
skin  of  the 
open  to  let 
jcome  stifli 

ihest,  there 
»  or  lying 
st,  dryness 
>red  urine, 

13  the  gen- 
:ulation  in 


DISEASES  OF  THE  ABDOMINAL  CAVITT. 


3t9 


the  veins.     The  most  frequent  causes,  therefore,  are  certain  diseases 
of  the  heart  and  kidneys.  -      '      .  ^ 

ExplanutJon. —  Modern  physiology  has  demonstrated  that  the  veins 
do  a  certain  part  of  the  work  of  absorption.  The  serous  membranes 
which  line  the  larger  cavities  of  the  body  exhale  watery  fluid  enough, 
and  no  more  than  enough,  to  keep  them  moist,  and  cause  tiie  organs 
within  to  play  smoothly  upon  their  surface.  If  the  fluid  were  not 
taken  away  as  fast  as  it  is  poured  out,  the  cavity,  —  being  a  shut  sac, 
. —  would  become  full,  and  we  should  have  dropsy.  It  is  the  office  of 
the  veins  to  absorb  this  fluid  and  convey  it  away  in  the  general  cur- 
rent of  the  blood. 

This  is  the  method  of  their  doing  it :  The  walls  of  the  veins  are 
80  constructed  as  to  permit  watery  fluids  to  pass  through  them,  either 
in  or  out.  When  they  are  comparatively  empty,  or  only  moderately 
full,  fluids  on  the  outside  pass  m,  and  mingle  with  the  contents. 
This  is  called  endosmosis.  When  they  are  very  full,  the  watery 
portion  of  the  blood  will  filter  through,  and  pass  oxU.  -  This  is  called 
exosmosis. 

Now,  if  the  reader  will  think  a  little,  he  will  easily  see  that  if  the 
veins  are  barely  full  enough  not  to  allow  any  fluid  to  pass  in,  the 
natural  exhalations  t)f  the  shut  sacs  would  bring  on  Jropsy ;  but  if 
the  veins  are  so  full  as  to  cause  water  to  flow  out,  then  the  dropsical 
accumulation  will  be  still  more  rapid. 

Such  being  the  office  and  nature  of  the  veins,  the  reader  may 
learn  how  disease  of  the  right  side  of  the  heart  will  cause  dropsy. 
When  the  right  ventricle  is  so  dilated  and  weakened  that  it  cannot 
send  the  blood  forward  to  the  lungs,  of  course  the  veins  which  bring 
it  to  the  right  side  of  the  heart,  will  become  fuU,  and  greaily  distended. 
Exosmosis  will  then  occur ;  the  watery  portion  of  the  blood  will 
begin  to  run  out,  either  into  the  large  cavities,  or  into  the  cells,  and 
dropsy,  either  general  or  local,  will  be  the  resulf. 


Treatment — This  must  be  governed  verj'  much  by  the  cause  of  the 
disease. 

In  dropsy  from  disease  of  the  heart,  »re  may  use  diuretics  and 
Buch  other  measures  as  are  recommended  for  dropsy  of  the  belly. 
If  the  urine  is  strongly  acid,  depositing  the  brick-dust  sediment, 
the  alkaline  diuretics  will  be  the  best,  as  the  acetate  and  bicarbon- 
ate of  potash  combined,  and  dissolved  in  water.  The  bitartrate  of 
potassa,  to  act  upon  the  bowels,  is  a  proper  remedy.  If  the  disease 
arise  from  general  debility,  the  following  powder  will  be  useful: 
digitalin,  three  grains ;  cinchonia,  half  a  dram ;  phosphate  of  iron, 
half  a  dram ;  and  white  sugar,  one  dram.  Mix,  and  triturate ;  divide 
into  sixteen  powders,  and  give  one,  in  pumpkin-seed  tea,  four  times 
a  day. 


N 


i 


^       4    ... 


'(     ■■• 


VENEREAL  OR  SEXU/L  DISEASES. 


Or  all  the  diseases  to  which  flesh  is  heir,  none  bring  so  much 
miserv,  moral  and  physical,  as  those  called  sexual  or  venereal.  To 
the  physician,  they  are  the  source  of  the  greatest  anxiety  and  per< 
plexity.  They  bring  him  into  possession  of  the  most  delicate  secrets, 
—  secrets  which  invjlve  the  peace  of  families  and  neighborhoods,  — 
secrets  which  his  honor  as  a  man,  and  his  truth  as  a  physician,  compel 
him  to  lock  fast  in  his  own  breast,  and  hold  sacredly  apart  even  from 
hia  nearest  companions, — secrets  which,  if  revealed,  would  fill  domes- 
tic circles  with  unutterable  bitterness  and  heartburnings,  and  whole 
neighborhoods  with  scandal  and  immorality.  These  secrets  are  often 
a  burden  to  him.  They  are  in  his  breast  like  undigested  food  in  the 
stomach, — disturbing  the  whole  nature. 

The  patient,  if  a  man  of  sensibility,  suffers  even  more,  of  course, 
than  his  physician.  In  many  cases,  he  is  a  man  of  virtuous  inten- 
tions, and  perhaps  of  religious  habits,  who  has  fallen  in  a  moment  of 
temptation ;  and  he  fears  that  the  effect  of  his  sin  will  spread  itself 
through  his  whole  system,  and  extend  to  the  end  of  life ;  or,  still 
worse,  that  having  poisoned  the  fountain  of  his  life,  it  will  go  down 
as  a  heritage  of  misery  to  his  offspring ;  or,  what  he  would  deprecate 
as  almost  equally  calamitous,  that  the  partner  of  his  bosom  may  be- 
come the  innocent  partaker  of  his  disease. 

In  this  state  of  apprehension,  he  turns  to  his  physician,  not  merely 
to  keep  his  secret,  but  to  cure  his  disease.  How  great  a  pity,  that  in 
such  circumstances,  he  does  not  always  fly  immediately  to  an  honor- 
able physician,  instead  of  seeking  the  advice,  as  many  do,  of  those 
miserable  quacks,  who  lure  him  to  their  dens  only  to  get  his  money, 
having  no  intention  or  ability  to  cure  his  complaint. 

These  diseases  are  divided  into  two  great  branches,  characterized, 
in  part,  by  different  symptoms,  and  generally  held  to  be  entirely  dif- 
ferent complaints.    The  first  to  come  under  consideration  is 

Pox. — 8i/philis. 

This  disease  had  a  veiy  early  origin.  It  was  known  among  the 
Jews,  as  we  learn  very  clearly  from  the  15th  chapter  of  Leviticus. 
Dr.  Adam  Clarke's  Commentary  upon  this  chapter,  at  least,  makes  it 
apparent    David,  the  king  of  Israel,  has  unconsciously  left  An  record, 


K- 


1 


VENEREAL  OR  SEXUAL  DISEASES. 


321 


*  so  much 
ereal.  To 
and  per- 
ate  secrets, 
srhoods,  — 
an,  compel 
even  from 
fill  domes- 
and  whole 
8  are  often 
bod  in  the 

,  of  course, 
lous  inten- 
moment  of 
tread  itself 
'e ;  or,  still 
ill  go  down 
1  deprecate 
m  may  be* 

not  merely 
ity,  that  in 
an  honor- 
lo,  of  those 
his  money, 

iracterized, 
entirely  dif- 

is 


among  the 

Leviticus. 

t,  makes  it 

;  ui  record, 


in  th(!  XXXVIII  Psalm,  a  most  graphic  description  of  Tertiary 
Syphilis,  experienced  in  his  own  person.  Dr.  Clarke  says :  "  It  is 
most  likely  the  Psalm  was  written  in  reference  to  some  severe  afflic- 
tion that  David  had,  after  his  illicit  commerce  with  Bathsheba ;  but 
of  what  nature,  we  are  left  to  conjecture  from  the  third,  fifth,  and 
scventli  verses."  The  Psalm  is  dated  not  quite  a  year  after  the  act 
alluded  to,  —  about  the  right  time  for  the  terrible  symptoms  David 
describes  to  make  their  appearance. 

The  term  syphilis  is  from  a  Greek  word  signifying  filthy.  There 
is  one  unvarying  sign  of  this  disease,  —  the  existence  of  an  ulcer  or 
ulcers,  usually  upon  the  genital  organs.  The  French  call  this  ulcer  a 
chancre.  The  common  name  is  simply  venereal  sore,  or  ulcer.  A 
pimple  first  appears ;  on  the  summit  oi  this  a  pustule  forms ;  then  the 
ruptui-e  of  the  top  of  this,  brings  to  view  the  ulcer  or  sore.  This  ulcer 
is  shallow,  more  or  less  circular  or  oval  in  form,  bounded  by  a  perpen- 
dicuhir  and  slightly  jagged  border,  and  furnished  with  a  smooth,  yel- 
low base,  moistened  by  an  unhealthy  secretion.  The  skin  around  the 
sore  is  a  little  thickened  and  inflamed.  This  is  a  simple  venereal 
ulcer.     It  generally  lasts  about  five  weeks,  and  then  heals. 

But  it  is  not  always  thus  simple.  It  may  be  an  inflammatory 
chanore,  attended  by  excessive  inflammation.  It  may  be  what  is 
called  a  sloughing'  chancre,  characterized  by  the  perishing  and  falling 
off  of  large  parts  of  flesh.  It  may  be  gangrenous,  or  marked  by  a  ten- 
dency to  mortification.  It  may  be  phagedenic,  or  eating,  —  being  dis- 
tinguished by  a  rapid  loss  of  substance,  or  eating  away  of  flesh.  Or, 
finally,  it  may  be  indurated,  —  being  noted  for  the  peculiar  hardness 
of  tlie  base,  and  of  the  flesh  immediately  around  it. 

A  venereal  sore  is  the  result  of  impure  connection  with  a  person 
having  the  syphilitic  disease.  The  poisonous  secretion  of  a  sore, 
applied  to  the  skin  of  a  healthy  person,  produces  inoculation,  and  a 
new  sore  upon  the  previously  healthy  person  is  the  result.  This 
chancre  appears  in  a  few  days  after  coition,  —  a  certain  time  being 
required  for  it  to  produce  its  eflect,  as  in  the  application  of  vaccine 
matter  to  the  arm. 


BubOt  —  The  next  symptom  in  the  order  of  occurrence,  which  fre- 
quently follows  the  ulcer,  is  the  bubo.  It  is  named  from  a  Greek 
word  which  means  groin,  —  from  its  usually  appearing  in  that  part 
It  is  a  painful  swelling  of  the  inguinal  gland  in  the  groin,  and  is 
caused  by  the  absorption  of  virus  or  poisonous  matter  from  the 
chancre.  This  gland  is  one  of  the  lymphatics,  a  class  of  vessels  a^ 
numerous,  all  over  the  system,  as  the  veins  and  arteries.  They  are 
likewise  called  absorbents.  Those  that  originate  from  the  private 
par;s,  absorb  th(>  poison  from  a  venereal  sore,  and  convey  it  to  the 
glands  in  the  groin,  which,  being  poisoned  by  it,  inflame  and  swell. 

The  bubo  generally  appears  in  from  one  to  two  weeks  from  the 
appearance  of  the  ulcer.  It  is  usually  upon  the  same  side  which  the 
chancre  occupies  upon  the  penis.  When  the  bubo  advances  to  sup- 
puration, and  becomes  an  open  sore,  it  is  then  a  glandular  chancre. 

Vegetations.  —  These  are  peculiar  growths  appearing  upon  differ- 

41 


•  ^'f ! 


■-\ 


ent  parts  of  the  skin,  which  resemble  certain  vegetables.  They  are 
found  most  frequently,  ia  the  male,  on  the  head  of  the  penis,  and  on 
the  membrane  lining  the  foreskin.  In  the  female,  they  are  found  at 
the  entrance  to  the  vagina,  and  not  unfrequently,  in  the  vagina  itself. 
They  sometimes  appear  on  the  neck  of  the  uterus. 

Primary  Disease.  —  Thus  far,  the  diseases  noticed  are  what  are 
called  primary.  If  properly  treated,  and  cured  in  season,  the  consti- 
tution is  not  infected,  and  no  subsequent  troubles  appear.  But  a 
result  so  fortunate  as  this,  is  not  common.  Generally,  the  treatment 
is  either  too  long  delayed,  or  is  too  brief  and  superficial.  The  poison 
is,  in  consequence,  absorbed  into  the  circulation  ;  the  whole  constitu- 
tion becomes  infected ;  the  fluids  and  solids  are  so  acted  on  and 
altered,  in  fact,  that  a  special  constitution  is  created.  For  this  reason, 
the  affections  of  the  skin,  the  mucous  membranes,  the  bones,  etc.^ 
which  follow,  are  called 

Constitntional.  —  These  constitutional  diseases  never  appear  imme- 
diately, as  the  result  of  an  impure  connection,  but  only  after  those 
affections  already  noticed.  The  primary  diseases  are  local ;  the  con- 
stitutional affections  are  general. 

The  first  thing  which  strikes  the  eye  in  these  constitutional  com- 
plaints, is  the  color  and  appearance  they  give  the  skin.  It  has  a  red- 
dish, coppery  tinge,  and  a  peculirly  dirty  appearance. 

The  order  in  v/hich  the  several  parts  are  affected,  are,  first,  the  skin 
and  mucous  membranes ;  second,  the  hard  substance  surrounding  the 
bones,  called  periosteum,  the  tendons,  and  the  bones  themselves. 
Those  affections  which  appear  upon  the  skin  and  mucous  membrane 
are  usually  called  secondary,  because  they  are  the  second  to  appear ; 
while  those  affecting  the  bones,  etc.,  are  denominated  tertiary,  be- 
cause, in  the  order  of  their  appearance,  they  are  in  the  third  class. 

Eruptions  of  the  Skin,  and  Ulcers.  —  Of  the  constitutional  erup- 
tions, there  is  a  great  variety, — so  great  that  I  cannot,  in  small  space, 
give  a  minute  description  of  them.  The  breast  and  arms  are  not 
unfrequently  the  first  to  be  affected.  Attending  these  eruptions,  there 
is  little  uneasiness,  and  no  pain  ;  though  there  is  sometimes  a  slight 
itching.  The  first  breaking  out  is  usually  of  a  copper  color,  some- 
what paler  than  it  subsequently  is.  The  eruption  is  often  in  the 
form  of  blotches,  —  elevated  only  a  very  little  above  the  skin.  They 
are  composed  of  small  pustules,  with  a  little  fluid  In  them,  which 
soon  dries  away,  and  the  whole  may  be  rubbed  off  like  bran.  This 
may  leave  the  skin  looking  tolerably  sound,  and  inspire  the  belief 
that  no  further  mischief  is  to  be  experienced.  No  hope  can  be  more 
delusive.  Parts  afflicted  with  this  complairU,  show  no  tendency  to  heal 
The  first  crop  of  pimples  is  soon  followed  by  a  second,  v.aich  pro- 
duces a  thicker  crust,  and  yields  a  larger  amount  of  bran.  This 
rubbed  off,  small  ulcers  appear  underneath. 

Tesicnlar  Emptions.  —  There  is  another  nyphilitic  affection  of  the 
skin,  which  appears  in  the  shape  of  vesicles,  like  small-pox.  These 
dry  and  leave  a  scab. 


i^aiBrf. 


They  are 
lis,  and  on 
1  found  at 
gina  itself. 

what  are 
the  consti- 
ir.     But  a 

treatment 
Phe  poison 
e  constitu- 
;d  on  and 
tiis  reason, 
jones,  etc, 

)ear  imme- 
after  those 
1 ;  the  con- 

ional  com- 
;  has  a  red- 

•st,  the  skin 
unding  the 
themselves, 
membrane 
to  appear ; 
ertiary,  he- 
'd class. 

ional  erup- 
jmall  space, 
ms  are  not 
)tions,  there 
Ties  a  slight 
':olar,  some- 
ften  in  the 
skin.  Thev 
;hem,  which 
bran.  This 
i  the  belief 
3an  be  more 
ency  to  heaL 
I  v;aich  pro- 
bran.     Tliia 


\^\ 


iction  of  the 
pox.     These 


TF 


■1 


PI 


PL 


I    I 


I 

K 


VKStLUnXL  UK  SEXU\L  DISEASES. 


32:i 


Scaly  EniptlfMtJi.  —  There  is  still  another  affection,  which  is  ir;  the 

form  of'  s*calcH,  runl  nuc  wciiJe  will  hv  j.ilcd  upon  another.  It  bo-jiiin 
With  an  erupMoi)  of  copper-colored  hiott  hi-**,  which  hccornc  covt  rc'l 
wuh  »cale»;  llicse  ure  rttuccoilcd  h>  M<al)H,  aiii  when  these  fali'oH, 
i«i'iilk»w*  ulcere  arc  left  with  copper  colorvd  edge*.  (Fi^f.  13J3.)  This 
w  a  ftubborii  form. 


T«b<^fenltiir  Kniptions,  —  li,  another  variety  of  the  dii«!a8e,  broad, 
Ksl,  c«>j*f»»'r-<'<»lored  ttiberch^:',  or  iiard  «levatioiis  ap|)ear,  moat  com- 
nJOiily  ..FmuH  the  »\dcs  of  the  nose,  or  on  the  checks.  (Jraciurdly,  they 
vtippur*'*',  und  are  succeeded  by  deep  ulcer.'*,  terminating  in  scars. 
This  ift  an  unfavorable  form  of  the  disea.se,  and  uuuully  app«'ar»  some 
."oosjd'^rsblf  tiini*  after  the  primary  symptoms,  in  persont«  whose  coii- 
b'i'.iait  II  ha;'  been  !<hattercd.     Pi.atk  V. 

Tn»«»  riitfwir  belongs  to  the  t<'rtiaiy  form  of  the  di.s«;aj»e;  orid  in  addi- 
tiofi  Jo  the  ubove,  patches  of  ni^ealthy  inflammation  are  npt  to  foriTj 
«f»  th<»  tongue,  and  after  a  time,  bn^ak,  disclosing  raggt'd,  oninge- 
eoio'fyJ  nlcrrsf.     Platk  Vl.     Fig.  5*. 

Maoy  other  forms  of  eruption  exis^t :  but  in  a  popular  work  likf? 
this*,  t  would  be  useless  to  make  the,  nice  distinctions  wiiich  their 
d'Hsi  rt,  titiii  would  require. 

t^K <;>((•.  of  the  worst  forms  of  the  sc(  on<lurv   aflection,'.,  are   fumjd 

apcit  -^ht  tnucous  uieuibrane  of  the  mouth  anci  throat.     These  corres- 

poni'    W    MumfxT  and  kind,  with   the  affectJon.s  of  the  skin.     They 

affec    '?•;  iips,  the  internal  sides  of  tlie  cheeks,  the  tongue,  the  tonsils, 

the  ponrvjni,  the  soft  palnte,  the  nasal  cavities,  etc.     They  are  terribly 

'      Ml  tlu'ir  enectg,  —  forming  gaping  ulcers,  and  eating  deeply 

,  u^^.     They  often  make  stocking  vvork  in  the  whole  mouth 

».-id   iisnmti   and,  when    attended   v.dlh   considerable   intlammarion, 

r.K.        ;•'  i.,..iit  impossibh"  to  swallow  anything,  or  even  to  open  the 

Mi'ji      .    >,ive  often  seen  breaches  through  the  palatine  ar(;h  (Plath 

VI,  Fig.  Vf.  hik!  even  the  whole  arch  destroyed  (Plate  VI,  Fig.  2} 

r't-rsons  ♦■> «    ■  often  died  from  starvation,  —  not  being  able  t(»  s%\'all('W 

.he  uloi.;>  >*,Muerimes  take  hold  of  ;he  tonsils,  and  "dig  them  nut  aa 

■  n  wen^  tlone  with  a  punch." 

'*'i:*iMi  '.sNv'TOtions  airect   the  mucous   membranes  of  the  geiiitii! 

>'><{!■      lu  the  fenmle,  they  ofttm  aflect  the  vagina,  and  the  neck  of 

>.  v  /Pi.ATii  VII,  Fig.  2);  and  thu.-^  may  exist  for  a  long  iinte, 

■     ojM' of  whites,  without  being  suspected  as  sncli.     They  atfect 

i    li  i«*v<ns  liairig  of  the  fundament  and  the  large  bowel.     They 

i.s  v\i.*t  in  the  ear,  and  more  often  in  the  eye.     This  latter 

.  .:    p4*!»«-8  under  tho  name  of  syphilitic  iritis.     In  Pi.atk   V, 


/■■i 


i^iF^-vi^arraiii 


I^3!»<ftfe^^-. 


■^S^SI*: 


I. 


m^ 


$ 


^m 


>-<HMt, '  -■" 


*  t 


^0 


ims^-- 


m: 


VENEREAL  OU  SEXUAL  DISEASES. 


.>    32y 


Scaly  Eruptions.  —  There  is  etill  another  affection,  which  is  in  the 
form  of  scales,  and  one  scale  will  be  niied  upon  another.  It  begins 
with  an  eruption  of  copper-colored  blotches,  which  become  covered 
with  scales ;  these  are  succeeded  by  scabs,  and  when  these  fall  oflT, 
shallow  ulcers  are  left  with  copper-colored  edges.  (Fig.  133.)  This 
ia  a  stubborn  form. 

V  f  i«'  188.  w. 


liibercnlar  Eniptions.  —  In  another  variety  of  the  disease,  broad, 
red,  copper-colored  tubercles,  or  hard  elevations  appear,  most  com- 
monly about  the  sides  of  the  nose,  or  on  the  cheeks.  Gradually,  they 
suppurate,  and  are  succeeded  by  deep  ulcers,  terminating  in  scars. 
This  is  an  unfavorable  form  of  the  disease,  nd  usually  appears  some 
considerable  time  after  the  primary  symptoms,  in  persons  whose  con- 
stitution has  been  shattered.     Plate  V. 

This  rather  belongs  to  the  tertiary  form  of  the  disease;  and  in  addi- 
tion to  the  above,  patches  of  unhifcalthy  inflammation  are  apt  to  form 
on  the  tongue,  and  after  a  time,  break,  disclosing  ragged,  orange- 
colored  ulcers.     Plate  VI.     Fig.  2. 

Many  other  forms  of  eruption  exist ;  but  in  a  popular  work  like 
this,  it  would  be  useless  to  make  the  nice  distinctions  which  their 
description  would  require. 

Some  of  the  worst  forms  of  the  secondary  affections,  are  found 
upon  the  mucous  membrane  of  the  mouth  and  throat.  These  corres- 
ponrJ  in  number  and  kind,  with  the  affections  of  the  skin.  They 
att'ect  the  lips,  the  internal  sides  of  the  cheeks,  the  tongue,  the  tonsils, 
the  pharynx,  the  soft  palate,  the  nasal  cavities,  etc.  They  are  terribly 
destructive  in  their  effects, — forming  gaping  ulcers,  and  eating  deeply 
into  the  parts.  They  often  make  shocking  work  in  the  whole  mouth 
and  throat;  and,  when  attended  with  considerable  inflammation, 
make  it  almost  impossible  to  swallow  anything,  or  even  to  open  the 
mouth.  I  have  often  seen  breaches  through  the  palatine  arch  (Plate 
VI,  Fig.  1),  and  even  the  whole  arch  destroyed  (Plate  VI,  Fig.  2) 
Persons  have  often  died  from  starvation, — not  being  able  to  swallow. 
The  ulcers  sometimes  take  hold  of  the  tonsils,  and  "dig  them  out  as 
if  it  were  done  with  a  punch." 

These  ulcerations  affect  the  mucous  membranes  of  the  genital 
organs.  In  the  female,  they  often  affect  the  vagina,  and  the  neck  of 
the  womb  (Plate  VII,  Fig.  2) ;  and  thus  may  exist  for  a  long  time, 
as  the  cause  of  whites,  without  being  suspected  as  such.  They  aflect 
also  the  mucous  lining  of  the  fundament  and  the  large  bowel.  They 
sometimes  exist  in  the  ear,  and  more  often  in  the  eye.  This  latter 
affection  passes  under  the  name  of  syphilitic  iritis.     In  Plate  V, 


/'-i 


.:  1  4 


::i3S^ 


!?: 


the  artist  han  well  represented  this  form  of  constitutional  disease  in 
the  eye. 

The  disorder,  having,  by  frigiitful  ulcers,  run  riot  upon  the  delicate 
structures  of  the  skin  and  mucous  meiiibnines,  advances  boldly  on- 
ward, attacking  the  muscles,  the  tendons,  the  hard  covering  of  the 
bones,  and  the  solid  bones  themselves.  No  part  of  the  human  frame, 
—  not  even  the  skeleton,  —  can  escape  this  devouring  complaint 
The  bones  of  the  nose  and  face  are  generally  the  first  to  be  attacked. 
These  perish  ■'lowly,  —  falling  away,  piece  by  piece,  —  the  nose,  in 
the  mean  tim»;,  sinking  down  nearer  to  a  level  with  the  cheeks. 
From  these  parts,  the  disease  may  spread  to  the  bones  of  the  whole 
8y.Htem. 

These  affections  of  t'ne  bones,  are  attended  by  pains  of  almost 
every  kind  and  degree.  These  pains  are  soinetmies  fixed  in  one 
place  ;  at  other  times,  wandering, — the  whole  skeleton  being  painful. 
In  these  la'..ter  cases,  they  seem  to  the  sufferer  to  reach  the  very  mar- 
row. Sometimes  when  the  pain  is  fixed  in  one  place,  the  feeling  is 
such  as  might  be  supposed  to  be  experienced  if  the  bone  were  being 
bared.     These  pains  are  most  terrible  during  the  nighu 

Upon  those  parts  where  the  skin  is  near  the  bone,  as  the  forehead, 
or  shin,  syphilitic  nodes  or  tumors  often  appear,  which  are  hard,  like 
cancerous  tumors.  Beside  the  above,  there  are  the  loss  of  the  hair 
(alopecia),  blindness,  deafness,  and  various  other  mischiefs,  resulting 
from  syphilis  which  need  not  be  described. 

Is  the  Constitutional  Diii»ease  Conununicable  ? —  Many  believe, — 
rven  among  those  who  are  eminent  in  the  profession,  —  that  the  con- 
stitutional forms  of  the  disease  are  not  communicable.  A  few  years 
ago,  indeed,  this  latter  opinion  wad  generally  received.  It  is  now 
quite  extensively  doubted,  or  rather,  disbelieved.  Facts  are  con- 
stantly occurring  under  the  eye  of  unprejudiced  physicians,  which 
make  it  very  evident  that  the  constitutional  disease  may  be  commu- 
nicated from  one  person  to  another. 

The  Disease  Hereditary. — It  is  no  small  amount  of  suffering,  bodily 
and  mental,  which  the  individuals  endure  who  contract  this  disease. 
!3ut  the  inflictions  visited  upon  them,  severe  as  they  are,  are  small, 
compared  with  the  aggregate  of  ills  entailed  by  it  upon  the  long  line 
of  their  posterity.  Whether  it  be  the  man  or  the  woman  whom  the 
syphilitic  virus  has  inoculated,  if  it  be  allowed  ti)  be  absorbed,  so  as 
to  affect  the  constitution,  it  will  be  very  likely  to  be  sent  down  to  the 
children,  and  children's  children.  The  divine  law  which  links  the 
sins  of  the  fathers  with  the  sufferings  of  even  the  third  and  fourth 
generation,  is  nowhere  more  painfully  illustrated  than  in  the  scourg- 
ing descent,  through  many  generations,  of  this  terrible  disease.  It 
may  be  passed  down  to  posterity  by  either  of  the  parents ;  but  if 
both  be  diseased,  its  transmission  will  be  the  more  certain.  If  the 
mother  be  infected,  she  will  infect  the  child  vhile  carrying  it  If 
the  father's  constitution  be  poisoned,  the  child  will  receive  the  infec- 
tion from  him,  through  the  semen,  and  will  be  likely,  while  in  the 
womb,  to  infect  the  mother.      I  recollect  but  one  author  of  note 


H 


.^,Sil^2^.- 


VENEREAL  OR  SEXUAL  DISEASES. 


325 


disease  in 

|he  delicate 
boldly  oa- 
ring of  the 
man  frame, 
1  complaint, 
attacked. 
Ihe  nose,  in 
phe  cheeks, 
the  whole 

of  almoHt 
ced  in  one 
ng  painful. 
»  very  mar. 
s  feeling  is 
were  being 

e  forehead, 
e  hard,  like 
of  the  hair 
8,  resulting 

believe,  — 
at  the  con- 
i.  few  years 

It  is  now 
»  are  con- 
ana,  which 
be  commu- 


ring,  bodily 
lis  disease. 
,  are  small, 
3  long  line 

whom  the 
rbed,  so  as 
own  to  the 
1  links  the 
and  fourth 
;he  scourg- 
lisease.  It 
ta;  but  if 
n.  If  the 
ing  it     If 

the  infec- 
lile  in  the 
)r  of  note 


(Ramsbotham)  who  has  mentioned  this  mode  of  infection.     I  have 
myself  seen  two  cases  of  it 

This  constitutional  disease,  whether  it  exist  in  the  mother,  or  be 
communicated  to  the  child,  and  thence  to  her,  by  an  infected  father, 
is  a  frequent  cause  of  abortion.  Throughout  nature,  blight  is  the  re- 
Kult  of  a  diseased  parentage.  Mature  fruit  is  seldom  obtained  from 
infected  seed. 

Ih  the  Oonstifiitionnl  Disense  Ciinible  7  —  No  question  connected 
with  the  complaint  possesses  a  greater  interest  than  this.  None  is 
pressed  more  ea'  .  ;stly  upon  the  physician.  In  a  certain  sense  the 
disease  is  curable.  Its  outward  manifestation  may  be  wholly  re- 
pressed. The  health  of  the  person  suffering  from  it  may  be  restored, 
and  become,  in  an  important  sense,  good.  But  this  cure  is  never 
brovght  about  by  nature ;  it  may  be,  and  is  often  effected  by  medicine. 
1  have  never  failed  to  effect  such  a  cure  in  any  case  which  has  come 
under  my  treatment.  Such  results  may  properly,  in  general  terms, 
be  called  cures. 

Yet  there  is  a  sense  in  which  a  cure  never  occurs.  It  is  a  well- 
attested  fact,  that  a  system  once  thoroughly  pervaded  by  the  poison, 
is  never  completely  purged  of  it.  It  may  be  shorn  of  all  its  active 
malignancies ;  but  it  has  too  intimately  permeated  the  tissues  and 
solid  bones,  to  be  wholly  expelled.  Pursue  it  as  we  will  with  the 
remedial  forces  of  our  art,  it  still  takes  refuge  in  the  most  subtle  pro- 
cesses of  animal  life,  —  still  infects  the  currents  of  being,  and  finds 
expression  in  the  scrofula,  in  the  lupus,  and  in  the  scaly  affections  of 
other  generations.  Dr.  Erasmus  Wilson,  the  great  authority  in  skin 
diseases,  says :  "  I  feel  convinced  that  a  considerable  proportion  of 
those  diseases  which  pass  under  the  name  of  scrofula,  are  the  produce 
of  the  syphilitic  poison,  —  are,  in  fact,  not  scrofulous,  but  syphilitic." 
Astruc  thought  the  same,  and  suggested,  what  is  doubtless  true,  that 
the  transmission  of  syphilis  must  occur  through  several  generations 
before  it  becomes  scrofula.  Bierchn,  Camper,  Stoll,  Portal,  Hufeland, 
and  Alibert,  have  all  advocated  the  same  opinion. 

This  is  doubtless  right,  though  there  are  many  authorities  on  the 
other  side.  He  must  be  a  poor  observer  who  cannot  discover  a  prob- 
able filial  relationship  of  scrofula  to  syphilis. 

A  variety  of  facts,  admitted  by  the  whole  profession,  go  far  towards 
demonstrating  this  relationship.  Scrofula  is  always  hereditary.  It 
is  a  disease  of  the  parent,  imparted  to  the  offspring.  But  there  is 
scarcely  any  disease  so  certainly  sent  down  to  posterity  as  syphilis. 

Scrofula  is  like  syphilis  in  many  of  its  characteristics.  It  is  like  it 
in  its  power  of  propagating  itself  from  parent  to  child.  It  is  like  it  in 
affecting  nearly  all  the  children  of  diseased  parents.  It  is  like  it  in 
the  variety  of  the  structures  it  attacks,  —  affecting  the  skin,  the 
mucous  membranes,  the  bones,  etc.  Like  syphilis  it  produces  hard 
tumors,  ulcers  of  the  skin,  abscesses,  and  decaying  of  the  bones. 
And  finally,  the  great  remedy  for  tertiary  syphilis,  iodide  of  potas- 
sium, is  likewise  the  great  remedy  for  scrofula ;  and,  indeed,  almost 
every  remedy  which  acts  favorably  upon  one,  is  found  useful  for  the 


■»■!»  M'i.iM"! 


IV 


other.     This  could  hardly  occur  were  not  the  discanes  identical  in 
nature. 

"We  can  Hciircely  be  Hurprised  that  a  discaMe  bo  'videly  diflfuiied  as 
scrofula  hIiouUI  be  the  prtxluct  of  nyphiliH,  when  we  rcHect  how  fright- 
fully prevalent  were  the  causes  of  this  latter  aiTection  during  the 
earlier  and  the  middle  ages  of  the  world. 

To  pass  over  the  records  of  earlier  times,  with  merely  mentioning 
Abraham,  and  Lot,  and  Jacob,  and  Reuben,  and  Uamson,  and 
David,  and  Solomon,  and  numerous  females,  of  whom  some  sing^ar 
things  are  written  in  the  elder  scriptures,  and  omitting  all  mention 
of  the  incredible  and  almost  universal  debauchery  and  prostitution 
of  Greece,  and  Rome,  and  Persia,  and  Media,  and  Egypt,  I  may 
say  that  Europe,  in  the  middle  ag-es,  was  well-nigh  converted  into  a 
vast  brothel. 

Foremost  in  the  race  of  profligacy,  were  the  nnests,  oisnops,  kings, 
and  emperors.  The  Iicentioui!>ne8M  of  Childeric  knew  no  bounds.  He 
carried  off  and  violated  the  wives  and  Ui-^ughters  of  his  vassals,  with- 
out regard  to  any  right,  human  or  divine.  His  8ucces.«or8  were  gen- 
erally a  race  of  lecherotis  men,  who  spread  debauchery  on  every  hand. 
The  French  monarehf*,  from  Pepin  and  Chiirlemagne,  were  a  race  of 
debauchees.  Their  courts  were  national  brothels,  in  which  the  finest 
women  in  the  land  were  trained  in  the  arts  of  seduction  and  lust. 
Francis  I.,  in  1515,  endeavored  to  invest  prostitution  with  el»!gance 
and  chivalry,  and  even  to  ennoble  it,  by  abandoning  the  public 
women  of  the  palace  to  his  subaltern  officers,  and  substituting  for 
them,  ladies  of  noble  blood.  In  this  movement,  the  nobles  and  the 
clergy  gave  the  king  their  support.  The  right  of  sleeping  with  their 
female  vassals  the  hrst  night  after  marriage  was  religiously  insisted 
on  by  bishops  and  abbes,  as  high  barons,  and  exercised  as  their  privi- 
lege. The  inferior  clergy  v;ere  content  to  haunt  the  taverns  and 
stews,  and  the  monks  paid  their  pimps  with  the  wealth  of  the  church. 
The  grand  vicar,  in  some  dioceses,  sold  indulgences  to  commit  adul- 
tery for  a  year ;  in  others,  a  cask  of  wine  paid  for  the  right  of  forni- 
cation for  a  lifetime. 

Brantonie  justifies  Francis  in  his  selection  of  girls  of  noble  blood, 
on  the  ground  that  "  they  could  not  communicate  the  venereal  dis- 
ease to  the  noblemen  of  the  courts,  like  the  common  prostitutes." 
But  the  king,  who  was  previously  diseased,  infected  them ;  and  these 
noble  women,  so  called,  passing  from  the  arms  of  the  prince  to  those 
of  the  courtiers,  presented  to  them  the  fatal  infection  received  from 
the  king. 

The  way  in  which  Francis  himself  was  infected,  illustrates,  in  a 
most  shocking  manner,  the  morals  of  the  times.  His  illicit  loves  with 
the  Belle  P'erronifire,  were  not  concealed  from  her  husband,  who, 
though  obliged,  outwardly,  to  regard  the  dalliance  of  his  wife  with 
the  monarch  as  an  honor,  was  inwardly  indignant,  and  determined 
to  become  infected  himself,  and  thus  disease  his  'wife,  and  revenge 
himself  upon  the  king.  This  plan  was  suggested  to  him  by  a  monk, 
who  had  another  motive,  namely,  that  of  punishing  Francis  for  his 
liberality  to  the  Lutherans.     "  How,"  saia  the  husband,  when  the 


YBNEREAL  OK  SEXUAL  DISEASES. 


327 


hitical  in 

lifTiiHod  aa 

>\v  fright- 

luring  the 

lentioning 
jiBon,  and 
singular 
mention 
foHtitution 
>t,  I  may 
led  into  a 

*pn,  kingH, 
uids.    He 
»ul»,  with- 
were  gen- 
cTj  hand, 
a  race  of 
tho  finest 
and  lust 
elegance 
he   public 
hjtiiig  for 
ii  and  the 
with  their 
\y  insisted 
heir  privi- 
ferna  and 
tie  church, 
mit  adul- 
t  of  forni- 

ble  blood, 
ereal  dis- 
jstitutes." 
ind  these 
J  to  those 
ived  from 

ates,  in  a 
3ves  with 
nd,  who, 
vife  with 
itermined 
1  revenge 
a  monk, 
is  for  his 
vhen  the 


fluggention  was  mado,  "  sliall  I  give  this  dincase  to  my  wife,  when  we 
are  both  sound?"  "(io  visit  an  infected  girl,"  said  the  monk,  "and  to 
render  the  matter  certain,  as  I  am  infected,  I  will  see  your  luifaithful 
wife."  The  result  was  such  as  the  husband  desired ;  and  in  1547, 
Francis  I.,  the  gay  and  chivalric  monarch,  perished  of  the  most  foul 
and  loathsome  of  all  diseases. 

Del)iiuchery  did  not  die  with  him.  It  was  cherished  by  his  succes- 
sor, (v'hurles  IX.,  and  his  mother,  Catherine  de  Medicis,  and  his  grand- 
son,  Henry  HI.  The  reigns  of  Henry  IV.,  Louis  XHI.,  Louis  XIV.; 
the  Regency,  and  of  Louis  XV.,  were  stained  by  the  same  licentious- 
ness and  disregard  of  |)ublic  decency,  until  the  whirlwind  of  the  two- 
lution  came  to  purify  the  moral  atmosphere. 

The  reader  will  now,  I  think,  be  in  no  moo<l  to  wonder  that  the 
kings  and  (pieens  of  Europe,  and  the  whole  royal  progeny,  whether 
the  dishonored  occupants  of  thrones,  or  the  more  private  recipients 
of  the  public  bounty,  are  a  scrofulous  and  deg«'nerating  race.  Nor 
need  it  be  much  wondered  at,  that  so  large  a  portion  of  men  and 
womei  iverywhere  have  more  or  less  scrofula  in  their  frames.  Happy 
are  thone  who  can  find  no  trace  of  this  complaint  in  their  constitu- 
tion !  They  should  rise  up  and  call  their  virtuous  progenitors  blessed. 
They  should  especially  thank  God  that  they  have  sprung  from  the 
Joins  of  a  race  more  noble  and  kingly  in  the  eyes  of  Heaven  than  all 
the  royal  lines  of  all  Europe. 

TreatFiient  of  Kvphilis.  —  In  the  treatment  of  this  disease,  the  first 
thing  which  requires  attention  is  the  pimple,  pustule,  or  sore.  This 
must  be  instantly  touched  with  caustic.  There  should  be  no  d(!liiy, 
for  if  the  sore  be  not  syphilitic,  the  caustic  will  do  no  harm ;  and  if 
it  be,  the  most  terrible  results  may  be  averted.  The  general  belief  is 
that  poison  remains  in  the  sore  for  a  lime  before  it  is  absorbed  into 
the  constitution.  It  is  of  the  utmost  importance  that  it  bj  destroyed 
before  the  absorption  takes  place. 

The  caubiics  used  are  nitrate  of  silver  (stick  nitrate),  nitric  acid, 
chloride  of  zinc,  potassa  with  lime,  caustic  potasst*  and  the  painless 
caustic. 

The  nitrate  of  silver  is  much  used,  but  the  best  surgeons  now  re- 
gard it  as  useless.  It  does  not  prevent  the  absorption  of  the  poison. 
The  caustic  potassa,  the  potassa  with  lime,  and  <he  painless  caustic, 
are  the  sure  remedies,  —  that  is,  if  applied  in  season.  But.  tliey  must 
be  employed  with  caution.  It  will  not  do  to  trust  them  ih  bungling 
hands.  A  little  vinegar  and  water  must  be  immediately  used  to  neu- 
tralize the  caustic  when  it  has  accomplished  what  we  desire.  After 
the  sore  is  cauterized,  a  piece  of  lint,  dipped  in  a  solution  of  watery 
extract  of  opium,  one  dram  to  four  ounces,  should  be  laid  on  it ;  and 
the  organ  inveloped  in  another,  piece  of  lint  soaked  in  tepid  water, 
and  covered  in  oiled  silk.  The' patient  should  remain  at  rest  as  much 
as  possible,  —  keeping  the  penis  elevated,  and  repeating  the  opium 
dressing  to  the  wound,  and  the  water  dressing  to  the  whole  organ, 
night  and  morning.  ■  In  addition,  the  patient  should  take  two  pills 
(19)  to  be  followed,  night  and  morning,  for  three  or  four  days,  with 


'Jfl 


■-■"■    '^■■-^^i^i^^ 


t»„awii.'.'i  3= 


t^a 


328 


VENEREAL  OR  SEXUAL  DISEASES. 


a  tablespoonful  of  (20).  In  some  cases,  a  piece  of  lint,  wet  with  the? 
tincture  of  muriate  of  iron,  diluted  and  Itept  upton  the  chancre,  will 
cause  it  to  heal  kindly,  and  with  safety  to  the  patient 

K  this  treatment  be  adopted  earbj  and  properly^  the  patient  is  cured, 
and  nothing  further  is  needed.  But  time  is  generally  lost  The  poi- 
son is  absorbed  before  the  patient  is  seen  by  the  physician ;  and  the 
question  then  is,  how  it  is  to  be  driven  out 

To  accomplish  this,  the  diet  "should  be  regular  and  unstimulating ; 
alcoholic  drinks  and  tobacco  should  be  forbidden ;  the  mind  should 
be  kept  at  rest ;  a  cold  or  tepid  bath  should  be  taken  daily ;  the  ac- 
tion of  the  bowels  and  kidneys  should  be  kept  properly  regulated. 
These  things  will  put  all  the  expelling  agencies  in  proper  condition 
for  work ;  and  no  single  medicine  will  put  them  all  into  action  like 
mercury.  For  this  reason,  no  other  single  drug  has  enjoyed  a  repu- 
tation for  curing  pox  so  wide  as  this. 

But  it  must  be  used  with  judgment.  No  remedy  is  more  safe,  if 
judiciously  employed,  or  more  destructive,  if  abused.  The  profuse 
and  ill-considered  way  in  which  it  was  used  in  former  times,  raised  a 
prejudice  against  it,  which  is  unreasonably  cherished  at  the  present 
day.  Abuse  made  mercury  a  curse;  judicious  use  makes  it  a  blessing, 
.--  at  least  in  this  disease. 

The  blue  pill  is  one  of  the  best  forms  of  it  (148),  combined  with 
extract  of  henbane.  One  pill  at  night  is  the  usual  amount  to  be 
taken.  Some  prefer  the  mercury  with  chalk  (149) ;  others,  the  corro- 
sive sublimate  (150) ;  others,  the  proto-iodide  of  mercury  (136).  Some 
one  of  these  should  be  given  about  five  days,  in  the  doses  named 
under  the  recipes,  —  being  careful  not  to  produce  salivation.  After 
the  fourth  or  fifth  t'lay,  we  can  generally  increase  the  frequency  of  the 
dose.  Should  salivation  be  accidentally  induced,  it  should  be  arrested 
by  a  solution  of  chlorinated  soda  (205),  one  part  to  twelve  of  water. 
The  mercurial  treatment  should  continue  for  a  week  after  the  sore 
has  disappeared ;  and  in  the  case  of  the  indurated  sore,  as  long  as 
there  is  any  hardness. 

Water  should  be  taken  freely,  and  various  diluent  drinks.  They 
v/ash  the  poison  out  through  the  millions  of  avenues,  called  pores, 
just  as  we  wash  filth  out  of  cities  by  pouring  water  into  the  sewers. 

B^cently,  Ricord,  the  great  French  authority  on  this  subject,  has 
introduced  a  new  treatment  of  syphilis  by  iron.  One  part  of  the 
potassio-tartrate  of  iron  is  dissolved  in  six  parts  of  water,  and  two 
teaspoonfuls  are  given  three  times  a  day.  The  same  solution  is  ap- 
plied to  the  external  sore  or  chancre.  Ricord  says  that  no  secondary 
symptoms  have  been  known  to  occur  after  this  treatment  The  Lon- 
don Lancet  sanctions  this  treatment  as  being  capable  of  doing  all 
that  Ricord  claims.  Should  its  success  prove  equally  great  in  this 
country,  it  will  take  rank  among  the  grci^test  gifts  to  the  profession. 
I  sincerely  hope  that  in  a  future  edition  of  this  book,  a  full  trial  of 
the  remedy  on  this  side  of  the  Atlantic  will  permit  me  to  record  such 
success. 

I  should  mention  that  there  are  those  who  claim  to  cure  the  disease 
with  other  remedies,  without  mercury,  and  I  am  not  disposed  to  be 


with  thf? 
ncre,  will 

13  cured, 
The  poi- 
and  the 

nulating ; 
id  should 

;  the  ac- 
egulated. 
condition 

tion  like 
d  a  repu- 

■e  safe,  if 
e  profuae 
(,  raised  a 
e  present 
L  blessing, 

ined  with 
lilt  to  be 
the  corro- 
5).  Some 
Bs  named 
tn.  After 
icy  of  the 
e  arrested 
of  water. 
'  the  sore 
.3  long  as 

cs.  They 
led  pores, 
!  sewers, 
bject,  has 
rt  of  the 
and  two 
on  is  ap- 
lecondary 
The  Lon- 
doing  ail 
it  in  this 
rofession. 
11  trial  of 
cord  such 

le  disease 
ted  to  be 


^  _j-  .   <i>i.iijaf.^ 


J': 


ii 


\M 


..■Aj'M-r 


32S 


VENF.HKAL  (>K  SKXl'AL  DISEASES 


1 


-J- 


tiiMospoi^nful  of  (20j.  In  porne  case.-*,  a  piece  of  lint,  tvct  wifh  th»« 
jiicUire.  of  nuirJnU'  of  iron,  diluted  and  kopt  upon  the  tiiACMjit',  will 
iHUhf.  it.  to  hcul  kindly,  and  wittt  safety  to  tiie  patient 

If  thiw  iiT:Utn<-nt  be  adopted  ec/r/y  juul  proper ly^i\i<^  fHititnt  .«>  «urod, 
and  nothu'.g  further  is  needed.  But  tttae  is  generally  Ut*\.  'V\w  \m.- 
pon  !!■;  -tlnorlKvl  bi  fore  the  p:itienL  is  seen  by  the  pliysictan  .  hikI  the 
'.juPstioM  then  id,  how  it  is  to  be  driven  out. 

To  accomplish  this,  the  diet  alionld  be  regular  and  nrwrjfuHlatinjk'; 
alcoholic  drinks  and  tobacco  should  be  forbidden  ;  the  tiiind  .shotild 
be  kept  at  rest;  a  cold  or  tepid  bath  sliouid  be  taken  daily  ;  the  ac- 
tion of  the  bowels  and  kidneys  should  b<j  kept  properJy  fgiilat<-d. 
Theye  thing.-  will  put  all  the  expelling  agencies  in  pri>p«r  f>ii«iitiou 
for  work;  and  no  single  luedieine  will  put  them  all  into  atii:»n  hke 
mercury.  For  this  reason,  no  other  single  drug  has  enjoyed  a  repii- 
taticn  fur  curing  pox  so  wide  as  this. 

But  it  nni»t  be  u v-d  with  judgin^'nt.  No  remedy  ia  more  safe,  if 
judit  ionsly  <»inpJoyi»d,  or  more  destructive,  if  abused.  The  profu.*e 
and  i)l"-«'fjj<Jd<red  way  m  which  it  wa^-  used  in  former  times,  raistd  a 
pr'^judii ;?  agjiuist  it,  which  Is  unreasonably  chc^rished  at  the  pre.M  at 
day.  Abuse  ttuide  mercury  a  curse;  judicious  use  makes  it  a  bie^sing, 
.^  Ht  least  in  this  disease. 

The  blue  pill  is  one  of  the  best  forms  of  it  (148),  combined  with 
extract  of  henbane.  t)ae  piU  ar.  ni<rht  is  the  ustial  amount  (o  be 
taken.  Some  prefer  the  nru^rcury  with  ^ihalk  (149);  others,  the  corro- 
sive sublimate  (loO) ;  others,  the  proto-iodide  of  ruercury  (ItMi).  iSome 
one  of  these  should  be  given  about  live  days,  in  the  doses  natncd 
under  the  recipes, —  being  careful  i^ot  to  produce  salivation.  Afl»r 
the  fourth  or  fifth  day,  we  can  generally  increase  the  freqtiency  of  the 
dose.  Sisould  salivation  be  accidentally  induced,  it  should  be  arresteij 
by  a  solution  of  chlorinated  soda  (205),  one  part;  to  twelve  of  water. 
The  mercurial  treatment  shoidd  continue  for  a  week  after  the  sore 
has  disappeared  ;  and  in  the  case  of  the  indurated  sore,  as  long  as 
there  is  any  hardness. 

Water  should  be  taken  freely,  and  various  diluent  drinks.  They 
wash  llu;  poison  out  thr^  igh  the  millions  of  avenues,  called  porcH, 
JTi.'t  as  we  wa-h  filth  out  of  cities  by  jKUiring  water  into  the  sewers. 

Recently,  Ricord,  the  great  French  authority  on  this  subject,  has 
introduced  a  new  treatment  of  syphilis  by  iVo«.  One  part  of  th«^ 
potassio-tartrate  of  iron  is  dissolved  in  six  parts  of  watt?r,  and  two 
teaspoonfuls  anj  given  three  times  a  day.  The  same  solution  is  a{> 
plied  to  the  external  sore  or  chancre.  Ricord  says  that  no  secondary 
symptouts  have  been  known  to  occur  after  this  treatment  The  Lon- 
don Lancet  sanctions  this  treatment  as  being  capable  of  dc*  ail 
that  Ri'ord  claims.  Khould  its  success  prove  equally  great  ui  thi* 
country,  it  will  take  rank  among  the  greatest  gifts  to  the  profession. 
I  sincerely  hope  that  iii  a  future  edition  of  this  book,  a  full  trial  of 
the  remedy  on  this  side  of  the  Atlantic  will  permit  me  to  record  auoh 
Buccess. 

I  should  metirion  that  there  are  those  who  claim  to  cure  tne  uip^ase 
with  other  remedies,  without  mercury,  and  I  arn  not  di.'sposed  to  be 


^ 


PI  6. 


ill  th«« 
'•,  wiil 

•  11  rod. 

Hid  the 

.ulmin».f ; 
\<i  shouW 
i>u*  ai;- 

■mditiou 

.  I  r<.!]ju- 

:<«fo,  if 
"  profudc 
,  viiimil  a 

ined  with 
Kit  to  be 
the  c'diro 
>).     Some 

n.  AtV.T 
icy  of  the 
e  arr«stcfi 
of  w.itc^r. 
the  sore 
a  long  ot^ 

:s.  Tb'y 
[ed  port's, 

sewers, 
bject,  haH 
rt  of  thf 

and  two 
on  is  aj> 
lecondarv 
riie  LoO' 
dc:  alt 
it  111  thi» 
rofessioii. 
ill  trial  of 
pord  such 

ied  fo  be 


'j^l 


r 


VENEREAL  OR  SEXUAL  DISEASES. 


829 


dogmatical,  and  say  it  cannot  be  done.  For  this  purpose,  perhaps  as 
good  a  recipe  as  has  been  proposed,  is  the  compound  syrup  of  stillin' 
gia,  tincture  of  poke  root,  tincture  of  sheep  laurel,  each  four  ounces, 
mixed  ;  of  which,  from  a  teaspoonful  to  half  a  tablespoonful  is  to  taken 
three  times  a  day.  I  think  well  of  this  remedy,  especially  if  it  be  in 
connection  with  a  small  amount  of  mercury. 

The  Bubo,  if  not  attended  with  pain,  may  be  treated  with  compres- 
sion ;  by  a  piece  of  plaster  of  ammoniac  with  mercury  ;  or  by  touch- 
ing it  with  nitrate  of  silver.  Should  there  be  inflammation,  and  the 
formation  of  matter  be  inevitable,  the  bubo  should  be  opened  by 
touching  it  with  the  caustic  potassa  ;  and  the  resulting  sore  must  be 
treated  with  th*^  solution  of  opium  and  water  dressing.  Should  the 
sore  need  stir  'ating,  it  may  be  touched  lightly  with  nitrate  of 
silver. 

Eraptions  upon  the  Skin.  —  In  treating  the  disease  after  it  appears 
upon  the  skin,  etc.,  we  shall  derive  great  advantage  from  the  use  of 
either  the  warm  or  the  vapor  bath  once  a  day.  With  this,  if  the  case 
be  not  very  old,  we  may  employ  (148)  or  (150) ;  but  if  the  disease  be 
an  old  one,  showing  itself  in  the  throat,  or  attacking  the  bones  of  the 
face,  we  must  give  iodide  of  potassium  (138),  combined  with  com- 
pound decoction  of  sarsaparilla.  This  is  the  great  remedy  for  tertiary 
syphilis ;  but  when  the  case  is  obstinate,  it  may  sometimes  be  discon- 
tinued, and  the  corrosive  sublimate  (139)  be  substituted  for  it. 

It  is  to  be  observed  that  the  older  the  disease  grows,  and  the  more 
chronic  its  character,  the  more  does  mercury  lose  its  control  of  it. 
In  the  first  attack,  the  blue  pill  is  the  best ;  in  the  second,  as  a  gen- 
eral thing,  the  iodide  or  the  biniodide  of  mercury ;  in  the  third,  the 
corrosive  sublimate  ;  in  the  attacks,  subsequent  to  this,  particularly  in 
the  tertiary  form  of  the  disease,  the  iodide  of  potassium.  When  the 
throat  and  nose  are  so  ulcerated  as  to  make  a  case  absolutely  terrible 
to  contemplate,  it  is  surprising  to  see  how  rapidly  the  recovery  will 
often  take  place  under  the  influence  of  this  latter  remedy. 

For  syphilitic  iritis,  apply  frictions  twice  a  day  on  the  eyelids  and 
eyebrows  with  ointment  (172)  (173) ;  and  administer  internally  two 
pills  of  (136),  daily. 

Case  I.  —  Mr. ,  aged  sixty,  was  sent  to  me  by  his  physician, 

from  the  State  of .     He  had  deep  and  extensive  ulcers  in  the 

upper  cavity  of  the  throat,,  extending  to  the  tonsils,  and  to  the  arch 
of  the  palate.  Swallowing  had  betjome  very  difficult,  and  much  fear 
was  felt  both  by  the  patient  and  by  his  physician,  that  death  would 
follow  at  no  distant  day,  from  absolute  inability  to  swallow  at  alL 
The  ulcers  had  the  peculiar  yellow  color  which  so  clearly  marks  these 
sores.  I  informed  him  that  his  disease  was  tertiary  syphilis.  He 
said  he  had  once  had  the  disease,  many  years  before,  but  had  sup- 
posed himself  cured.  The  letter  brought  me  from  his  physician,  a 
most  respectable  man,  showed  that  he  also  had  no  suspicion  of  the 
real  nature  of  the  complaint  This  case  is  well  represented  by  Platr 
VI.,  Fig.  1.  *^  . 


^ao 


VENEREAL  OR  SEXUAL  DISEASES. 


|i    ' 


\'l 


ivk 


I  put  this  patient  upon  a  preparation  of  iodide  of  potassium,  and 
aeveral  other  articles,  which  I  keep  on  ha.'id,  and  syringed  his  throat 
once  a  day,  with  a  weak  solution  of  the  acid  nitrate  of  mercury  (226), 
and  in  one  week,  he  swallowed  his  food  easily.  In  three  weeks,  ho 
went  home,  his  throat  was  nearly  well,  and  his  bodily  health,  which 
had  been  much  shattered,  restored.  His  physician,  much  astonished 
at  his  altered  condition,  wrot«  immediately  to  know  what  I  had  done 
for  him.  This  patient,  though  in  humble  circumstances,  has  ever 
since,  sent  me  an  annual  present,  which,  though  not  of  great  value,  is 
highly  prized  by  me  as  evincing  a  gratitude  not  forgetful  of  peculiar 
benefits. 

\ 

Case  II.  —  In  the  summer  of  1856,  a  gentleman  of  distinction  came 
to  me  from  a  distant  state  ;  and,  being  so  much  reduced  as  to  make 
it  doubtful  whether  he  would  ever  reach  Boston,  he  brought  his  family 
physician  with  him  to  render  him  assistance  on  the  journey  in  case 
of  possible  emergency. 

His  voice  was  reduced  very  nearly  to  a  whisper.  I  found  a  breach 
through  the  palatine  arch,  and  considerable  ulceration  in  the  back  of 
the  pharynx,  though  not  as  much  as  is  represented  in  Plate  VI., 
Fig.  1.  He  was  harassed  with  a  cough,  and  his  flesh  and  strength 
were  so  far  reduced  that  his  high  official  duties  had  been  for  some 
time  laid  aside..  He  was  supposed  by  his  friends  to  be  verging  tow- 
ards the  last  stages  of  consumption ;  and  their  consent  was  gained 
for  his  journeying  to  Boston,  only  because,  as  they  supposed,  no  hojx; 
opened  to  him  in  any  other  direction. 

My  pronouncing  it  a  case  of  tertiary  syphilis  surprised  the  very 
excellent  physician  who  came  with  him,  and  who  failed  to  recognize 
the  nature  of  the  complaint  only  because  he  had  not  been  accustomed 
to  seeing  cases  of  the  kind.  The  disease  was  of  eighteen  years  stand- 
ing,—  being  the  lingering  constitutional  result  of  a  case  of  gonorrhaa 
(and  I  have  seen  several  such  results  of  gonorrhoea,  whatever  Ricord 
may  say  to  the  contrary),  contracted  in  a  single  lapse  from  virtue  in 
earry  manhood. 

The  treatment  was  almost  identical  with  that  in  Case  L,  except 
that  tonics,  —  particularly  some  of  the  preparations  of  iron,  —  were 
required  to  bring  up  the  strength.  The  iodide  of  potassium  showed 
its  usual  specific  power,  and  I  had  the  pleasure  to  send  the  patient 
home  in  a  tolerably  good  state  of  health. 


Case  III.  —  One  of  the  worst 
Bented  in  the  person  of  Mr.  — 


cases  I  have  ever  treated  was  pre- 
— ,  who  came  from  a  considerable  dis- 


tance to  consult  me  in  reference  to  a  badly  ulcerated  throat,  for  which 
all  tried  remedies  had  proved  useless.  The  first  glance  at  the  throat, 
showed  the  ulceration  to  be  syphilitic.  The  uvula  and  the  entire 
palatine  arch  were  gone  ;  the  ulceration  had  gone  deep  into  the  phar- 
ynx. These  two  circumstances  made  swallowing  extremely  difficult ; 
indeed,  nothing  could  be  swallowed,  except  the  most  bland  liquids, 
and  death  by  starvation  was  near  at  hand. 

No  time  was  to  be  lost.     I  put  the  patient  upon  large  doses  of 


w 


VENEREAL  OK  SEXUAL  DISEASES. 


3ai 


lasium,  and 
hia  tiiroat 
^rcury  (226), 
e  weeks,  ho 
ealth,  which 
astonished 
I  had  done 
htis  ever 
eat  value,  is 
of  peculiar 

\ 

notion  came 
as  to  make 
it  his  family 
rney  in  case 

md  a  breach 
the  back  of 
Plate  VI., 
ind  strength 
en  for  some 
'erging  tow- 
was  gained 
sed,  no  ho|)e 

led  the  very 
to  recognize 
accustomed 
years  atand- 
:>{  g-onarrhaa 
tever  Ricord 
nn  virtue  in 

SE  I.,  except 
iron,  —  were 
lum  showed 
i  the  patient 


ed  was  pre- 
iderable  dis- 
it,  for  which 
t  the  throat, 
I  the  entire 
ito  the  phar- 
jly  difficult ; 
and  liquids, 

ge  doisea  of 


iodide  of  potassium,  with  compound  infusion  of  gent'ai'  and  fluid 
extract  of  aarsaparilla,  and  showered  the  throat  every  other  day  with 
a  weak  solution  of  acid  nitrate  of  mercury  (2'?6),  and  in  xen  days, 
tender  t)eef  steak  was  chewed  and  swallowed  with  comfort. 

This  patient  stayed  in  Boston  aix  weeks,  and  went  home  with  ten 
pounds  more  flesh  than  he  brought  with  nlm ;  and  by  using  the  above 
remedies  six  months,  has  regained  excellent  health.  Plate  VI., 
Fig.  2,  is  a  representation  of  this  ihroat  as  it  appeared  when  it  came 
under  treatment 

fortunately,  these  cases,  terribly  destructive  as  they  are.  are  almost 
always  curable,  if  properly  managed. 

Clap.  —  Gonorrhoea. — Blenorrhagia. 

The  reader  is  aware  that  the  nose,  mouth,  and  lungs,  are  lined  with 
a  mucous  membrane,  which  is  liable  to  become  inflamed  from  various 
causes.  This  inflanmiation  we  call  a  cold  or  catarrh.  During  its 
continuance,  mucus,  and  oilier  matters  of  different  color  and  degrees 
of  consistency,  are  more  or  less  freely  discharged. 

The  mucous  membrane  of  the  private  parts  of  both  sexes,  is  just 
like  that  of  the  mouth  and  throat,  and  subject  to  similar  inflamma- 
tions and  discharges.  But  these  inflammations  of  the  private  parts, 
instead  of  being  produced  by  changes  of  weather,  etc.,  generally  result 
from  the  application  of  the  specihc  poison  of  gonorrhoea.  When  a 
woman  abandons  herself  to  unlimited  intercourse  with  different  men, 
the  private  parts  become  stimulated  to  so  unnatural  an  extent,  that 
the  secretions  of  the  parts,  which  are  largely  augmented,  at  length 
become  altered  in  their  nature,  acrid,  and  finally  poisonous,  —  so  acrid 
and  poisonous  that  they  cause  inflammation  of  the  parts,  and  when 
applied  to  the  male  organ,  in  the  sexual  act,  they  poison  and  inflame 
that. 

This  is  the  shortest  and  plainest  explanation  I  can  give  of  clap. 
From  this  explanation,  one  may  learn  why  a  man  will  sometimes 
take  a  disease  from  a  woman  who  has  never  had  any  evidences  of 
being  diseased  herself.  If  she  have  indulged  her  sexual  propensities 
unreasonably,  though  not  enough  to  produce  inflammation  upon 
herself,  her  secretions  may  yet  have  become  acrid  enough  to  poison 
one  whose  organs  are  delicate  and  sensitive.  And  more  than  this. 
The  secretions  of  a  female  may  become  acrid  and  poisonous  from 
other  causes  than  excesaive  venery.  The  discharges  in  bad  cases  of 
whites  will  sometimes  irritate  and  inflame  the  male  organ,  and  induce 
a  disease  which  has  every  appearance  of  gonorrhoea.  A  husband,  in 
great  distress  of  mind,  sometimes  submits  a  case  of  this  sort  to  the 
physician's  inspection,  and  lays  upon  him  the  delicate  and  responsible 
duty  of  deciding  whether  the  wife  ha?  been  unfaithful.  No  act  in  a 
whole  professional  life  can  be  more  momentous  than  a  decision  of 
this  sort  If  a  man  be  well  skilled  in  his  art,  he  may  give  an  answer 
in  such  case,  which  shall  dispel  the  most  terrible  apprehensions,  and 
save  the  peace  of  a  loving  family. 

The  poison  when  applied  by  a  diseased  person  to  the  niale  or 


332 


VENEREAL  OR  SEXUAL  DISEASES. 


female  organs,  requires  a  certain  time  to  produce  its  peculiar  effect,— 
generally  from  three  to  eight  days. 

Syniptums. —  The  first  symptom  of  the  disease  is  uneasiness  in  the 
end  of  the  penis,  accompanied,  generally,  with  a  little  redness,  and 
difficulty  in  passing  water.  The  color  of  the  first  discharge  may  be 
white  or  straw-colored.  There  is  tenderness  where  the  parts  are  red. 
Scalding  in  passing  water  is  sometimes,  not  always,  present  at  first. 

This  13  the  beginning,  or  first  stage  of  clap.  Now  is  the  time  to 
cure  it  easily.  But,  unfortunately,  the  physician  seldom  sees  a  case 
in  thia  early  stage.  Before  he  is  allowed  to  inspect  it,  the  second 
stage  has  generally  appeared,  which  is  known  by  violent  scalding 
when  water  is  passed,  by  chordee,  or  painful  erections  of  the  penis, 
and  by  an  increased  discharge  of  greenish  matter  often  tinged  with 
blood,  and  coming  from  much  farther  down  the  urethra,  or  water- 
passage.  The  matter  sometimes  comes  from  as  far  down  as  opposite 
the  scrotum,  or  bag  which  holds  the  testicles.  There  is  more  or  leas 
pain  in  the  loins  and  back.  The  whole  body  of  the  penis  may  be- 
come affected,  and  abscesses  form. 

A  third  and  more  terrible  stage  of  the  disease  begins  when  the  in- 
flammation has  reached  the  lowest  part  of  the  water-passage,  just 
where  it  enters  the  bladder.  Around  this  part  of  the  passage,  and 
lying  upon  the  bladder,  is  a  gland  in  size  and  shape  like  the  largest 
chestnut  It  is  called  the  prostate  gland.  On  either  side  of  it,  lie  the 
receptacles  of  the  semen,  each  of  which  sends  its  duct  into  the  water- 
passage.  When  the  inflammation  extends  through  this  gland,  it  irri- 
tates the  neck  of  the  bladder,  and  causes  a  distressing  desire  to  pass 
water ;  and  from  its  proximity  to  the  larger  bowel,  it  sends  its  irrita- 
tion thither  likewise,  and  impels  a  terrible  effort  to  evacuate  the 
the  bowels,  called  tenesmus.  It  is  the  same  awful  feeling  experienced 
in  dysentery.  Few  things  can  be  more  terrible  than  these  two  dis- 
tressing feelings  conjoined,  —  the  desire  to  pass  water  and  to  empty 
the  bowels.  Racked  with  terrible  pains,  and  awful  tenesmic  dis- 
tresses, and  often  with  painful  erections,  the  patient  passes  back  and 
forth  between  the  bed  and  stool,  —  often  vowing,  in  the  sincerity  of 
his  heart,  that  if  he  can  but  recover  from  this,  he  will  never  be  caught 
again.  The  enlargement  of  this  prostate  gland  may  become  chronic 
and  permanent,  and  be  the  affliction  of  a  man's  life. 

Stricturet  —  One  of  the  most  troublesome  and  persistent  conse- 
quences of  gonorrhoea  is  a  partial  closing  up  of  the  water-pipe,  at- 
tended generally  by  quite  a  serious  obstruction  to  ihe  passage  of  the 
water.  It  is  called  stricture.  The  mucous  membrane  which  lines 
this  passage,  being  long  inflamed,  becomes  thickened  and  less  pliable 
or  elastic.  The  tissues  which  lie  underneath  this  membrane,  also 
become  swollen  and  hardened,  and,  pressing  upon  the  water-passage, 
lessen  it  still  further,  —  making  the  stricture  more  diflicult  of  cure. 

In  8^  'cture,  the  stream  of  urine  is  altered  in  size,  length,  and  force. 
Its  course  is  changed,  when  the  stricture  is  lateral.  The  stream  is 
often  flattened,  like  the  blade  of  a  pen-knife,  or  twisted  like  a  gimlet, 
or  forked,  —  one  stream  reaching  beyond  the  other.     In  consequence 


VENEREAL  OR  SEXUAL  DISEASES. 


333 


|r  effect,— 

less  in  the 
Iness,  and 
;e  nmy  be 
ts  are  red, 
at  first. 
e  time  to 
eea  a  case 
he  Becond 
t  scalding 
the  penis, 
nged  with 
or  water- 
is  opposite 
ore  or  less 
8  may  be- 

len  the  in- 

ssage,  just 

ssage,  and 

the  largest 

if  it,  lie  the 

the  water- 

md,  it  irri- 

iire  to  pass 

s  its  irrita- 

acuate  the 

xperienced 

e  two  dis- 

i  to  empty 

eamic  dis- 

back  and 

incerity  of 

be  caught 

ne  chronic 


ent  coiise- 
er-pipe,  at- 
age  of  the 
^hich  lines 
ess  pliable 
•rane,  also 
;r-passage, 
>f  cure, 
and  force, 
stream  is 
!  a  gimlet, 
n  sequence 


of  obstruction,  the  bladder  is  not  entirely  emptied,  and  the  desire  to 
urinate  immediately  returns,  and  is  very  urgent. 

Gleet.  —  Another  very  troublesome  n?sult  of  gonorrhoea  is  gleet.,  — 
a  thin,  colorless  discharge,  which  persists,  in  a  chronic  form,  after  all 
active  inflammation  has  subsided.  It  is  very  annoying,  and  very  ob- 
stinate. It  is  often  dependent  on  the  altered  condition  of  the  mucous 
membrane  occasioned  by  stricture. 

Orchitis. —  Another  very  severe  result  of  clap  is  swe'Ung  of  the 
testicles,  called  orchitis.  It  begins  frequc^ntly  with  chills  and  fever, 
with  a  feeling  of  weight  in  the  scrotum,  and  pains  in  the  loins.  The 
swelling  rapidly  increases,  and  reaches  its  height  in  from  three  to  five 
days. 

Beside  the  above,  there  are  still  other  mischiefs,  which  follow  this 
disease,  such  as  inflammation  of  the  prostate  gland,  already  described, 
of  the  bladder,  an''  of  the  kidneys. 

In  the  female,  gonorrhoea!  inflammation  affects  the  external  geni- 
tals called  the  vulva,  the  water-pipe,  the  vagina,  and  the  neck  of  the 
womb. 

There  is  a  difference  of  opinion  as  to  whether  gonorrhcea  ever  pro- 
duces secondary  or  constitutional  symptoms.  Ricord,  the  great 
French  authority  on  this  subject,  affirms,  and  with  him  a  great  num- 
ber of  followers,  including  most  of  the  profession  in  this  country, 
that  constitutional  symptoms  never  follow  clap ;  that  they  never  re- 
sult from  anything  but  a  syphilitic  ulcer.  Vidal,  a  French  authority, 
safer,  in  my  judgment,  than  Ricord,  though  not  as  renowned,  says,  on 
the  contrary,  that  secondary  and  tertiary  complaints  do  follow  viru- 
lent gonorrhoea.  Wilson,  the  highest  English  authority,  and  many 
others,  agree  with  him.  Unprejudiced  observers  feel  well  convinced 
that  this  latter  opinion  is  right  I  have  myself  seen  not  less  than 
half  a  dozen  cases  of  secondary  and  tertiary  syphilis,  which  were 
preceded  by  gonorrhoea,  and  nothing  more.  Case  L  was  of  this 
kind. 

Treatment.  —  In  the  first  stage  of  the  disease,  there  are  two  meth- 
ods of  treatment,  either  of  which  may  be  adopted  with  success.  The 
first,  which  has  many  advocates,  is  the  local  treati.ient.  An  injection, 
with  a  glass  syringe,  is  immediately  made,  of  a.  solution  of  nitrate  of 
silver,  of  the  strength  of  five  to  ten  grains  to  the  ounce,  of  water.  It 
should  be  retained  from  one  to  five  minutes,  by  pressing  the  head  of 
the  penis  between  the  thumb  and  finger.  If  done  before  the  third 
day,  this  will  generally  cure  the  disease. 

The  physician  should  have  entire  control  of  the  patient,  and  com- 
pel him,  if  possible,  to  keep  his  room,  and  live  for  a  few  days  on 
crackers  and  water,  or  something  equally  simple.  All  meats  and 
stimulating  drinks  are  to  be  excluded. 

The  other  mode  of  treatment,  which  is  perhaps  the  more  commonly 
adopted,  is  more  general  in  its  nature.  It  embraces  the  use  of  warm 
baths,  warm  sweating  drinks,  and  rest.  If  the  patient  is  full  of  blocxl, 
and  strong,  from  five  to  fifteen  leeches  are  applied  to  the  space  be- 
tween *he  scrotum  and  fundament.     These  things,  With  a  low  diet. 


I 


334 


VENEREAL  OR  SEXUAL  DISEASES. 


will  frequently  reduce  the  disease  in  a  few  days.  If  the  discharge 
should  continue,  atrer  a  fair  trial  of  the  above,  then  copaiba  and 
cubebrt  (272)  are  to  be  used.  Several  articles  rre  added  in  th(!  alK)ve 
prescription,  to  make  the  copaiba  acceptable  to  the  stomach.  Tins 
preparation  can  he  taken  by  most  persona,  and  generally  produces 
very  gratifying  resulLs.  Vidul  strongly  recommends  an  electuary,  or 
thick  paste  (273),  of  which  a  piece  twice  as  large  as  a  nutmeg  is  to 
be  taken  in  the  course  of  the  day.  The  prescriptions  which  contain 
copaiba  and  cubebs  are  numerous ;  but  the  above  two  are  as  gootl  as 
a  hundred.  With  these  articles,  the  baths,  the  leeches,  and  the  repose, 
are  to  be  united. 

V^idal  says  he  never  resorts  to  injections  first,  but  employs  the  anti- 
inflammatory course  first.  If  that  fail,  then  he  uses  the  injection 
(207),  three  or  four  times  a  day ;  ajid  if  he  employs  the  nitrate  of 
silver  at  all,  it  is  only  as  an  astringent  (208).  Prescription  (304)  is  a 
valuable  injection. 

When  the  second  stage  sets  in,  and  the  symptoms  become  more 
violent,  injections  must  not  be  used.  For  the  very  severe  scalding  in 
passing  water,  which  is  now  felt,  take  thirty  drops  of  a  solution  of 
potassa  in  half  a  tumblerful  of  water,  twice  or  three  times  a  day. 
Persons  of  full  habit,  may  be  benefited  by  dissolving  a  grain  or  two 
of  tartar  emetic  in  a  tumbler  of  water,  and  taking  to  the  extent  of 
producing  a  little  nausea.  Relief  is  occasionally  obtained  by  holding 
the  penis  for  some  time  in  warm  water. 

For  the  painful  chordee,  or  erections,  camphor  and  opium  (120)  are 
required,  —  from  one  to  three  pills  a  day.  Thirty  drops  of  laudanum 
may  be  given  when  the  patient  retires.  Cold  applications  to  the  gen- 
ital organs,  or  walking  barefooted  upon  the  cold  floor,  will  frequently 
give  relief.  When  other  things  fail,  three  pil  a  a  day  may  be  taken 
of  extract  of  hyoscyamus,  containing  from  one  to  four  grains  each. 
The  quantity  of  drinks  must  be  diminished,  and  cold  lotions  must  be 
applied  to  the  penis  on  going  to  bed,  —  the  patient  covering  himself 
lightly. 


Gleet  is  generally  very  obstinate,  and  often  requires  a  very  pro- 
tracted treatment.  If  there  be  any  tenderness  along  the  under  side 
of  the  penis,  it  is  well  to  apply  three  or  four  leeches.  Occasionally 
recipe  (272)  will  have  an  excellent  effect.  But  gleet  is  an  unhealthy 
action,  sustained  by  habit,  and  may  often  be  cured  by  simply  exciting 
a  new  action  which  shall  break  the  old  habit.  It  is  always  well, 
therefore,  to  resort  to  injections.  Sugar  of  lead  and  sulphate  of  zinc 
(207)  answer  a  good  purpose ;  or  sulphate  of  zinc  and  tannin  (209) 
may  be  tried.  Chloride  of  zinc  (210)  does  well  in  some  obstinate 
cases. 

But  gleet  is  often  dependent  on  stricture,  and  when  this  is  the  case, 
we  must  learn  the  location  of  it  by  exploring  the  water-pipe  with  a 
bongie.  When  the  instrument  reaches  the  constricted  part,  the  pa- 
tient feels  pain,  or  the  surgeon  meets  an  obstruction,  —  often  both. 
When  the  stricture  is  found,  it  is  either  to  have  the  solid  nitrate  of 
silver  applied  to  it  with  an  instrument  called  the  parte  caustique,  or  a 


<lischargn 
|)|)ail)ii  and 
tliL'  alx)vi! 
i";li.  TliiH 
produces 
lectuary,  or 
jtmog  is  to 
lich  contain 
]  as  good  as 
[the  repose, 

^8  the  anfi- 

iiijectiou 

nitrate  of 

1  (304)  is  a 

come  more 
Hcalding  in 
solution  of 
mea  a  day. 
ain  or  two 
3  extent  of 
by  holding 

m  (120)  are 
■  laudanum 
to  the  gen- 
frequently 
ay  be  taken 
grains  each, 
nis  must  be 
ing  himself 


I  very  pro- 
under  side 
'ccasionally 
unhealthy 
>ly  exciting 
ways  well, 
ate  of  zinc 
nnin  (209) 
!  obstinate 

is  the  case> 
>ipe  with  a 
irt,  the  pa- 
>ftcn  both, 
nitrate  of 
Hique,  or  a 


vemereal  ur  sexual  diseases. 


88» 


solution  of  nitrate  of  silver  (211),  or  of  acid  nitrate  of  mercury  (226), 
with  a  shower  syringe  which  I  have  had  prepared  for  the  pur|H)se. 
When  these  means  tail,  we  must  pass  a  small  lM)ngie  gently  through 
the  stricture;  then  a  larger,  and  th(;n  a  still  larger  one,  until  the  ol>- 
struction  be  removed.  They  should  be  used  once  or  twice  a  day,  and 
not  be  retained  long  in  the  passage.  They  frequently  have  to  be 
UHcd  ten  or  twelve  weeks,  and  should  not  be  discontinued  till  the  cure 
is  complete.  Put  no  confidence  in  those  quacks  who  promise  to  cur*; 
these  old  troubles  in  a  few  days.  They  want  your  money,  'Ut  have 
no  expectation  or  ability  to  cure  you  at  all. 

For  inflammation  of  the  testitrles,  apply  leeches  at  once.  To  thi» 
should  be  added  warm  fomentations,  and  poultices.  If  these  means 
fail,  more  serious  measures  are  to  be  adopted,  which  it  would  be  out 
of  place  to  describe  in  this  book. 

Inflammation  of  the  prostate  gland  is  also  to  be  treated  with 
leeches  and  poultices,  —  likewise  a  warm  hip-bath.  The  water  must 
be  drawn  off  with  a  catheter  until  it  can  be  passed  in  the  natural 
way. 

Prevention  of  Sexunl  Diseases. —  I  have  several  times  been  in  doubt 
as  to  the  best  method  of  presenting  some  of  the  topics  which  the  wide 
scope  of  this  book  has  brought  before  me ;  but  no  one  subject  ha* 
perplexed  me  like  the  one  announced  in  the  above  heading,  —  not 
that  it  is  not  easy  enough  to  furnish  the  rules  for  preventing  venereal 
disease,  but  that  it  is  a  grave  question  in  morals  whether  to  instruct 
the  world  in  the  methods  of  such  prevention  is  right.  Is  it  proper  to 
give  any  oth'ir  advice  than  the  simple  direction  to  abstain  from  all 
liability  to  disease  ?     That  is  the  question. 

If  such  advice  would  be  heeded,  of  course  no  other  should  be  given. 
But  it  would  not.  If  the  person  disregarding  it  would  alone  suffer 
the  penalty  of  the  trangression,  it  might  then  be  best  to  embody  th'^ 
whole  advice  in  the  simple  imperative  word,  abstain!  But  this  can- 
not be.  The  infection  will  be  imparted  to  a  third  person,  and  onward 
to  thousands ;  and  many  of  these  thousands  will  be  innocent  wives, 
who  will  perish  of  the  disease,  or  send  the  infection  down  to  the 
second,  the  third,  the  fourth,  and  to  all  generations !  "While  a  strict 
morality  might  seem,  therefore,  at  first  view,  to  forbid  the  inculcation 
of  rules  for  avoiding  infection,  the  good  of  the  race  would  appear  to 
justify  and  require  it. 

The  first  requisite  for  prevention  is  cleanliness.  Frequent  washing 
is  of  prime  importance. 

The  precautions  should  not  be  the  same  before  and  after  the  vene- 
real act,  when  a  person  is  about  to  expose  himself  to  risk.  Before 
the  act,  the  parts  should  be  carefully  examined,  to  see  if  there  be  any 
break  in  the  skin.  The  least  breach  in  this  covering  of  the  penis 
greatly  promotes  contagion.  Before  coition,  there  should  be  no  wash- 
ing with  soap,  for  this  deprives  the  parts  of  the  mucus  and  oil, — 
thus  rendering  the  naked  and  exposed  skin  liable  to  infection.  On 
the  contrary,  to  apply  a  solution  of  alum,  tannin,  or  a  decoction  of 
oak  bark,  or  aromatic  wine,  constringes  or  hardens  the  covering  of  the 


336 


VKNEIIEAL  UK  SEXUAL  1)I«EA8E& 


I 


organ,  and  renders  contagion  more  difficult  An  article  called  ron* 
duin  is  oftt!n  used  to  wurd  otl  disease.  It  is  a  sack  made  of  gold 
beater's  skin,  and  is  drawn  over  the  penis  like  a  glove  over  the  finger, 
and  thus  prt)tects  it  from  contact  with  j)oitM)nou8  matter. 

Of  still  greater  importance  are  prompt  measures  of  prevention 
after  the  Jt.  Ixitions  should  be  immetliately  applied  to  every  part 
of  the  organ,  and  in  the  case  of  females,  should  be  used  as  injectioMH. 
These  lotions  should  be  acids  or  alkalies.  A  mixture  of  vinegar  and 
water  h  is  been  recommcnd«'d  as  an  excellent  waxh.  Recortl  recom- 
mends aromatic  wine;  Malapert,  corrosive  sublimate  (21:i),  in  the 
form  of  solution.  Probably  the  best  preventive  is  composttl  mainly 
of  alcohol  and  soap  (213),  as  recommended  by  Lnnglebert. 

An  ex|)osed  p<;rson,  using  any  one  of  these  solutions,  particularly 
the  last,  or,  in  the  absence  of  all  these,  washing  thoroughly  with  lioap 
and  water,  will  be  likely  to  esca|>e  contagion. 

Medical  Police. — What  is  called  general  prophylaxis,  or  prevention, 
or  medical  police,  is  not  a  subject  of  legislation  in  this  country.  The 
moral  sense  of  the  American  people  does  not  admit  its  necessity.  In 
Europe,  the  authorities  watch  over  prostitution.  They  even  go  so 
far  as  to  regulate  it  They  appoint  practitioners,  whose  duty  it  is  to 
act  as  a  sort  of  medical  police,  and  particularly  to  visit  houses  of 
prostitution  once  or  twice  a  week,  and  examine  all  the  inmates. 
When  a  girl  is  found  diseased,  she  is  immediately  removed  to  a  hos- 
pital^ and  not  permitted  to  return  until  she  is  welL 


Self- Pollution. — Masturbation.  —  Onanism. 

There  is  probably  no  vice  to  which  so  many  boys  and  young  men, 
and  even  girls  and  young  women,  are  addicted,  and  from  which  so 
many  constitutions  break  down,  as  self-pollution.  Small  boys  and 
girls  learn  the  vile  practice  of  the  larger  ones  at  school,  and  generally 
continue  it  up  to  maturity,  without  tne  least  suspicion  that  they  are 
inflicting  upon  themselves  either  a  moral  or  a  physical  injury. 

This  comes  of  the  false  modesty  and  bastard  morality  which  with- 
holds from  the  young  all  knowledge  of  the  proper  functions  of  their 
sexual  organs,  and  of  the  inconceivable  mischief  resulting  from  their 
abuse.  A  gentleman  of  distinction  lately  said  to  me  :  "  I  instruct  my 
boys  as  faithfully  on  this  subject  as  upon  any  other  moral  or  physical 
question,  and  I  tell  my  wife  it  is  her  duty  to  do  the  same  with  the 
girls."  This  is  wise.  Yet,  how  few  parents  ever  speak  to  their  boys 
or  girls  on  the  subject,  or  give  them  the  least  reason  to  suppose  there 
is  any  better  rule  for  their  conduct  than  their  own  desires  f 

Symptoms. —  These  are  very  numerous.  The  principal  are,  head- 
ache, wakefulness,  restless  nights,  indolence,  indisposition  to  study, 
melancholy,  despondency,  forgetfulness,  weakness  in  the  back  and 
private  organs,  a  lack  of  confidence  in  one's  own  abilities,  cowardice, 
inability  to  look  another  full  in  the  face,  and,  among  females,  hysterics, 
whites,  and  a  desire  for  seclusion  from  society  and  solitude. 


cnlled  con* 
ttde  of  gold 
the  finger, 

prevention 
every  part 

s  iiijectionH. 

viiiegnr  and 

eoitl  recoiii- 
'■i),  in  the 

)»ed  mainly 

t, 

particularly 

ly  with  Goap 


r  prevention, 
untry.  The 
ijcesaity.  In 
even  go  so 
duty  it  iit  to 
it  houses  of 
the  inmates. 
tred  to  a  hos- 


young  men, 
)m  which  so 
Eill  boys  and 
nd  generally 
;hat  they  are 

which  with- 
:ions  of  their 
g  from  their 
[  instruct  my 
il  or  physical 
me  with  the 
to  their  boys 
appose  there 

al  are,  head- 
on  to  study, 
le  back  and 
8,  cowardice, 
les,  hysterics, 
le. 


VENEREAL  OK  HRXUAL  DISEASES. 


337 


I  have  already  spoken  of  the  rcceptacloB  of  semen,  lying  on  each 
side  of  the  proHtatc  gland.  From  tht'  fore  part  of  these  rece|)tacle», 
the  semen  passes  through  two  ducts,  about  a  finger's  breadth  in 
length,  into  the  urethra  or  water-pi|K^,  just  in  front  of  the  prostate. 
From  excessive  solf-poUution,  these  ducts  become  very  irritable,  and 
also  debilitated  and  relaxed,  —  so  much  so  that  they  will  not  retain 
the  semen ;  and  during  lascivious  dreams,  it  flows  olF.  These  sttmi- 
lutl  losses  are  called  ''  nocturnal  emissions."  Bo  constant  is  the  drain 
they  keep  up  u{x>n  many  yt)ung  men  who  have  abused  themselves 
excessively,  that  the  whole  man,  mentally,  morally,  and  physically, 
biK-otnes  a  wreck.  There  are  few  object*  more  pitiable  to  behoul 
than  a  young  man  in  this  ctindition,  —  his  nervous  system  feeble, 
tremulous,  arid  broken ;  his  memory  weakened  and  fading  out ;  his 
eye  unsteady  and  incapable  of  looking  a  friend  in  the  face  ;  his  loins 
and  back  weakened,  giving  him  the  feeble  gait  of  old  age;  his  once 
erect  form  cowe<l  ana  bent ;  his  high  sense  of  manliness  all  oozed  out 
of  him ;  his  mind  taking  up  and  dropping  the  simplest  threads  of 
thought,  losing  its  way  in  the  plainest  paths  of  reflection,  and  often 
starting  back  aflVighted  at  the  glimpse  of  chaotic  insanity  o|)ening 
before  him,  —  turning  here  and  there  for  relief,  but  finding  little  hope 
of  recovery,  except  in  marriage,  and  yet  knowing  himself  unfitted  to 
be  the  husband  of  an  intelligent  woman ! 

Treatment.  —  Every  kind  of  treatment,  no  matter  how  judicious  or 
well  applied,  will  be  unsuccessful,  unless  the  vice  which  has  produced 
the  disease  be  absolutely  and  entirely  abandoned.  This  is  the  first 
thing  to  be  secured.  It  may  be  extremely  difficult  for  the  patient  to 
do  this,  with  his  mental  and  moral  nature  all  broken  and  in  ruins,-' 
with  no  heart  to  feel,  and  will  to  execute ;  and  yet  it  must  be  done, 
or  a  cure  cannot  be  effected. 

To  bring  this  about,  everything  must  be  done  by  the  physician  to 
strengthen  the  moral  nature  of  the  patient,  and  to  raise  his  self-respect 
and  hope.  The  most  careful  directions  must  be  given  for  restraining 
the  imagination.  The  patient  must  be  directed  and  encouraged  to 
drive  out  from  the  mind,  instantly,  and  upon  all  occasions,  every 
lascivious  thought ;  to  cultivate  the  society  of  the  most  intellect- 
ual and  virtuous  females ;  to  make  himself  busy  with  useful  and,  if 
possible,  agreeable  employment ;  to  avoid  solitude ;  and  to  sleep 
with  some  friend.  He  should  sleep  on  a  mattress,  and  never  on 
feathers. 

Where  there  is  considerable  debility,  tonics  will  be  required,  as  the 
mineral  acids  (60)  (62)  (78),  and  bitters  (77)  (67)  (66)  (59),  and 
strychnine  (83)  (95)  (85),  and  iron  (80)  (93)  (72)  (73)  (71).  In  addi- 
tion to  some  of  the  above  preparations,  the  syrup  of  the  hypopbos- 
phites  should  be  taken  for  some  time. 

The  food  should  be  nutritious  and  easy  of  digestion,  and  the  cold 
alkaline  sponge  bath  should  be  taken  once  a  day,  with  brisk  rubbing ; 
and  the  private  parts  should  particularly  be  washed  daily  with  cold 
water. 

In  conclusion,  I  say  emphatically  to  parents,  do  not  let  yoiu  soxui 

43 


838 

VENEREAL  OB  SEXUAL  DISEASES. 

and  daughters  remain  ignorant  on  this  subject.     It  is  plainly  your 
duty  to  enlighten  and  to  warn  them.     It  is  a  matter  in  which  young 
persons  are   generally  disposed  to   do  right,   if  rightly   instnutctl. 
Avnil  yourself  of  your  right  to  give  counsel,  and,  if  need  be,  to  um' 
authorfty. 

' 

y 

.    ■  ,      '.                 1 

^'~ . 

'  ■       : 

'--■■>■.' 

1  , 

' 

- 

- 

i 

•   . 

- 

linly  your 
ch  youiie; 
nstrncteil, 
be,  ft)  um' 


=^1 


n 


FEMALE   DISEASES. 


In  aVtdition  to  the  diseases  common  to  both  sexes,  women  are 
subject  to  a  class  of  distressing  complaints  peculiar  to  themselves, 
and  denominated,  in  general  ♦ci-ms,  female  diseases.  Involving  con- 
siderations of  a  delicate  nacure,  these  complaints  have  too  generally 
and  too  long  been  shut  out  from  works  intended  for  popular  distribu- 
tion. Hence  there  is  a  general  ignorance  of  a  class  of  diseases  which 
are  fast  unfitting  woman  for  the  high  duty  of  continuing  the  race ; 
and  the  subjects  of  these  maladies  are  generally  themselves  so  unin- 
formed of  the  true  nature  of  their  sufferings,  that  they  are  neither 
prepared  to  seek  relief  in  the  proper  direction,  or  to  submit  to  the 
remedy,  if  it  chance  to  be  proposed. 

It  is  intended  here  to  speak  of  these  disorders,  as  I  have  done  of  all 
others,  in  a  plain  and  simple  way,  to  describe  them,  so  far  as  the 
present  state  of  medicine  permits,  just  as  they  are,  and  to  make 
known  the  only  modes  of  treatment  which  have  been  found  available 
for  their  cure.  The  sufferings  of  woman  require  this ;  the  interests 
of  humanity  require  it ;  and  the  writer  is  impelled  to  it,  as  he  thinks, 
by  a  just  sense  of  responsibility. 

Physicians,  in  my  judgment,  are  chargeable  with  a  great  wrong  in 
concealing  within  their  own  breasts  information  upon  what  are  called 
delicate  subjects,  —  information  which  the  good  of  the  world  requires 
should  be  divulged,  and  which  they  ought  to  pour  into  the  public 
mind,  and  make  common,  and  which  they  would  thus  popularize,  but 
for  their  stiff  pride  and  conservatism. 

The  idea  that  our  knowledge  cannot  be  imparted  to  the  world 
without  injuring  the  public  morals,  is  simply  absurd.  We  are  moie 
afraid  of  bringing  the  common  people  too  near  to  us,  of  letting  down 
our  dignity,  and  of  opening  our  profound  secrecta  to  popular  eyes. 
The  result  is  *8  it  should  be,  that  unsophisticated  people  are  apt  to 
give  physicians  a  wide  berth,  and  to  have  nothing  to  do  with  them, 
unless  necessity  compels.  Let  doctors  strip  off  their  reserve,  antl 
while  they  remain  gentlemen,  become  likewise  companions,  impart- 
ing their  knowledge  freely  and  familiarly  to  all,  and  the  public  con- 
fidence, now  considerably  shaken,  will  be  frankly  restored  to  the  pro- 
fession. 

It  should  be  the  object  of  a  good  physician  to  know  all  he  can,  and 
to  impart  h»s  knowledge  to  as  many  «is  possible.     Knowledge  is  not 


340 


FEMALE  DISEASES. 


merely  pjower ;  it  is  happiness,  it  is  wisdom,  it  is  health,  it  is  virtue ; 
yes,  it  is  always  virtue,  except  'n  some  rare  instances,  where  the  worst 
natures  pervert  it.  No  physicians  are  so  much  loved  as  those  who 
are  frank,  and  have  no  concealments.  The  day  for  mysterious  nods 
of  the  head,  and  rollings  of  the  eyes,  and  shrugs  of  the  shoulder,  has 
gone  by.  Men,  and  women  too,  (or  those  of  them  who  are  wise), 
wish  to  know  distinctly  what  their  diseases  are,  and  what  is  neces- 
sary, not  to  palliate  and  prolong,  but  to  cure  them. 

Time  trheu  Female  Diseases  Begin.  —  Female  complaints  begin  to 
make  their  appearance  at  the  period  of  lae  called  puberty,  —  the  time 
when  the  girl  passes  from  childhood  to  womanhood.  This  is  the 
period  when  menstruation  is  established,  which  consists  of  a  discharge 
horn  the  genital  organs,  composed  of  blood  and  mucus,  and  which 
occurs,  when  regular,  every  four  weeks.  Up  to  this  period,  the  system 
of  reproduction  has  remained  dormant  By  the  intervention  of  this 
mysterious  function,  the  young  female  becomes  a  new  being.  The 
heart  unfolds  itself  to  new  emotions ;  the  mind  assumes  a  solidity 
before  unknown,  and  even  the  body  acquires  beauty  from  a  sudden 
rotundity  of  form. 

This  is  the  period  when  the  great  question  of  female  health  is  very 
apt  to  be  settled  once  for  all,  and  for  life.  The  girl  who  is  well 
trained  at  this  time,  generally  has  a  foundation  laid  for  health  and 
character,  which  is  worth  more  to  her  than  riches.  At  no  time  does 
the  mother  need  so  much  wisdom  and  knowledge  as  now.  To  es- 
tablish the  health  and  develop  the  alTectiuns  of  the  daughter  at  this 
critical  period,  is  a  sacred  trust  which  she  can  devolve  upon  no  other 
being;  nor  can  she  meet  her  responsibilities  at  this  time,  unless  better 
informed  than  most  mothers  are.  The  general  apathy  in  regard  to 
this  maternal  duty  is  deplorable. 

False  Delicaey.  —  The  refined  delicacy  which  withdraws  these  sub- 
jects Lom  the  public  gaze,  is  commendable,  for  it  casts  a  beautiful 
charm  over  society ;  but  when  carried  so  far  as  to  spread  a  veil  even 
over  the  eyes  of  mothers,  it  is  quite  unnaturdl,  and  leads  to  the  worst 
results ;  for  in  the  bad  management  of  girls  at  this  critical  period  is 
laid  the  foundation  of  many  of  the  diseases  vhich  shatter  the  consti- 
tution of  so  many  women.  For  this  bad  management,  it  is  not 
mothers  alone  who  are  to  be  blamed.  The  neglect  of  the  medical 
profession  to  furnisn  the  necessary  information  should  come  in  for  its 
full  share  of  reproacl'. 

Tlie  Establishment  of  tlie  Menses.  —  Nature  always  comes  slowly 
and  by  degrees  to  the  inauguration  or  establishment  of  any  of  her  great 
functions.  It  is  so  in  regard  to  menstruation,  or,  as  it  is  variously 
called,  "the  menses,"  "the  courses,"  "the  change,"  "the  flowers," 
"  nature,"  etc.  For  some  time  before  the  flow  begins,  there  are  cer- 
tain symptoms,  or  premonitions,  which,  to  the  eye  of  the  physician, 
plainly  enough  foretell  the  impending  change.  To  the  mother  these 
signs  would  be  equally  intelligible,  were  she  as  well  infor""ed  as  she 
should  be.    It  is  plainly  her  duty  to  be  intelligent  enough  to  assist 


".a  •-vu|•■tars,\,^yaac■- 


is  virtue ; 
he  worst 
lose  who 
ious  nods 
jldcr,  has 
re  wise), 
is  neces" 


begin  to 
the  time 
lis  is  the 
discharge 
nd  which 
le  system 
on  of  this 
ng.  The 
a  solidity 
a  sudden 

Ith  is  very 
lo  is  well 
ealth  and 
time  does 
r.  To  es- 
:er  at  this 
1  no  other 
less  better 
regard  to 

these  sub- 

.  beautiful 

L  veil  even 

the  worst 

period  is 

the  consti- 

it  is  not 

e  medical 

B  in  for  its 

les  slowly 
f  her  great 
variously 
flowers, 
'e  are  cer- 
pliysician, 
ither  these 
"cd  as  she 
I  to  assist 


FEMALE  DISEASES. 


341 


nature  in  the  establishment  of  this  important  function.  But  how 
often,  either  from  ignorance,  or  from  false  ideas  of  delicacy,  does  she 
fail  to  interfere,  and  allow  the  daughter  to  be  taken  by  surprise,  and 
perhaps  frightened  and  thrown  into  convulsions! 

From  inquiries  made  of  about  one  thousand  women,  a  distin- 
guished English  physician  found  that  about  one  quarter  were  unpre- 
pared for  the  appearance  of  the  menses.  Some  of  the  girls  were 
frightened  and  went  into  hysterical  fits ;  others  thought  they  were 
wounded,  and  washed  with  cold  water.  The  flow  was  stopped  in 
several  cases;  and  in  some,  never  restored;  while  the  health  of  all 
in  whom  it  was  interrupted,  was  seriously  impaired. 

Syniptonis  of  the  First  Henstmatton.  —  A  variety  of  symptoms  pre. 
cede  and  foretell  the  first  menstruation.  Headache,  dizziness,  slug- 
gishness of  thought,  and  disposition  to  sleep  ;  —  these,  occurring  in  a 
girl,  may  be  taken  as  hints  that  the  "change"  is  at  hand.  If  to  these 
be  added  pains  in  the  back  and  lower  limbs,  the  intimations  will  be 
still  more  significant. 

At  this  time  a  girl  loses  a  relish  for  the  society  of  children ;  she  is 
apt  to  acquire  a  taste  for  solitude  ;  her  temper  becomes  wayward  and 
fretful ;  her  eyes  acquire  a  peculiar  lustre ;  she  becomes  a  sort  of 
mystery  to  her  friends  and  herself, — not  her  physical  frame  only;  her 
whole  character  is  changed.  She  is  about  stepping  into  a  new  life. 
Her  emotions,  thoughts,  anticipations,  retrospections,  are  all  new  to 
her,  and  her  outward  manifestations  are  new  to  her  friends.  An  in- 
telligent mother  will  not  fail  now  to  prepare  her  mind  for  the  impor- 
tant event  close  at  hand. 

The  ape  at  trhich  this  change  takes  place,  depends  very  much  upon 
a  variety  of  circumstances.  It  occurs  much  earlier  in  warm  than  in 
cold  climates.  It  is  hastened  by  high  living;  by  the  whirl,  and  bustle, 
and  excitement  of  city  life  ;  by  reading  novels  which  are  full  of  love 
incidents  ;  by  attending  balls,  theatres,  and  parties ;  and  by  mingling 
much  in  the  society  of  gentlemen. 

Early  Henstmation  not  Desirable.  —  It  is  a  law  both  in  animal  and 

vt  3;etable  life,  that  the  later  the  period  at  which  maturity  is  reached, 

the  greater  the  solidity  of  the  body,  and  the  longer  it  lives.     Girls 

"ho  menstruate  early,  do  so  because  the  body  is  weakened  by  climate 

luxury,  and  the  nervous  system  unduly  developed  by  excitement ; 
while  those  who  come  late  to  womanhood,  have  firmer  constitutions, 
enjoy  better  health,  and  live  longer.  Those  mothers,  therefore,  com- 
mit great  errors,  who  are  anxious  and  administer  "forcing  medicines," 
because  their  daughters  do  not  menstruate  at  fourteen  or  fifteen.  If 
girls  are  sufli^ring  from  no  special  ill  health,  no  anxiety  need  be  felt  if 
"the  custom  of  women"  do  not  come  to  them  till  the  age  of  eighteen, 
or  even  twenty.  The  delay  should  excite  thankfulness  rather  than 
regret.  It  shows  that  the  constitution  has  not  in  it  the  seeds  of  early 
dissolutiv/U  ;  that  it  is  fortifying  itself  against  future  disease. 

Girls  who  come  thus  tardily  to  maturity,  are  much  more  "regular" 
in  after  life.     They  bear  children  with  fewer  accidents,  and  are  af- 


I 


.'1 
•I 


•^li 


'M2 


FEMALE  DISEASES. 


dieted  much  less  with  female  diseases.  The  duty  of  mothers  is  plain; 
it  is  to  bring  their  daughters  forward  as  late  as  possible,  by  refusing 
their  early  admission  to  society,  by  withdrawing  from  them  all  excit- 
ing reading,  by  prohibiting  their  early  attendance  at  concerts  and 
theatrical  entertainments,  by  prescribing  for  them  the  most  unstimu- 
lating  diet,  and  by  requiring  a  large  amount  of  exercise  in  the  open 
air. 

A  wide  investigation  has  shown  that  the  first  menstruation  occurs, 
in  hot  climates,  at  the  average  age  of  thirteen  years  and  nineteen 
hundredths ;  in  temperate  regions,  at  fourteen  years  and  seventy-four 
hundredths ;  in  cold  latitudes,  at  sixteen  years  and  fifty-three  hun- 
dredths. Under  the  hot-house  culture  of  modern  society,  and  espec- 
ially among  the  wealthy  classes,  where  indolence,  luxury,  and  excite- 
ment, unite  to  weaken  the  constitution,  this  change  is  constantly 
occurring  at  a  more  tender  age. 

How  Female  Diseases  p.re  induced.  —  All  living  things  have  their 
origin  in  germs.  The  germ  from  which  the  higher  animals  spring, 
man  included,  is  an  ovum,  or  egg:  Every  animal  and  every  vegetable 
is  provided  with  an  organ  for  the  production  of  germs.  In  woman, 
this  organ  is  called  ovary.  There  are  two  ovaries,  about  half  an  inch 
in  length,  —  one  lying  on  each  side  of  the  womb,  to  which  they  are 
attached  by  ligaments,  or  cords.  The  ovarian  bodies  contain  vast 
numbers  of  vesicles,  or  cells,  or  eggs,  which  are  the  true  germs  of 
human  life,  and  the  only  sources  from  which  it  can  spring. 

Between  the  ages  of  fourteen  and  forty-five  (speaking  in  general 
terms),  every  healthy  woman  matures  and  deposits  an  ovum  once  in 
twenty-eight  days.  This  vesicle,  some  time  before  the  monthly  flow, 
begins  to  germinate  and  swell,  and  after  a  time,  like  a  grain  of  wheat 
in  the  earth,  it  bursts  its  covering,  and  springs  forth.  It  then  passes 
through  what  is  called  the  fallopian  tube  into  the  womb,  whence  it  is 
cast  off". 

During  the  swelling  and  bursting  of  this  vesicle  or  germ,  the  ves- 
sels of  the  ovaries,  and  womb,  and,  particularly,  of  the  membrane 
lining  the  womb  and  its  neck,  are  so  crowded  with  blood  as  to  pro- 
duce in  the  parts  a  state  of  congestion.  If  the  parts  be  examined 
with  a  speculum  at  this  time,  they  will  be  found  red,  sensitive,  and 
almost  inflamed.  So  great  is  this  congestion,  that  the  woman  often 
complains  of  pain  in  the  ovaries  and  the  womb,  —  and  a  general 
sense  of  heat,  aching,  and  dragging  down  in  the  lower  part  of  the 


bowels.     The 
thighs. 


pain  often  extends  to  the  back,  the  groins,  and  the 


This  Condition  Repeated  Every  Montli.  —  When  we  consider  that 
this  state  of  things  is  repeated  every  four  weeks,  and  that  the  con- 
gested or  crowded  state  of  the  vessels  begins  some  days  before  the 
monthly  flow,  and  lasts,  in  all,  some  ten  days,  making  about  one  third 
part  of  every  month,  we  need  not  wonder  that  inflammation  so  often 
supervenes,  with  all  its  attendant  ill  health  and  suflferings. 

Increased  by  Various  Causes.  —  If  we  reflect,  further,  that  this  con- 


31 


is  jplain; 

refusing 

all  excit- 

jerts  and 

unstimu- 

the  open 

1  occurs, 
nineteen 
^enty-four 
iree  hun- 
nd  espec- 
nd  excite- 
instantly 


lave  their 
lis  spring, 
vegetable 
n  woman, 
If  an  inch 
h  they  are 
itain  vast 
germs  of 

\n  general 
n  once  in 
ithly  flow, 
1  of  wheat 
hen  passes 
hence  it  is 

n,  the  ves- 
membrane 
as  to  pro- 
examined 
sitive,  and 
fnan  often 
a  general 
art  of  the 
i,  and  the 

isider  that 
t  the  con- 
before  the 
i  one  third 
n  so  often 


t  this  con* 


FEMALE  DISEASES. 


343 


gestion  is  increased,  amon^  the  wealthy,  by  high  living,  and  among 
all  classes,  by  over-stimulation  of  the  nervous  system,  and  by  the  las- 
civious morals  of  the  age,  we  see  stronger  reasons  for  expecting,  — 
what  is  really  occurring,  —  a  continually  increasing  amount  of  suiier' 
Ing  from  female  diseases. 

And  when  we  know,  still  further,  that  American  females  are  care- 
loss  of  their  health  ;  that  they  often  attend  balls  and  theatres  at  the 
very  time  of  suffering  from  this  monthly  affliction ;  that  they  fre- 
quently wet  their  feet,  and  otherwise  expose  themselves  to  colds,  we 
cannot  feel  surprise,  even  when  we  learn  that  from  one-half  to  thrse- 
fourths  of  all  women  in  cities,  and  quite  a  large  proportion  of  them 
in  the  country,  have  inflammation  of  the  ovaries,  or  of  the  womb,  or 
of  the  neck  of  the  womb,  or  suffer  some  of  the  forms  of  displace- 
ment of  this  latter  organ. 

Child  Bearing.  —  The  inflammatory  state  of  the  uterine  organs  is 
often  induced  by  injuries  received  in  child-bearing,  and  by  excessive 
indulgence  in  sexual  pleasures.  ^  ,  _     ; 

WeaJiness  of  the  Sexual  System.  —  The  womb,  moreover,  like  any 
other  organ,  may  be  naturally  frail,  and  easily  affected  by  disease. 
This  weakness  of  the  sexual  system  is  indicated  by  the  diflSculty 
with  which  menstruation  is  established,  and  the  presence  of  the 
whites,  both  before  and  after  each  monthly  flow.  Women  in  whom 
the  generative  organs  are  weak,  are  much  more  liable  to  inflamma* 
lion  of  the  womb,  and  to  all  the  complaints  peculiar  to  the  sex. 

Fio.  184. 


Description  of  tlie  Sexnal  Orpns.  —  Before  describing  thn  ^ftipii- 

)ar  diseases  to  which  the  female  generative  organs  are  haole,  it  is 
proper  to  give  the  reader  a  brief  description  of  the  ch'.ef  of  these 
organs. 

Tlie  Womb  itself,  in  its  healthy,  natural  state,  is  about,  two  inches 
long,  and  one  inch  broad,  —  weighing  a  little  more  than  an  ounc;e ; 
and  is  in  shape  like  a  pear.  It  is  lined  v;  -th  a  mere  rudimentary 
mucous  membrane. 

Tlie  Neck  of  the  Womb  has  a  cavity  distinct  from  that  of  the  body 
of  the  organ,  and  is  lined  with  a  mucous  membrane  well  supplied 
with  follicles  or  glands. 


! 


■A 

n 


mm 

1 

H 

Snn'f 

344 


FEMALE  DISEASES. 


Hie  Fallopian  Tubes  open ,  one  from  each  side  of  the  base,  or  largest 
end  of  the  womb,  and  extend  outward  to  the  ovaries. 

The  Ovaries  are  a  bundle  of  eggs  lying  one  on  each  side  of  the 
base  of  the  womb.  They  are  more  particularly  explained  else- 
where. 

Fig.  134  gives  some  idea  of  these  organs.  A,  is  the  body  of  the 
womb ;  B,  the  neck  of  the  womb ;  C,  C,  the  vagina ;  D,  one  of  the 
ovaries ;  F,  F,  the  fallopian  tubes ;  E,  E,  the  fimbriated  extremi- 
ties ;  G,  the  small  ligament  attaching  the  fimbriated  extremity  to  the 
ovary. 

luflammation  of  the  Neck  of  the  Womb.  —  Inflammation  of  the 
body  of  the  womb  is  a  comparatively  rare  disease,  but  inflammation 
of  the  neck  of  this  organ  is  so  common  that  in  nearly  nineteen  out 
of  twenty  cases,  wlien  females  seek  relief  for  whites,  for  painful  men- 
struation, for  stoppage  of  the  menses,  or  even  for  what  they  suppose  to 
be  falling  of  the  womb,  a  careful  examination  will  show  that  this 
pendent  portion  of  the  womb  is  in  a  state  of  marked  inflammatioii, 
or  of  absolute  ulceration.  The  whites,  if  they  continue,  without  in- 
termission, from  one  menstrual  flow  to  another,  are  almost  always  the 
result  of  one  of  these  conditions  of  the  uterine  neck. 

It  would  surprise  most  persons,  out  of  the  medical  profession,  and 
many  physicians,  to  know  how  large  a  proportion  of  the  more  grave 
diseases  which  inflict  such  terrible  suffering  upon  woman,  and  so 
completely  shatter  her  constitution,  are  dependent  for  their  exist- 
ence upon  a  simple  local  inflammation,  either  in  the  neck  of  the 
uterus,  or  in  one  or  both  of  the  ovaries.  Many  a  female  has  for 
years  sufiered  agonies  greater  than  those  of  death  itself,  arising,  as 
she  supposed,  from  a  complication  of  ills  which  invade  every  part  of 
the  system,  while  the  whole  of  her  troubles  arose,  in  fact,  from  an 
inflamed  spot  which  could  be  covered  by  the  ball  of  the  finger. 

Difficulties  of  Studying  Uterine  Diseases.  —  The  facts  stated  above 
have  been  but  a  short  time  known  to  medical  mesi ;  and  to  large 
numbers  of  the  profession,  are  still  unknown.  The  reason  is,  that 
very  serious  obstacles  have  stood  in  the  way  of  studying  the  diseascM 
of  womfen. 

The  social  relations  of  the  sexes,  and  the  great  delicacy  of  the 
matters  to  be  investigated,  were  long  the  cause  of  inquiries  and  ex- 
aminations so  indirect  that  little  knowledge  was  gained,  and  as  little 
benefit  conferred. 

Woman,  always  distinguished  for  her  modesty,  could  not  be  ex- 
pected to  invite  investigations  which  were  not  proffered,  whatever  the 
extremity  of  her  suflerings ;  and  man,  scrupulously  sensitive  lest  he 
should  make  himself  an  intruder  by  stepping  within  delicate  inclos- 
ures,  have  both,  in  times  past,  mistaken  their  duty  by  misinterpreting 
the  demands  of  the  highest  delicacy. 

NeedAil  Examinations  not  Indelicate.  —  Rightly  viewed,  no  inqui- 
ries or  examinations  are  indelicate  which  are  necessary  to  a  full  un- 
derstanding of  the  nature  of  disease,  and  which  are  made  with  th» 


or  largest 

de  of  the 
ined  else* 

xly  of  the 
ne  of  the 
extremi- 
lity  to  the 

on  of  the 
ammatioi) 
leteen  out 
nful  men- 
juppose  to 
that  this 
immation^ 
athout  in- 
ilways  the 

ssion,  and 
nore  grave 
in,  and  so 
heir  exist- 
Bck  of  the 
.le  has  for 
arising,  as 
ery  part  of 
t,  from  an 
ger. 

ated  above 
d  to  large 
on  is,  that 
le  diseases 

icy  of  the 
js  and  ex- 
nd  as  little 

lot  be  ex- 
latever  the 
ve  lest  he 
ite  inclos- 
iterpreting 

no  inqui> 

a  full  un- 

1  with  th» 


344 


FEMALE  niSEASBS. 


The  Falkiplaii  Tul»es  opf-n,  o\w.  from  paoh  side  of  the  btts- ,  t>r  jarf^!«t 
eiwi  "f  tf'c  womb,  and  extend  outward  to  the  ovaries. 

Thr  Ovaries  are  a  bundle  of  eggs  Ijr'mg  one  on  each  *sikf-  t%i  !}>«• 
bnse  of  (he  womb.  They  are  more  particularly  exfulai'.Msd  eh*,  - 
where. 

Fig.  134  gives  Bome  idea  of  these  organs.  A,  is  tho  St>iiy  of  th« 
womb ;  B,  tno  neck  of  the  womb ;  C,  U,  the  vagina ;  I).  oi»t>  o/'  th*- 
ovaries;  F,  F",  the  fallopian  tuU-H ;  E,  E,  the  fimbriutrd  extr<"jii»- 
ties  ;  G,  the  small  llgHmeiit  artaching  the  fimbriated  extrt'iuity  to  th« 
ovary. 

Inflflinniiition  of  the  iVeck  of  the  Womb.  —  Innammm'ii  ;>  of  iW 
bo<.l)  of  the  W'Omb  is  a  comparatively  rare  disease,  but  iii'iiiuinnuoo 
of  the  neck  oi  this  organ  is  so  foiumon  that  in  nearly  nm«;io«'Ti  uut 
of  twenty  cases,  \\h<M»  femalea  seek  relief  for  whites,  for  pHinful  men- 
atruaticMi,  fur  «lopjmg<-  of  the  monies-,  or  even  for  what  tlu'v  sapptK**^  U> 
be  falling  of  the  womb,  a  careful  exaaiination  will  show  that  rhi» 
jjtiident  portion  of  the  womb  is  in  a  .state  of  marked  infinmirtaiton, 
fyr  of  absoluie  ulceration.  The  whites,  jf  they  continue,  withont  lo- 
te.nnission,  frotn  one  menstruul  flow  to  another,  are  almost  aiwaya  it>e 
refiult  of  one  of  these  couditions  of  the  uterine  neck. 

It  would  surprise  unost  persons,  out  of  the  medical  profession,  and 
many  physicianh,  to  know  how  large  a  proportion  of  the  more  grave 
diseases  which  inflict  such  t'-rrible  snft'ering  upon  woman,  atid  so 
completely  shatter  her  constitution,  are  dependent  fur  their  fxiat- 
cnce  upon  a  simple  local  inflammation,  either  in  the  neck  of  (h<? 
uterus,  or  in  one  or  both  of  the  ovaries.  Many  a  female  hais  lor 
years  suffered  agonies  greater  than  those  of  death  itself,  arising,  &» 
she  supposed,  from  a  complication  of  ills  which  invade  every  pari  of 
the  system,  while  the  whole  of  her  troubles  arose,  in  fa(!t,  fr^>ia  an 
inflamed  spot  which  could  be  covered  by  the  ball  of  the  finger. 

Diflieiilties  of  Stmlyjnif  I  terine  Diseases.  —  The  facts  stated  alwve 
have  been  but  a  short  time  known  to  medical  men;  and  to  Iviri."- 
numbers  of  the  profession,  are  still  unknown.  The  reason  is,  tii-t 
very  serious  obstsicles  ha'fe  stood  in  the  way  of  studying  the  diseasow 
of  women. 

The  social  relations  of  the  sexes,  and  the  great  delicacy  of  th** 
matters  to  be  investigated,  were  long  the  cause  of  inquiries  and  trx- 
aminations  so  indirect  that  littie  knowledge  was  gained,  and  as  litt4e 
benefit  conferred. 

Woman,  always  distinguished  for  her  modesty,  could  not  be  ex- 
pected to  invite  invt^atigations  which  were  not  proft'ered,  whatever  the 
extremity  of  her  nutFerings;  and  man,  scrupulously  sensitive  lest  he 
should  make  himself  an  intnider  by  stepping  within  delicate  indos- 
ures,  have  both,  in  times  past,  luiBtaken  their  duty  by  misinterpreting 
the  demands  of  the  highest  deln^acy. 

Nce^ifnl  F.xaminations  not  Iti(ii>Ueaite.  —  Rightly  viewed,  no  inqui- 
ries or  examinations  are  indelicate  ^vhich  are  necessary  to  a  full  un- 
derstanding of  the  uttture  of  disease,  and  which  arc  made  with  th» 


ii 


trgi!»t 


•'    t;. 

i-j    to  *(, 

a    of  iW 

ifHi-H  out 
nful  mcM- 

that  rhU 
iininftrion, 
irhoni  io- 
liways  ?h«' 

asion,  ,ui<i 
lore  ^rave 
n,  and  »o 
H'.ir  vmit- 

ie  has  ibr 

ari;vn^,  *» 
vy  jiarl  t>f 
t,  from  an 
tjer. 

\\ed  a'.wvr 
(1  tt»  laria;*.' 
L>n  is,  tbit 
le  diseaacN 

icy  of  ttit' 
^H  and  trx- 
id  as  little 

lot  he  en- 
atevet  the 
ve  lest  he 
itc  inclos- 
iterpreting 

no  inqui- 
a  full  un- 
with  thtf 


J^-^ 


FEMALE  DIhiKASKS. 


345 


sole  purpoHe  of  rendering  its  cure  po88ible.  I  agree  with  Dr.  Meigs, 
the  elder,  that  the  delicacy  or  indelicacy  of  examining  the  persons  of 
fetnaloB  for  the  purpose  of  exploring  disease,  depends  on  the  motive 
with  which  it  is  done.  To  pure-minded  persons,  it  is  never,  I  think,  a 
Bource  of  impurity.  On  the  contrary,  the  self-restraint,  the  honorable 
feeling,  and  the  nice  sense  of  delicacy  which  it  calls  into  exercise, 
often  heighten  the  tone  of  a  man's  virtue,  and  certainly  increase  a  true 
woman's  respect  for  it.  Unfortunately  there  is  now  and  then  a  gross- 
niiiidcd  man  in  the  profession,  who,  in  these  investigations,  will  vio- 
late the  most  sacred  of  all  trusts  committed  to  his  hands ;  but  such 
monsters,  —  few  in  number,  —  soon  find  their  level,  and  are  shunned 
as  the  most  vile  of  the  race. 

It  is  now  so  well  understood  that  these  investigations  do  not  lead 
to  immoralities,  that  the  most  highly  educated,  intelligent,  refined, 
and  virtuous  females,  almost  invariably  raise  the  fewest  objectiuna  to 
Buch  examinations  as  a  physician  of  character  may  propose.  / 

MethcNls  of  Investigatini^  Female  DiseaseH.  —  The  symptoms  of 
these  complaints  will  be  spoken  of  in  their  proper  place,  as  the 
several  diseases  come  under  a  brief  review.  I  merely  wish  to  allude 
here  to  the  methods  of  physical  exploration  which  modern  practice 
has  called  to  its  aid. 

Tlie  Touch.  —  These  methods  consist,  first,  of  wiiat  is  called  the 
j   touchf  which  is  made  either  externally  upon  the    bowels,  or  inter- 
I   nally,  with  the  index  finger,  through  the  vagina,  or  passage  from  the 
external  genital  organs  to  the  neck  of  the  womb. 

j       The  Specnllllll.  —  In  the  second  place,  of  ocular  inspection  of  the 

i  vagina  and  neck  of  the  uterus,  through  an  instrument  called  the  spec- 

j  ulum.     By  this  instrument,  the  eye,  as  well  as  the  finger,  is  made  to 

I  assist  in  learning  the  real  condition  of  the  parts. 

j  The  finger  informs  us  whether  there  is  any  deviation  from  nature 
in  the  bulk,  the  firmness,  the  smoothness,  or  the  sensibility  of  the 

'  parts ;  while  the  siffht,  through  the  speculum,  affords  absolute  cer- 
tainty as  to  whether  the  parts  are  suffering  from  inflammation,  ulcer- 
ation, abrasion,  or  eruption.     The  following  is  the  best  form  of  spec- 

!  ulum  yet  used. 

rn.ut 


The  end  is  so  shaped  as  to  catch  the  neck  of  the  womb,  and  then 
by  drawing  the  instrument  forward  slightly,  the  diseased  surface  is 
presented  for  as  perfect  inspection  as  if  located  externally. 


Inflammation,  Ulceration,  and   Enlargement  of  the 

Heok  of  the  Womb. 

Inflammation  of  the  neck  of  the  uterua  is  very  common ;  ulcera- 
tion and  permanent  enlargement  (technically  called  hypertrophy),  are 
its  results,  when  it  is  not  arrested  in  due  time.  These  aflections,  in 
fact,  and  the  same  troubles  as  they  afTect  the  ovaries,  make  up  the 
bulk  of  female  diseases,  —  being  the  real  causes  of  the  most  of  lluwe 
symptoms  which  have  passed  under  the  name  of  whites,  suppres»iun, 
painful  menstruation,  sterility,  general  debility,  etc. 

The  neck  of  the  womb,  when  healthy,  is  soft  and  smooth.  No 
hardness  or  condensation  of  tissue  can  be  felt  by  the  finger,  on  preHit- 
ing  over  it.  It  is  elastic,  too,  and  feels  unctuous  to  the  touch.  This 
latter  sensation  is  communicated  by  the  layer  of  mucus  winch  covers 
it.  Pressure  upon  it  produces  no  pain.  Platk  VII.,  Fig.  1,  is  a 
fine  specimen  of  the  size,  shape,  color,  and  appearance  of  a  healthy 
womb. 

Inflammation,  when  found  in  this  part,  may  begin  in  the  mucous 
membrane  which  covers  the  neck,  or  in  that  which  lines  its  cavity,  or 
in  the  small  glands  in  the  body  of  the  organ. 

Syniptonis.  —  Inflammation  of  the  mucous  membrane  covering  the 
neck  of  the  uterus,  destroys  the  unct'ious  feel  which  it  has  in  health. 
It  also  causes  the  neck  to  swell,  its  vessels  being  crowded  full  of 
blood.  If  the  body  of  the  organ,  as  well  as  the  surface,  be  reached 
6y  the  inflammation,  it  will  be  hardened,  as  well  as  enlarged;  and  in 
consequence  of  its  increased  weight,  it  is  apt  to  drop  down  somewhat 
into  the  cavity  of  the  va«^ina.  In  married  ladies,  it  is  often,  by  physi- 
cal pressure,  pushed  a  little  backward,  or  retroverted.  Examination 
with  the  speculum,  shows  the  inflamed  neck  to  be  of  a  vivid  red, 
instead  of  a  pale  rose-color.  It  may  be  covered  with  red  or  white 
pimples,  which  are  glands  enlarged  with  muco-pus. 

In  the  healthy  state,  the  mouth  of  the  womb  is  so  much  closed  as 
to  be  just  perceptible  when  the  finger  passes  over  it.  Inflammation 
causes  it  to  be  more  or  less  open,  and  its  lips  to  be  parted. 

Inflammation  Followed  by  Ulceration.  —  In  a  majority  of  cases,  in- 
flammation of  the  neck  of  the  womb  and  of  its  cavity,  is  soon  fol- 
lowed by  ulceration,  which  generally  appears  first  around  the  mouth, 
and  just  within  the  cavity  of  the  neck.  From  thence  it  spreads  both 
inward  and  outward.  Plate  VII.,  Fig.  3,  furnishes  a  good  speci- 
men. 

Tarions  Degprees  of  Ulceration,  etc.  —  Of  course  these  inflamma- 
tions and  ulcerations  mix  and  run  into  each  other  in  all  possible 
forms, — presenting  excoriations,  or  raw  places  ;  granulations,  or  pim- 
ply surfaces ;  and  iiidurations,  or  hardened  parts.  Sometimes  these 
pimply  patches  will  be  red  and  hard,  and  again  the  whole  surface  will 
be  spongy,  and  will  bleed  upon  the  slightest  touch. 

Li  many  cases,  these  ulcerations  laakj  wretched  work  with  the 


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Photographic 

Sciences 

Corporation 


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23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


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CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Mlcroreproductions  /  Institut  Canadian  de  microreproductions  historiques 


FEMALE  DISEASES. 


347 


mouth  of  the  womb,  eating  deeply  into  the  cavity,  and  giving  it  a 
ragged  and  unsightly  appearance.  Plate  VII.,  Fig.  4,  may  be  taken 
as  a  sample. 

Velvety  Feel  from  llcerntioii.  —  Uh^eration  generally  gives  to  the 
surface  on  which  it  exists,  a  soft,  velvety  feel,  which  the  finger  gener- 
ally recognizes.  This  velvety  sensation,  with  the  open  state  of  the 
mouth,  are  the  most  important  evidences  we  can  derive  from  the 
touch,  of  this  form  of  disease. 

The  Discliargfe  from  these  ficers  h  always  Pus,  or,  in  common 
language,  matter.  It  is  sometimes  poured  out  scantily,  at  other  times, 
very  freely.  It  may  be  thick  and  yellow,  or  thin,  and  of  a  lighter 
color. 

The  inflammatory  and  ulcerated  condition  of  the  neck  of  the 
womb,  often  gives  rise  to  pain  ;  and  when  the  seat  of  the  disease  has 
not  been  examined,  as  it  should  be,  this  pain  has  frequently  been 
called  neuralgia.  In  this  way,  ignorance  has  compelled  neuralgia  to 
stand  sponsor  for  a  great  many  pains  with  which  it  has  had  nothing 
to  do.  -  ' '  ., 

Tliese  Ulcers  Disturb  Menstruntioii.  —  Menstruation  is  generally 
changed,  more  or  less,  in  its  character,  by  the  presence  of  inflamma- 
tion or  ulceration  in  the  neck  of  the  womb.  It  usually  becomes  more 
painful.  In  some  cases  it  is  made  more  profuse,  in  others  more  scanty. 
It  may  come  on  more  frequently,  or  it  may  be  postponed,  protracted, 
or  abridged  in  its  continuance.  There  is  generally  pain  of  a  dull, 
aching  kind,  low  down  in  the  back.  There  is  often  a  feeling  of  ful- 
ness, pain,  and  a  sense  of  bearing  down  in  the  lower  part  of  the 
bowels ;  sometimes  the  pain  extends  to  the  groins  and  thighs. 

Exteusive  Disturbances  from  these  luflamiiiatioiis,  etc. — The  nerves, 
with  which  the  womb  is  liberally  supplied,  belong  to  those  of  the 
sympathetic  system.  Hence,  the  condition  of  the  uterus  influences  a 
wide  circle  of  sympathies.  By  these  nerves  this  organ  is  brought  into 
close  relationship  with  the  organs  of  animal  life.  If  the  former  suf- 
fer, the  latter  suffers  also.  The  stomach,  being  intimately  connected 
with  the  womb,  physically,  feels  keenly  these  inflammations  and 
ulcerations  of  the  uterine  neck.  At  times,  the  pain,  debility,  general 
disturbance,  and  dyspeptic  state  of  the  stomach  are  such  as  to  cheat 
both  the  doctor  and  the  patient  into  the  belief  that  this  organ  is  the 
seat  of  the  disease.  But  in  such  cases,  the  symptoms  of  stomach 
disease  will  all  disappear  the  moment  the  local  affection  i::  removed 
from  the  neck  of  the  womb. 

The  liver,  too,  often  participates  in  these  troubles,  and  becomea 
sadly  deranged.  It  is  sometimes  even  greatly  .  rged  and  congested, 
and  patients  frequently  have  the  various  symptums  of  what  are  called 
iiver  complaints. 

Severe  pains  are  sometimes  felt  under  the  breast  bone,  and  over 
the  chest  generally,  making  the  patient  apprehensive  of  disease  of 
the  lungs ;  and  indeed  consumption  is  not  a  very  unfrequent  result  of 
uterine  diseases. 


Paina  are  often  felt  in  the  region  of  the  heart,  which  organ  is  often 
harassed  with  palpitations. 

The  flesh  is  apt  to  waste  under  the  symptoms  excited  by  these  in. 
flammatory  and  ulcerative  processes  in  the  uterine  neck ;  and  even 
the  brain,  though  lying  in  some  measure  beyond  the  circle  of  influ- 
ences set  in  motion  by  the  organic  nerves,  suffers  disturbance  and 
pain. 

Even  the  special  senses  of  sight  and  hearing  may  be  drawn  into 
this  general  vortex,  and  both  be  much  impaired.  And  to  crown  tlii.s 
catalogue  of  ill:<,  it  may  be  mentioned  that  those  distressing  thinga 
called  hysterical  fits,  proceed  from  the  same  lo<  ;il  disorders. 

In  brief,  there  is  scarce  a  point  in  the  human  body  to  which  these 
inflammatory  and  ulcerative  conditions  of  the  uterine  neck  may  not 
■end  theii  sympathetic  pains  and  aches,  and  where  they  may  not  in 
time  induce  real  disease.  This  is  the  reason  why  so  many  women 
suffering  from  these  local  complaints,  tell  the  phyiscian,  when  consult- 
ing him,  that  they  are  "  diseased  all  over."  If  asked  where  the  com- 
plaint is  located,  they  will  answer  —  "  It  is  everywhere."  In  the  most 
earnest  manner  the  assurance  will  be  given — ^^  Doctor,  there  isnH  any 
well  part  about  me." 

Treatment.  —  It  is  just  as  unreasonable  and  useless  to  treat  these 
Inflammations  and  ulcerations  through  the  stomach,  as  it  is  an  in- 
flamed or  ulcerated  throat.  They  are  local  diseases,  affectinff  a  par- 
ticular part,  and  the  remedy  must  be  local.  ' 

Like  all  other  affections,  these  can  only  be  managed  intelligently 
after  their  nature  is  well  understood.  Nothing  can  really  be  done  to- 
wards a  cure,  until  it  is  known  what  the  mertter  is ;  and  no  competent 
physician  will  move  a  single  step  in  the  treatment  of  one  of  these 
cases,  until  he  has  made  a  thorough  examination.  He  owes  this  to 
himself  and  to  his  patient,  —  the  more  so  as  the  neck  of  the  womb 
may  be  as  easily  examined  as  the  upper  part  of  the  throat,  and  the 
local  remedy  may  be  almost  as  readily  applied  in  the  former  case  as 
in  the  latter. 

If,  upon  the  introduction  of  the  speculum,  the  uterine  neck  be  found 
simply  inflamed  and  enlarged,  the  application  of  a  strong  solution  of 
nitrate  of  silver,  once  in  five  or  six  days,  will  often  prove  sufficient  io 
reduce  both  the  inflammation  and  the  swelling.  If  it  should  not,  the 
Bolid  stick  should  be  lightly  applied.  If  this  should  not  succeed 
(though  it  will  in  most  cases)  then  introduce  a  speculum,  and  when 
the  neck  of  the  womb  is  fairly  lodged  in  its  extremity,  drop  in  two  or 
three  leeches  and  allow  them  to  fill. 

If  ulceration  be  present,  the  solid  nitrate  of  silver  must  be  applied  to 
the  ulcer  once  in  five  days.  One  who  is  not  accustomed  to  treat  these 
affections  in  this  simple  way,  will  at  first  be  surprised  at  the  rapidity 
with  which  the  local  trouble  will  disappear,  and  with  it,  the  thousand 
and  one  aches  and  pains  which  torment  the  whole  body.  As  the 
terrible  pains  in  the  whole  face  and  head,  which  are  produced  by  a 
single  tooth,  all  instantly  come  to  an  end  when  the  tooth  is  extracted, 
BO  do  the  bad  feelings  all  over  the  body  subside  as  fast  as  the  local 


Till 


rgan  is  often 


;k 


by  these  in- 
and  even 
ircle  of  influ- 
turbance  and 

drawn  into 
crown  tlii.s 
easing  things 
rs. 

which  these 
neck  may  not 
y  may  not  in 
Tiany  women 
vhen  consult- 
ere  the  com- 
In  the  most 
here  is  n't  any 


;o  treat  these 
8  it  ia  an  in- 
'ecting  a  par- 

i  intelligently 
ly  be  done  to- 
no  competent 
one  of  these 
owes  thia  to 
of  the  womb 
roat,  and  the 
Drmer  case  as 

leck  be  found 
g  solution  of 
!  sufficient  to 
lould  not,  the 
not  succeec! 
m,  and  when 
rop  in  two  or 

be  applied  to 
to  treat  these 
;  the  rapidity 
:he  thousand 
•dy.  As  the 
oduced  by  a 
ia  extracted, 
as  tile  local 


FEMALE  DISEASES. 


»49 


ailmenta  of  the  uterine  neck  are  cured.  There  ia  no  exception  to  this 
rule,  except  where  the  sympathetic  affection  has  become  fixed  by  long 
neglect  of  the  primary  uterine  disease.  It  is,  therefore,  surprising 
that  so  many  excellent  women,  whose  lives  are  of  the  greatest  value 
to  themselves  and  friends,  should  be  permitted  to  perish  of  these  ail- 
ments, when  the  cure  is  so  simple,  and  many  times  so  entirely  within 
the  reach  of  the  most  ordinary  skill.  It  is  a  reproach  to  the  profes- 
sion which  should  be  wiped  away. 

If  there  are  a  hundred  motivp^"  for  gaining  the  mastery  over  other 
diseases,  there  are  a  thousand  or  learning  to  control  these.  More 
than  any  other  disease,  or  all  others,  they  make  the  homes  of  men 
(]<  solate,  by  robbing  them  of  woman,  their  ornament  and  solace.  The 
pliysician  who  neglects  to  make  himself  acquainted  v/ith  all  there  is 
to  be  known  of  these  complaints,  shows  himself  not  only  unfit  for  his 
profession,  but  deficient  in  some  of  the  prime  elements  which  combine 
to  make  a  true  man. 

Hardening  of  the  Uterine  Neck,  —  In  many  cases  the  uterine  neck 
is  not  only  intiamed  and  enlarged,  it  is  indurated  and  hardened.  At 
times,  it  is  enlarged  and  hardened  on  one  side,  and  not  much  on  the 
other.  In  still  other  cases,  there  are  enlarged  spots,  or  nodes,  giving 
the  whole  neck  a  knotty  feel  under  the  finger. 

These  hardened  conditions  of  the  uterine  neck  proceed  from  vari- 
ous causes,  and  are  more  difficult  to  cure  than  the  ordinary  inflam- 
mation, or  even  ulceration.  They  sometimes  indicate  cancerous  dis- 
ease, and  then,  of  course,  involve  the  most  serious  considerations.  In 
many  of  these  cases,  nitrate  of  silver  fails  to  produce  its  usual  effects. 
We  then  have  to  resort  to  the  acid  nitrate  of  mercury,  or,  as  it  is 
often  called,  Bennet's  Caustic.  No  definite  rules  can  be  given  as  to 
the  extent  to  which  this  article  should  be  reduced.  It  is  sometimes 
applied  very  strong,  and  immediately  neutralized  by  the  application 
01  water. 


Uterine  Syringe.  —  For  applying  the  several  remedies  to  the  inter- 
nal cavity  of  the  uterine  neck,  I  have  contrived  a  silver  syringe,  which 
is  bent  a  little  at  the  extremity,  and  pierced  with  fine  holes  all  round. 
With  this  instrument,  the  remedy  is  carried  directly  to  the  diseased 
part,  and  applied  instantaneously  to  every  side  of  the  cavity. 

Beside  these  local  applications,  i*  is  frequently  necessary  to  resort 
to  soothing  or  astringent  injections  into  the  vagina,  hip  baths,  and 
injections  into  the  bowels,  some  mild  physic,  and  rest  in  a  horizontal 
position.  These  matters  will  all  be  judiciously  regulated  by  the  at- 
tending physician,  if  he  is  master  of  his  business.   .     , 

Case  I. —  Mrs.  F.  applied  for  relief  from  incessant  bearing  down, 
pains  in  the  back  and  hipsj  pressure  upon  the  top  of  the  head,  palpi- 
tation of  the  heart,  bad  appetite,  the  whites,  and  a  brick-colored  de- 
posit in  the  urine,  after  standing  a  time. 

I  made  an  examination,  and  found  thi  neck  of  the  womb  enlarged 
and  ulcerated,  as  in  Plate  VII.,  Fig.  4. 

There  was  no  doubt  as  t»  the  treatn'ent  re'][U<rcd.     I  applied  th« 


\  B 


■ 


il 


350 


FEMALK  DISEASES. 


solid  nitrate  of  silver  to  the  ulcerated,  surface  once  in  five  daya,  for 
three  months,  —  at  the  same  time,  building  up  the  health,  which  was 
much  broken,  by  iron  and  other  tonics  (75)  (63),  by  a  generous  diet, 
and  by  gentle  exercise  in  a  carriage. 

The  appetite  and  general  health  came  back,  the  whites  and  pains 
all  disappeared,  and  the  patient  felt,  as  she  said,  "  like  a  new  being." 

Case  II.  —  Mrs.  C,  the  mother  of  two  children,  had  suffered,  siry.e 
the  birth  of  the  second  child,  great  pain  low  down  in  the  back,  with 
bearing  down,  and  a  distressing  desire,  a  good  part  of  the  time,  to 
pass  water.  She  had  a  continual  discharge  from  the  vagina,  of  a 
cream-like  matter,  which  very  much  reduced  her  strength.  Beside 
these  symptoms  she  had  pains  everywhere,  particularly  in  the  head. 

An  examination  revealed  that  the  neck  of  the  womb  was  much 
enlarged  and  hardened,  and  badly  ulcerated  about  the  mouth.  (See 
Plate  VII.,  Fig.  3.) 

Once  in  six  days,  the  solid  nitrate  of  silver  was  applied  to  the 
ulcerated  surface.  This  was  done  fire  times,  which  caused  the  ulcer 
to  heal,  but  did  not  reduce  the  size  of  the  neck,  or  diminish  its  hard- 
ness. 

To  effect  these  objects,  I  touched  the  whole  hardened  surface  with 
acid  nitrate  of  mercury,  and  immediately  pressed  upon  the  cauterized 
surface  a  sponge  saturated  with  water.  I  repeated  this  twice,  that 
the  acid  might  not  penetrate  too  deep.  These  operations  were  re- 
peated once  a  week,  for  six  weeks,  —  thirty-drop  doses  of  syrup  of 
iodide  of  iron  being  given,  in  the  mean  time,  three  times  a  day,  with 
a  vegetable  bitter  and  mineral  acid  (63).  At  the  end  of  this  time,  the 
hardness  had  given  way,  and  the  uterine  neck  was  brought  down  to 
near  its  ordinary  size.  The  other  symptoms  disappeared,  and  the 
patient  has  had  no  return  of  her  sufferings. 

Inflammation,  etc.,  of  the  Ovaries. — Ovaritis. 

The  inflamed  condition  of  the  ovaries  is  indicated  by  increased 
heat,  and  pain  upon  pressure.  The  pain  in  the  ovarian  region  is 
sometimes  intermittent,  sometimes  constant,  and  occasionally  passes 
down  to  the  lo>iis  and  thighs. 

There  are  acute  and  chronic  inflammations  of  the  organs ;  but  it 
will  be  sufficiently  accurate,  in  a  work  of  this  kind,  to  treat  of  them 
as  essentially  n:.c. 

The  effects  of  inflammation  upon  the  ovaries,  as  upon  other  bodies, 
are  various,  sometimes  enlarging  and  hardening,  at  other  times,  col- 
lapsing and  blasting  them.  This  last  effect,  it  is  hardly  necessary  to 
say,  cuts  off  all  hope  of  bearing  children. 

The  Causes  of  ovarian  inflammation  are  numerous.  One  of  the 
most  important  causes  has  already  been  noticed,  namely,  the  conges- 
tion of  the  parts,  for  several  days,  at  every  menstrual  period.  This, 
amounting  as  it  does  almost  to  inflammation,  is  often  intensified  by 
other  causes,  such  as  wetting  the  feet,  taking  sudden  colds,  excessive 
fatigob  [torn  dancing,  an*l  excit-ng  drinks. 


five  clays,  for 
h,  which  Was 
generous  diet, 

es  and  pains 
new  being." 

mffered,  airy.e 
e  back,  with 
the  time,  to 
vagina,  of  a 

igth.     Beside! 

n  the  head, 
was  much 

mouth.     (See 

pphed  to  the 
sed  the  ulcer 
inish  its  hard- 
surface  with 
;he  cauterized 
is  twice,  that    | 
ions  were  re-    j 
!  of  syrup  of    j 
!S  a  day,  with 
this  time,  the 
ight  down  to 
ared,  and  the 


haritis. 

by  increased 
ian  region  is 
onally  passes 

rgans ;  but  it; 
reat  of  them 

other  bodies, 
5r  times,  col- 
necessary  to 

One  of  the 
,  the  conges- 
Jriod.  This, 
itensified  by 
ds,  excessive 


FEMALE  DISEASES. 


851 


Sexual  indulgence  often  proves  a  cause  of  inflammation  in  those 
I  bodies.  It  is  particularly  apt  to  have  this  efloct  in  the  newly-married 
female,  with  whom  it  is  a  novel  stimulus,  and  often  applied  with  im- 
moderate excess.  In  late  marriages,  when  the  stimulus  to  tlie  ovaries 
has  long  been  denied,  its  sudden  presentation  is  liable  to  make  an  in- 
flammatory impression.  Its  entire  absence,  too,  in  persons  of  strong 
passions,  may  result  in  ovarian  disease. 

This  inflammation  may  be  produced  by  the  new  state  of  things 
existing  at  the  critical  period  called  the  tvrn  of  life,  when  it  reacts  on 
the  womb,  producing  the  floodings  which  often  bring  menstruation 
to  a  close.  The  congestion,  too,  which  has  been  present  erery  month 
for  many  years,  does  not  immediately  cease  at  this  change  ;  and  not 
finding  relief  by  the  accustomed  flow,  the  ovarian  bodies  are  exposed 
to  inflammation. 

In  all  large  cities,  the  pest-houses  of  civilization,  where  the  women 
are  more  numerous  than  the  men,  there  are  many  females  whose  vir- 
ginity is  a  burden,  and  numerous  others  who  give  themselves  up  to 
sexual  excesses ;  —  to  both  these  classes,  the  turn  of  life  is  very  liable 
to  promote  these  ovarian  disorders. 

There  is  another  class  of  causes,  which,  though  not  so  easily  re- 
cognized, are  equally  cogent  in  exciting  this  form  of  disease.  I  mean 
all  those  excitements  which  arise  from  unbridled  thoughts,  from  books 
of  questionable  character,  from  music,  social  intercourse,  and  stimu- 
lating food  and  drinks,  —  all  which  promote  and  intensify  burning 
desires,  which,  though  natural  and  proper  in  themselves,  cannot  law- 
fully be  gratified  in  a  community  where  the  female  sex  greatly  pre- 
ponderates, numerically,  over  the  male.  When  we  consider  how 
powerful  within  a  woman's  breast  the  conflict  often  is  between  tlie 
impulse  of  passion  and  the  dictates  of  duty,  and  how  strongly  this 
conflict  must  react  upon  the  sexual  organs,  and  especially  upon  the 
ovaries,  the  centre  of  the  sexual  system,  we  can  easily  see  in  how 
many  cases  they  may  become  inflamed. 

Another  cause  of  this  disease  is  suppression  of  the  menses.  The 
engorged  and  crowded  state  of  the  vessels  of  the  womb,  of  the  ute- 
rine neck,  and  of  the  ovaries,  not  finding  vent  in  the  accustomed  flow, 
inflammation  in  any  one  of  these  organs  is  a  very  natural  result. 

The  inflammation  of  these  ovarian  bodies  is  a  frequent  result,  too, 
of  a  similar  condition,  previously  existing  in  the  neck  of  the  womb. 
In  passing  from  the  uterine  neck  to  the  ovarian  bodies,  the  inflamma- 
tory condition  often  fastens  itself  upon  the  broad  ligament,  the  fallo- 
fian  tubes,  and  their  fimbriated  extremities.  (See  Plate  VIIL,  Figs, 
and  2.)  The  whole,  it  will  be  seen,  presents  an  amount  of  disease 
which  it  is  painful  to  contemplate. 

The  womb  being  turned  over,  and  pressing  against  one  of  the 
ovaries,  may  cause  it  to  inflame  by  mechanical  irritation.  Pessaries, 
injudiciously  used,  may  do  the  same  thing. 

Symptoms. —  The  first  and  most  obvious  symptom  is  a  pain  a  little 
to  the  right  or  left  of  the  womb.  This  pain  is  almost  always  increased 
by  walking,  riding,  or  by  external  pressure.    It  is  especially  augmented 


ii 


n 


S«':lt 


352 


FEMALE  DISEASES. 


by  straightening  the  thigh,  by  which  the  parts  over  the  infiamma- 
tion  are  put  upon  the  stretch.  When  standing  up,  ladies  suffering 
from  this  disease,  are  generally  compelled  to  rest  the  foot  on  a  stool, 
so  as  to  bend  the  thigh,  and  relax  the  muscles.  The  pains  radiate 
from  the  ovaries,  and  go  down  to  the  loins  and  thighs,  and  sometimes 
to  the  fundament.     They  are  of  a  dull,  dragging,  heavy  nature. 

Sometimes  the  ovarian  bodies  become  vere  much  enlarged,  and 
dropping  down,  somewhat,  press  upon  the  lower  bowel,  causing  con- 
stipation, or  upon  the  neck  of  the  bladder,  creating  a  frequent  desire 
to  urinate,  and  an  inability  to  pass  the  water  freely. 

I'reatnient.  —  As  inflammation  of  the  ovaries  is  always  increased 
during  the  menstrual  flow,  it  is  not  proper  to  meddle  with  it  at  these 
monthly  periods,  lest  the  trouble  be  aggravated.  Immediately  after 
one  of  the  turns  has  passed,  from  six  to  eight  leeches  should  be  ap- 
plied over  the  diseased  ovary.  When  the  bites  are  healed,  a  blister 
may  be  used  in  the  same  place.  The  scarf-skin  should  not  be  re- 
moved, and  the  irritated  surface  must  be  healed  as  soon  as  possible. 
The  blister  should  be  camphorated  to  prevent  strangulation.  The 
part  should  next  be  rubbed  for  a  few  minutes,  night  and  morning, 
with  an  alterative  and  anodyne  ointment  (169). 

After  the  next  menstruation,  the  same  things  should  be  repeated, 
and  again  after  the  next,  and  so  on,  for  five  or  six  months,  or  even 
longer,  if  need  be.  The  already  bloodless  condition  of  the  patient 
may  require,  however^  that  the  leeches  should  not  be  applied  more 
than  once,  or,  at  most,  twice. 

The  bowels  should  occasionally  be  opened  by  some  simple  cathartic, 
for  the  purpose  of  removing  all  hard  substances  which  may  press 
against  and  fret  the  inflamed  ovaries.  The  purgatives  employed 
should  be  of  the  most  cooling  kind,  such  as  salts  or  oil ;  while  aloes, 
and  all  harsh  cathartics  must  be  avoided. 

Injections  of  tincture  of  belladonna  and  hyoscyamus  are  useful  for 
quieting  neighboring  parts,  and  warding  off  external  disturbances. 
They  act  like  soft  substances  thrown  upon  the  pavement  in  front  of  a 
sick  man's  house. 

The  patient  should  be  kept,  as  much  as  possible,  in  the  recumbent 
position,  lying  upon  the  bed  or  the  lounge,  and  should  only  be  per- 
mitted to  move  about  to  such  extent  as  will  not  irritate  the  inflamed 
parts. 

Case.  —  Miss  R.  M.  B.  suffered  a  great  deal  of  pain  every  month 
while  menstruating.  She  had  also  a  great  tenderness  upon  pressure 
just  at  the  left  of  the  upper  part  of  the  womb,  and  at  times  a  severe 
pain  in  the  same  region,  which  often  extended  down  into  the  groin 
and  thigh. 

The  left  ovarium  was  so  much  enlarged  that  it  could  be  distinctly 
felt  through  the  walls  of  tne  bowels. 

Immediately  after  the  next  monthly  period,  I  applied  six  leeches 
over  the  inflamed  ovarium,  and  when  the  bites  were  healed,  put  a 
blister  over  the  same  region.  After  this  healed,  the  same  space  was 
rubbed,  twice  a  day,  with  an  ointment  (169).     Immediately  after  the 


FEMALE  DISEASES. 


353 


infiamiTia- 
HufFering 
on  a  stool, 
ns  radiate 
sometimes 
fure, 

rged,  and 
using  con- 
lent  desire 

increased 
it  at  these 
lately  after 
uld  be  ap- 
d,  a  blister 
not  be  re- 
is  possible, 
ion.     The 

morning, 

J  repeated, 
hs,  or  even 
he  patient 
plied  more 

e  cathartic, 

may  press 

employed 

vhile  aloes, 

'  useful  for 
sturbances. 
I  front  of  a 

recumbent 
nly  be  per- 
e  inflamed 


ery  month 

in  pressure 

38  a  severe 

the  groin 

!  distinctly 

ix  leeches 
led,  put  a 
space  was 
i  after  the 


courses,  the  same  thing  was  repeated  for  four  months,  —  the  patient, 
each  time,  being  kept  quiet  for  a  few  days,  and  then  permitted  to  take 
gentle  exercise  out  of  doors.     The  diet  was  generally  nourishing. 

The  patient  was  well  at  the  end  of  four  months,  and  has  had  no 
return  of  the  inflammation. 

This  was  a  simple  case,  requiring  only  the  most  simple  course  of 
treatment ;  but  it  furnishes  the  general  outline  to  be  pursued  in  all 
cases  of  inflamed  ovaries. 

"Whites. — Leucorrhcea. — Fluor  Alhus, 

Leucorrhcea  is  from  two  Greek  words,  "Kjevypt  and  pew,  and  fluot 
albus  from  two  Latin  words,  albus  and  fluo,  having  precisely  the 
same  meaning  as  the  Greek,  namely,  a  white  discharge.  Hence,  in 
popular  language,  the  disease  is  called  the  ^'■whites;"  it  is  also  called 
^female  vjea/eness" 

These  terms  are  well  enough,  perhaps,  if  we  have  in  mind  that 
they  convey  to  us  only  the  idea  of  a  symptovi  of  disease.  They  all 
mean,  with  the  exception  of  the  last,  a  white  discharge  from  the 
female  genital  organs.  They  are  slightly  inaccurate,  as  the  discharge 
is  sometimes  yellow,  or  green,  or  otherwise  variant  from  white.  Any 
discharge  from  the  female  genital  organs  which  is  not  bloody^  comes 
under  the  term  "  whites." 

A  Symptom  Only.  —  As  the  name  of  a  disease,  the  term  whites  has 
no  specific  meaning.  It  does  not  designate  any  particular  complaint. 
It  is  a  symptom,  just  as  the  matter  expectorated  and  raised  in  lung 
diseases  is  a  symptom  ;  and  as  such  only  should  it  be  regarded. 
When  persons  cough  and  raise  a  great  deal,  they  do  not,  on  consult- 
ing a  physician,  say  they  have  got  the  expectoration ;  but  they  say 
they  fear  they  have  some  disease  of  the  lungs,  because  they  expecto- 
rate. They  look  upon  the  expectoration  a-,  the  sign  or  symptom  of 
disease. 

So  fenjales,  and  physicians  too,  must  learn  to  look  upon  the  whites, 
not  as  a  disease,  but  as  the  sign  or  symptom  of  disease,  which  sign 
they  should  become  skilled  in  interpreting. 

There  is  no  reason  why  the  discharge  from  the  genital  organs 
should  not  be  as  well  interpreted  as  the  expectoration  or  discharge 
from  the  throat.  The  parts  from  which  it  comes,  may  be  about  as 
easily  and  as  well  inspected. 

3fo  Female  Ailments  so  Common. — There  are  no  female  troubles  to 
which  the  attention  of  the  physician  is  so  often  called  as  these  annoy- 
ing and  debilitating  symptc.ns  called  whites  ;  and  there  is  no  depart- 
ment of  medical  practice,  in  which  the  really  able,  as  well  as  conscien- 
tious and  painstaking  physician,  is  so  well  tested.  If,  regarding  these 
discharges  as  they  are,  simply  as  signs,  he  searches  faithfully  for  their 
cause,  he  will  be  led  to  a  treatment  which  in  a  great  majority  of 
cases  will  be  succesf?ful.  And  surely  no  success  in  life  can  be  more 
prized  by  a  right-minded  physician.     It  procures  health,  the  highcs; 

45 


%...L 


1 


354 


FEMALE  DISKASi;«. 


earthly  boon,  for  suflcrin^'  woman,  and  gratitude,  the  most  prized  of 
all  rewards,  for  himself. 

Tliere  are  Four  Kinds  «f  Disclinr^es  from  the  female  genital  or- 
gans,—  mucus,  pus,  mucus  and  pus  combined,  and  the  watery.  The 
first,  mucus,  does  not,  in  itself,  imply  disease ;  but  when  pus  is  dis- 
charged, we  know  that  inflammation  exists,  because  such  a  cause 
alone  can  produce  it. 

Seat  of  the  Disease.  —  The  cause  which  produces  the  whites  may 
have  its  seat  either  in  the  vagina,  or  in  the  neck  of  the  womb;  and 
in  practice,  it  is  of  course  quite  important  to  know  where  its  location 
is.  Tile  character  of  the  discharge  generally  settles  this  point  If  it 
be  thin  and  watery,  or  thick  and  cream-like,  it  is  from  the  vagina  or 
passage  which  leacls  to  the  womb  ;  if  ropy,  gluey  or  album'nous,  like 
white  of  egg,  it  is  from  the  cavity  of  the  uterine  neck. 

Treatments  —  Some  physicians  always  prescribe  the  same  remedy 
for  the  whites.  They  might  as  well  have  but  one  prescription  for 
expectoration.  The  remedy  must  have  reference  to  the  cause  of  the 
discharge ;  until  the  cause  be  searched  out,  every  prescription  is  a 
mere  trial  at  guessing,  —  a  sort  of  practice  well  enough  adapted  to 
quacks,  but  not  becoming  scientific  men. 

When  a  case  of  whites  is  brought  before  a  physician  who  under- 
stands his  business,  he  makes  no  prescription  until  he  has  discovered 
what  the  disease  is.  Having  determined  this  point,  his  remedies  have 
an  intelligent  bearing  upon  the  case.  This  being  so,  I  have  no  reme- 
dies to  set  down  for  whites,  simply  as  such.  I  shall  proceed,  there- 
fore, to  speak  of  several  other  complaints  which  bear  more  or  less 
upon  this.    For  treatmeut,  see  page  390. 


Absence  of  the  Menses. — Amenorrhcea. 

The  absence  of  the  menses  is  divided  into  two  kinds,  —  retention 
and  suppression.  It  is  retention  when  the  monthly  flow  has  never 
appeared,  —  suppression,  when,  having  been  established,  it  is,  by  one 
cause  or  another,  stopped. 

Retention  Explained.  —  The  ovaries,  as  we  have  before  said,  are 
the  centre  of  the  female  sexual  system.  It  is  the  swelling  or  ripening 
of  an  ovum  or  egg,  every  four  weeks,  which  causes  the  large  now  of 
blood  to  the  parts,  and  the  consequent  menstrual  discharge. 

But  it  sometimes  happens  that  the  ovaries  are  not  developed  at  the 
usual  time  of  life.  The  monthly  evacuation  does  not  then  appear. 
There  is  retention.  There  may  be  retention,  too,  from  other  causes, 
after  the  ovaries  are  matured.  Costiveness  may  sometimes  occasion 
it,  —  so  may  a  degenerated  and  low  state  of  the  blood. 

There  may  be  mechanical  causes  of  retention.  The  mouth  of  the 
womb  may  be  entirely  closed,  or  the  neck  may  be  so  constricted  as 
to  close  the  passage  through  it,  leaving  no  outlet  for  the  monthly  accu- 
mulation.    The  hymen,  also,  may  have  no  opening  through  it    When 


ost  prized  of 

3  genital  or- 
/atery.  The 
pus  is  dis- 
)uch  a  cause 


whites  may 
womb ;  and 
)  its  location 
jK)int  If  it 
the  vagina  or 
iim'nous,  like 


same  remedy 
escription  for 
cause  of  the 
jcription  is  a 
h  adapted  to 

who  under- 
las  discovered 
•emedies  have 
lave  no  reme- 
woceed,  there- 
more  or  less 


Is,  —  retention 
ow  has  never 
1,  it  is,  by  one 

sfore  said,  are 
ng  or  ripening 
:  large  now  oi 
rge. 

veloped  at  the 

;  then  appear. 

other  causes, 

times  occasion 

mouth  of  the 
constricted  as 
monthly  accu- 
agh  it    When 


FEMALE  DISEASES. 


3^50 


these  mechanical  obrttriurtions  exint,  there  are  sometimes  largo  collec- 
tions of  Muitl  in  thi'  womb,  which  cause  enhirgcnicnt  of  the  body,  and 
in  some  inHtanccs,  puiiifnl  suspicions  that  thc^  suHcn'r  has  committed 
imprudences,  and  is  in  the  family  way.  Physicians  should  be  on  their 
guard  against  falling  into  such  errors,  and  lending  the  sanction  of  their 
name  to  these  blasting  mistakes. 

Snppression  Explililied.  —  Suppression,  —  a  stoppage  after  flow  has 
been  once  established,  —  may  be  caused  by  inflammation  of  the  ova- 
ries,—  the  blood,  in  this  diseased  condition,  being  drawn  so  entirely 
to  these  swelling  and  germinating  bodies,  that  the  accustomed  flow 
from  the  womb  does  not  take  place. 

Inflammation  in  the  neck  of  the  womb  may  also  cause  a  stonpaga 
So  may  a  fright,  as  from  a  fire  occurring  in  the  neighborhootl,  or  a 
cold  taken  by  being  caught  in  a  shower.  Girls  sometimes,  in  their 
utter  thoughtlessness  or  ignorance,  dip  their  feet  in  cold  water,  when 
their  courses  are  upon  them,  and  bring  on  a  suppression  of  a  most 
dangerous  character.  The  most  lovely  and  innocent  girls  have  done 
this  for  the  purpose  of  attending  a  party;  and,  in  some  instances,  the 
stoppage  induced  has  ended  in  death  within  a  few  hours.  The  pro- 
found ignorance  of  their  own  mechanism,  and  of  the  laws  which  gov- 
ern it,  in  which  girls  are  kept  who  are  just  budding  into  life,  is  a  seri- 
ous reproach  both  to  parents  and  physicians. 

Suppression  may  be  induced  by  whatever  reduces  the  quantity  or 
quality  of  the  blood,  as  consumption,  or  by  great  depression  of  spirits. 
With  some  rare  exceptions,  woir.en  have  not  their  turns  while  in  the 
family  way. 

Treatment. — Before  anything  can  be  done  in  the  way  of  treatment, 
the  case  must  be  thoroughly  investigated,  and  the  specific  cause  of 
the  disease  searched  out. 

If  it  prove  to  be  retention,  and  arises  from  a  bloodless  condition, 
and  an  undeveloped  state  of  the  ovaries,  iron  is  the  proper  remedy 
(61)  (73)  (74)  (75),  with  a  generous  diet  and  exercise;  .^<,  of  doors. 
If  caused  by  an  inflammatory  state  of  the  uterine  neck  or  ovariee, 
the  proper  treatment  lias  been  already  indicated.  If  from  costiveness, 
relief  may  generally  be  found  from  prescriptions  (5)  (9).  The  me- 
chanical causes  alluded  to  above,  when  found  to  exist,  must  be  removed 
by  gently  dilating  the  mouth  of  the  womb  or  the  uterine  neck,  with 
bougies,  beginning  With  the  smallest,  and  increasing  the  size,  or  by 
puncturing  the  hymen,  as  the  case  may  require. 

In  Treating  Suppression,  it  should  be  borne  in  mind  that  at  a  cer- 
tain time  each  mouth,  nature  makes  an  attempt  to  restore  the  lost 
function.  Even  when  she  is  not  successful,  probably  an  ovum  is  ma- 
tured and  in  some  way  disposed  of.  The  intelligent  physician  will  of 
course  avail  himself  of  this  favorable  moment  to  try  his  skill  in  bring- 
ing about  the  desired  regularity.  When  this  time  arrives,  he  should 
order  three  or  four  leeches  applied  to  each  groin  at  night.  The  next 
night,  he  should  direct  the  use  of  a  pungent  foot  bath  (242) ;  also  (1 6) 
as  a  cathartic 


3.')6 


FEMALE  DISEASES. 


Wlicn  suppressiorj  exiHts,  it  is  not  always  proper  to  try  in  this 
direct  way  to  bring  on  the  turns.  Then-  may  be  no  l>lood  to  spare; 
and  tins  may  be  tlie  sole  reason  why  the  courses  do  not  appear. 
When  this  is  the  case,  nothing  is  to  be  done  but  to  build  up  the 
health  as  rapidly  as  possible,  and  when  this  is  suilicientiy  established, 
the  courses  will  be  all  right 

Profuse  Menstruation. — Menorrhagia. 

Menstruation  may  continue  too  lone,  or  occur  too  often,  or  he  too 
;  rofiise  while  it  lasts;  or  all  these  irregularities  may  l)e  experienced  by 
the  Huine  person.  Any  one  of  them  will  prove  a  serious  irritation, 
and  a  drain  upon  the  constitution  ;  the  whole  togt^tlier.  if  not  arrested, 
will  undermine  and  destroy  it, 

Tlie  Cause  of  this,  like  the  sourse  of  all  other  female  diseases.,  ia, 
in  a  great  majority  of  cases,  overlooked. 

It  is  not  to  be  attributed,  as  so  many  suppose,  to  a  congested  state 
of  the  womb;  but  is  rather  the  result,  in  a  great  many  instances,  of 
llic  inflammatory  or  ulcerated  condition  of  the  uterine  neck, 

In  still  ajiother  large  number  of  cases,  it  arises  from  a  succession 
of  ovarian  abortions.  When  the  blood  has  run  low,  and  nutrition  is 
defective,  as  in  the  consumptive  habit,  the  ovarian  vesicles  fail  to 
reach  maturity.  Like  other  products  of  the  economy,  they  become 
blighted,  and  abort.  And  as  these  blights  occur  often,  nature  is  busy 
every  two  or  three  weeks  in  casting  them  off.  Hence,  the  menses 
ap|>ear  often.  They  come  and  go  witliout  order,  because  they  spring 
from  a  process  which  is  a  contraversion  of  nature's  laws. 

Explanation.  —  It  is  not  easy  to  explain  how  inflammation  and 
ulceration  of  the  uterine  neck  should  in  one  case  produce  suppression, 
and  in  another  profuse  menstruation.  Yet  it  is  a  settled  truth,  that 
such  opposite  results  do  come  from  one  and  the  same  apparent  cause. 
Probably  the  explanation  is  to  be  found  in  the  dilVcrciit  degrees  of 
inflammatory  action,  in  the  varieties  of  constitution,  and  in  the  vari- 
ant degrees  of  tenacity  with  which  the  vessels  iiold  tlie  blood. 

Bleeding  from  the  female  genital  organs  may  be  produced  by  a 
variety  of  causes  which  have  nothing  to 
do  with  menstruation.  Such  bleedings 
are  properly  uterine  or  vaginal  hemor- 
rhages, and  not  profuse  menstruation. 
They  are  the  result  of  inflammatioiis, 
or  tumors  within  the  uterine  neck  (Fig. 
136),  or  weakness.  The  womb  may 
bleed  for  days,  or  even  for  months,  from 
pure  debility. 


Fio.  136. 


Treatment — As  profuse  menstruation 
and  uterine   hemorrhage  spring  from  a 
variety  of  causes,  so  the  remedies  are  various.     Here  again  we  are 
confronted  with  the  same  absolute  necessity  to  investigate  accurately 


try  in   this 

|)(1  to  spare ; 

not  appear. 

|)uil(l  up  tlio 

eutablidhed, 


ten,  or  be  too 
[pcripiicetl  by 
jua  irritation, 

not  arrested, 

disease!),  ia, 

igested  state 
instances,  of 
'ck, 

a  succession 
d  nutrition  is 
sides  fail  to 
tiiey  become 
lature  is  busy 
!,  the  menses 
e  they  spring 

Timation  and 
i  suppression, 
I'd  truth,  that 
iparent  cause. 
it  degrees  of 
i  in  the  vari- 
>1o<h1. 
rod  need  by  a 

136. 


igam  we  are 
te  accurately 


FEMALE  DISEASES. 


357 


the  true  nature  of  the  complaint,  before  we  venture  a  single  prescrip- 
tion. All  the  cases  present  one  general  feature.  There  is  too  great 
a  loss  of  blood;  and  the  first  thojght  is  that  astringent  medicines  arc 
necessary  to  arrest  it.  But  if  the  bleeding  be  occasioned  by  a  ytoly- 
pus,  or  by  in(lammp.tory  ulceration,  astringents  would  not  arrest  it, 
and  might  do  great  mischief. 

Wh«'n  the  iiiiiiioderute  flowing  is  caused  by  a  general  breakdown 
of  tilt!  nutritive  powers,  and  by  ovarian  abortions,  the  great  aim  nmst 
be  to  rally  the  vital  powers  by  iron,  quinine,  porter,  wine,  a  generous 
diet,  exercise  on  horseback  am'  on  foot,  and  warm  and  cold  bathing. 
When  produced  by  local  diseases  of  the  ovaries  and  neck  of  the 
womb,  the  treatment  is  to  be  local,  —  such  as  has  been  described.  If 
a  polypus,  or  other  tumor,  be  tho  cause,  the  remedy  must  be  sought 
for  under  the  appropriate  head.  If  the  womb  has  become  relaxed, 
and  bleeds  from  pure  debility,  —  as  it  may,  —  something  must  be 
found,  if  possible,  which  will  condense  its  substance,  —  making  it 
harder,  smaller,  and  more  solid.  For  this  purpose,  cold  bathing,  as- 
tringent injections  into  the  front  passage,  and  acid  drinks,  are  useful. 
But  one  of  the  best  remedies  is  the  wine  of  spurred  rye  (267).  One 
teaspoonful  should  be  taken  three  times  a  day.  This  article,  by  caus- 
ing the  womb  to  contract,  solidifies  and  condenses  it,  —  thus  arresting 
the  blood  which  oozes  from  its  relaxed  tissues. 

Case. —  Miss  S.  F.  was  treated,  in  1855,  for  great  loss  of  blood  by 
too  frequent  and  too  profuse  menstruation.  She  had  suffered  for  a 
number  of  years,  —  her  courses  coming  on  every  three  weeks,  some- 
times every  two  weeks,  and  lasting  from  a  week  to  ten  days.  She 
had  become  very  pale,  and  much  debilitated ;  and,  as  she  had  a  slight 
cough,  her  friends  feared  that,  if  not  relieved,  she  would  soon  sink  in 
consumption. 

Having  made  an  examination,  and  learned  that  there  was  no  or- 
ganic disease,  but  tiiat  the  exhaustive  bleeding  was  caused  entirely 
by  debility,  I  prescribed  sulphuric  acid  (60)  three  times  a  day,  with 
half  a  pint  of  cold  water  injected  into  the  bowel  once  a  day,  and  qui- 
nine (67)  three  times  a  day. 

The  patient  was  required  to  take  a  very,  generous  diet  of  juicy 
meats,  broths,  etc.,  and  to  be  in  the  open  air  to  a  reasonable  extent. 

The  case  began  immediately  to  improve,  and  in  a  few  v«'cks  the 
courses  were  restored  to  a  healthy  state.  No  other  treatment  was 
used,  except  to  drop  the  sulphuric  acid  in  two  instances,  for  a  few 
days,  usirg  in  place  of  it,  tannin  in  one  case,  and  alum  in  the  other. 

Painful  Ilenstruation. — Dj/smenorrhoea. 

DvtM'-NORRHffiA  is  from  ^"iree  Greek  words  Sw,  fif)v,  and  ^e'o),  which 
mean,  (iterally,  a  difficult  tUhly  Jlow.  These  words  do  not  precisely 
describe  the  complaint;  ^./f  it  consists  not  so  much  in  a  difficulty  as  in 
k  pcmful  flow. 

Ityniptoms. —  This  affection  is  always  marked  by  more  or  less  pain 


mAnm,  ■tnilMtlft.<Jin*J 


■  ;b-A.il>'.rr7ti\.-'^V^- 


358 


FEMALE  DISEASES. 


while  the  courses  are  on,  —  especially  during  the  first  day  or  two. 
The  pain  sometimes  begins  two  or  three  days  in  advance  of  the  evac- 
uation. It  extends  over  the  whole  lower  part  of  the  belly,  —  running 
down,  at  times,  to  the  thighs,  and  causing  great  distress  in  the  back. 
It  is  frequently  so  violent  as  to  resemble  the  pains  of  labor,  compell- 
ing the  sufferer  to  take  the  beci,  and  drawing  from  her  tears  and 
groans,  and  occasionally  throwing  her  into  spasms  most  painful  to 
witness.  So  terrible  are  the  monthly  sufferings  which  some  women 
experience  from  this  cause,  that  the  anticipation  of  it  destroys  much  ' 
of  their  peace,  even  during  the  intervals  of  respite. 

The  Causes  of  this  complaint  are  very  numerous.  There  is,  doubt- 
less, such  a  thing  as  pain  in  the  womb  from  rheumatism,  and  espec- 
ially from  neuralgia,  though  these  are  much  rarer  forms  of  the  com- 
plaint than  many  suppose. 

Pains  at  the  monthly  periods  are  often  induced  by  a  displacement 
of  the  womb.  If  the  organ  fall  over  backward  or  forward,  its  nerves 
are  pressed  upon  in  an  unnatural  way,  and  when  the  parts  are 
crowded  with  blood,  it  is  very  natural  for  ))ainful  sensations  to  be 
excited.  In  these  cases,  the  neck  of  the  organ  is  bent  at  right  angles, 
and  the  canal  which  passes  through  it  i.s  of  course  striciured,  so  that 
the  evacuations  are  necessarily  made  with  difficulty. 

And  this  leads  me  to  remark,  that  the  passage  through  the  uterine 
neck,  becomes,  occasionally,  from  inflammation  or  other  cause,  almost 
closed.  The  result  is,  much  difficulty  and  great  pain  in  passing  the 
monthly  secretion. 

There  are  no  causes  which  excite  painful  menstruation  more  often 
than  inflammation  in  the  uterine  neck  and  the  ovaries.  An  increased 
i7ow  of  blood  to  an  inflamed  part  always  causes  pain.  An  inflamed 
f  jot  or  leg  has  to  be  laid  up  in  a  chair,  because  it  aches  when  put 
down.  The  reason  is,  that  when  hanging  down,  it  is  more  full  of 
blood,  and  the  sensitive  nerves  are  painfully  compressed.  When  the 
finger  is  hot  with  inflammation,  we  assuage  the  pain  by  holding  it  up 
for  the  blood  to  run  down.  For  the  same  reason,  the  inflamed  ovaries 
and  uterine  neck  ache  when  the  blood  flows  to  them,  in  large  quan- 
tities, at  the  menstrual  period. 

Congestion  of  the  lining  membrane  of  the  womb  itself  is  a  frequent 
cause  of  painful  menses.  It  is  a  condition  of  the  membrane  of  the 
womb,  similar  to  that  of  the  lart/nx  in  membranous  croup.  There  is  the 
same  pouring  out  of  what  physicians  call  coagulable  lymph,  which 
forms  itself  into  a  membrane.  This  membrane  the  womb  strives  by 
strenuous  contractions  to  throw  off,  and  finally  succeeds  in  expelling 
it,  not  whole  and  entire,  but  in  shreds  and  patches.  These  shreds, 
which  women  sometimes  call  skinny  substances,  are  characteristic  of 
the  disease.  The  efforts  to  expel  them  cause  pains  very  much  like 
those  of  natural  labor,  and  sometimes  almost  as  severe. 

Treatment  —  Painful  menstruation,  excited  by  the  falling  over  of 
the  womb,  backward  or  forward,  is  cured,  of  course,  by  putting  the 
organ  back  into  its  proper  position. 

Pains  caused  by  stricture  of  the  canal  through  the  uterine  neck,  are 


/ 


|y  or  two. 

the  evac- 

running 

[the  back. 

J,  compell- 

fteara  and 

>ainfiil  to 

le  women 

ays  much' 

I  i3,  doubt- 
Ind  espec- 

the  corn- 
placement 

its  nerves 

parts  are 
ons  to  be 
jht  angles, 
sd,  so  that 

le  uterine 
ise,  almost 
assing  the 

Tiore  often 
1  increased 
n  inflamed 
when  put 
)re  full  of 
When  the 
Iding"  it  up 
ed  ovaries 
irge  quan- 

a  frequent 
ine  of  the 
lere  is  the 
ph,  which 
strives  by 
expelling 
se  shreds, 
teristic  of 
auch  like 


g  over  of 
tting  the 

neck,  are 


FEMAT.K  DTSKASES. 


3.'59 


cured  only  by  enlarging  the  passage.  This  is  effected  by  introducing 
at  first  a  very  small  bongie,  and  then  a  larger  and  a  larger,  until  the 
passage  is  of  the  usual  size.  It  is  a  delicate  operation,  quite  success- 
ful in  careful  and  skilful  hands,  but  liable  to  produce  mischief  when 
improperly  conducted. 

In  all  thr  forms  of  this  disease,  the  treatment  should  aim,  not 
merely  at  palliation,  but  at  a  cure.  And  generally,  I  am  happy  to 
say,  a  cure  is  attainable.  Yet  how  many  women  suffer  for  yeara^ 
until  health  has  fled,  and  life  has  become  a  burden,  —  receiving  from 
their  medical  attendant  the  assurance  that  palliation  onlv  is  pos- 
sible ! 

It  is  necessary  at  each  monthly  turn,  to  do  something,  in  these 
cases,  to  quiet  the  pain.  For  this  purpose,  twenty  drops  of  lauda- 
num, in  a  wine  glass  of  tepid  water,  thrown  into  the  bowel,  will  be 
highly  8er\  ceable.  For  a  like  purpose,  one  pill  (116)  may  be  taken 
twice  a  day,  beginning  one  day  before  the  menstrual  flow.  A  bella- 
donna ointment  (170)  may  be  rubbed  upon  the  neck  of  the  womb 
with  great  advantage. 

In  the  congestive  form  of  this  disease, — that  in  which  the  membrane 
is  formed  on  the  internal  surface  of  the  womb,  and  thrown  off  in  frag' 
ments,  —  the  liquid  acetate  of  ammonia,  or  spirits  of  Mindererus,  is  a 
very  valuable  remedy  taken  in  two  tcaspoonful  doses,  in  a  table- 
spoonful  of  cold  water,  three  or  four  times  a  day,  while  the  pain  lasts. 

Case  I.  —  Miss  E.  S.  of  B.,  aged  twenty-two  years,  applied,  in 
1856,  for  relief  from  great  suffering  at  her  monthly  periods.  Her 
nMJiises  had  been  disturbed  some  time  before  by  taking  cold,  since 
which  time,  her  mother  stated,  her  pains,  for  a  short  time  before  the 
flow  began,  and  during  the  first  day,  had  been  terrible,  not  much  less 
severe,  indeed,  than  those  of  natural  labor,  or  child-bearing.  The 
pains,  at  these  times,  had  been  of  a  terribly  bearing-down  kind ;  had 
frequently  been  preceded  and  accompanied  by  sickness,  vomiting,  and 
fever ;  and  finally,  what  came  from  her  at  first  was  not  so  much 
blood,  as  a  kind  of  skinny  substance,  in  shreds  and  patches. 

It  was  immediately  evident  that  this  was  a  case  of  painful  men- 
struation (dysmenorrhcea)  of  the  congestive  kind.  The  womb  was 
every  month  too  full  of  blood,  —  its  internal  surface,  in  fact,  if  not  its 
whole  substance,  inflamed.  Hence,  a  false  membrane  like  that  of 
croup,  was  formed,  which  the  womb  contracted  and  struggled  hard  to 
throw  off,  and  finally  tore  to  pieces,  and  exjielled  in  shreds. 

Of  course  this  Joral  inflammation  was  to  be  reduced,  which  wa« 
done  by  first  giving  a  brisk  purge  (31),  which  was  followed  by  apply- 
ing half  a  dozen  leeches  directly  over  the  womb.  On  the  following 
day,  a  blister  was  raised  in  the  same  place.  In  two  weeks,  three 
leeches  were  applied,  and  again  followed  by  a  blister.  These  appli- 
cations were  repeated  every  fortnight,  for  three  months,  being  carefni 
not  to  use  them  within  three  days  of  the  monthly  turns,  either  before 
or  after. 

The  pain,  at  each  turn,  was  assuaged,  by  injecting  into  the  bowel 
twenty  drops  of  laudanum  in  a  gill  of  tepid  water,  by  rubbing  upon 


/ 


r 


. 


the  mouth  of  the  womb  some  of  the  ointment  (170^,  and  by  giving 
two  teaspoonful  doses,  in  a  little  cold  water,  of  the  liquor  of  acetate 
of  ammonia,  three  times  a  day. 

The  patient  was  cured  in  three  months,  and  has  since  had  easy  and 
natural  menstruation. 

Case  II.  —  Mrs.  L.  C.  was  treated  for  a  case  of  painful  menstrua- 
don,  in  1857. 

The  lady  also  had  terrible  pains,  attended  by  forcing  down  as  if 
her  bowels  were  all  coming  out  of  her.  Yet  she  had  but  a  very 
scanty  discharge.  Every  month  she  was  made  literally  sick,  and 
was  obliged  to  take  to  her  bed. 

On  examination,  it  was  found  that  the  great  difficulty  in  passing 
the  menstrual  fluid,  as  well  as  the  scantiness  of  the  quantity,  was 
owing  to  the  smallness  of  the  passage  through  the  neck  of  the  womb ; 
this  passage  was  nearly  closed  up ;  it  was  strictured. 

There  could  he-  no  doubt  as  to  the  treatment  required.  Medicines 
could  do  no  good.  This  passage  must  be  gradually  opened.  To  do 
this,  I  introduced  a  small  metallic  male  catheter  into  the  strictured 
passage,  and,  gently  turning  it  once  or  twice  round,  withdrew  it. 
This  was  done  once  in  three  days,  for  three  months, — using  each 
time  a  slightly  larger  instrument.  Thenceforward,  her  menstruation 
was  natural  and  easy.     She  was  well. 

Chlorosis. —  Greensickness. 

Before  the  age  of  puberty,  the  girl  is  only  a  child.  She  has  within 
her  only  the  elements  of  a  woman.  The  change  to  which  she  is  des- 
tined, brings  with  it  a  wonderful  development  both  of  body  and 
mind. 

To  effect  this  development,  and  bring  out  the  new  being  in  the 
perfection  designed  by  the  Creator,  a  large  amount  of  hidden  nerve 
power  is  required.  She  requires  to  have  been  born  with  a  well-vital- 
ized constitution,  and  to  have  been  physically  trained  in  a  way  to 
harden  and  energize  it.  Without  these  antecedents,  her  develop- 
ments at  puberty  will  be  feebly  and  imperfectly  made.  Her  devel- 
opment and  evolution  of  germs  will  be  so  defective  as  to  cause  her 
'menstruation  to  be  only  partially  established,  or  to  fail  altogether. 

Symptoms.  —  Where  the  inherent  powers  of  the  system  are  just 
sufficient  to  bring  about  a  first  menstruation,  it  often  happens  that 
they  seem  to  be  spent  by  the  effort,  and  that  the  evacuation  fails  to 
appear  again  for  several  months.  Indeed,  the  whole  organization  may 
break  down  at  this  point,  and  become  blasted,  as  it  were,  like  a  blade 
of  wheat  which  has  grown  well  for  a  time,  but  which  fails  to  develop 
the  kernel. 

The  blood  at  this  period,  may  become  impoverished,  and  fail  to 
distribute  adequate  nourishment  and  development  to  the  various  tis- 
sues. When  this  occurs,  it  loses  a  part  of  its  red  globules,  and  in- 
creases its  watery  portion.     As  a  result,  the  skin  becomes  pale,  and 


7 


giving 
acetate 


easy  and 


nenstraa- 


jwn  as  if 
a  very 
sick,  and 


It 


pastsnig 
tity,  waa 
le  womb ; 

iledicines 
L  To  do 
strictured 
hdrew  it 
iing  each 
struation 


as  within 
16  is  des- 
jody  and 

ig  ill  the 
len  nerve 
vell-vital- 
a  way  to 
develop- 
!er  deyel* 
:au8e  her 
ether. 

are  just 
lens  that 
1  fails  to 
tion  may 
e  alilade 
)  develop 

d  fail  to 
rious  tis- 
I,  and  in- 
pale,  and 


FEMALE  DISEASES. 


361 


sometimes  of  a  yellowish  hue;  the  bowels  become  torpid  and  con- 
fined ;  the  nervous  system  sensitive  and  weak ;  the  digestion  is  im- 
paired ;  the  appetite  is  either  lost,  or  perverted,  —  longing  for  unnatu- 
ral food ;  the  tongue  is  white ;  the  heart  palpitates ;  the  spirits  are 
depressed ;  the  temples  and  ears  throb ;  the  head  occasionally  aches 
and  whirls  with  dizziness ;  the  sleep  is  disturbed  and  abbreviated ; 
and  hysterics  are  now  and  then  superadded  to  close  the  catalogue 
of  ills. 

This  is  Chlorosis,  briefly  depicted  in  its  origin  and  its  symptoms. 
The  word  is  from  the  O  -^ek  ;^\fijjO«3?,  which  means  green  and  pale. 
By  nurses  it  is  called  the    ^reen  sickness." 

Its  Causes  are  quite  numerous,  among  which  may  be  reckoned  im- 
poverished diet,  damp  atmosphere,  sedentary  habits,  long  confine- 
ment indoors,  overworking  the  mind  in  childhood,  constipation  of  the 
bowels,  and  an  inherited  feeble  constitution. 

Treatment.  —  Chlorosis,  as  a  general  thing,  is  connected  either  with 
retention  or  suppression  of  the  menses  ;  and  in  treating  it,  physicians 
are  too  much  in  the  habit  of  resorting  indiscriminately  to  forcing 
medicines,  called  emmenagogues.  From  such  practice,  great  injury 
often  results. 

It  is  not  always  suflicicntly  considered  that  a  woman  fails  to  men- 
struate, or  ceases  to  do  so,  because  she  is  sick;  and  if  we  would  cause? 
her  courses  to  return,  we  must  restore  her  health.  .  To  do  this  should 
generally  be  the  great  object  of  treatment  Let  the  health  be  restored, 
and  the  menses  will  come  back.  The  only  philosophical  treatment  is 
that  which  will  invigorate  the  system. 

In  chlorosis,  the  vital  powers  are  in  a  state  of  dilapidation.  How 
can  they  be  roused  ?  By  exercise  on  horseback  and  on  foot ;  by  wear- 
ing clothing  enough  to  keep  warm;  by  a  tepid  bath  two  or  three  times 
a  week,  and  brisk  rubbing  with  a  coarse  towel ;  and  by  a  generous 
diet,  composed  of  tender  meats,  animal  broths,  etc. 

This  treatment,  however,  should  be  preceded  by  unloading  the 
Dowels  with  prescription  (35)  or  (40),  according  to  choice.  One  pill 
should  be  taken  at  night  When  the  liver  is  considerably  deranged, 
prescription  (40)  will  be  particularly  serviceable.  Half  a  pint  of 
tepid  water  thrown  into  the  bowel,  night  and  morning,  will  help 
relieve  costivencss. 

The  bowels  having  been  well  opened,  give  a  tablespoonful  of  pre- 
scription (59),  two  or  three  times  a  day ;  or,  of  prescription  (60),  a 
teaspoonful,  the  same  number  of  times,  each  day. 

In  the  treatment  of  this  disease,  iron,  in  some  form,  is  almost  al- 
ways needed.  Pres<  riptions  (61)  (71)  (73)  (74)  (75)  (80)  and  (316) 
are  suitable  preparations. 

A  girl  suffering  from  this  disease  should  always  be  taken  out  of 
ichool.     The  mind  should  be  divided  between  rest  and  recreation. 

CaM. —  Miss  J.  T.,  aged  nineteen,  was  treated  by  me  for  this  com- 
plaint in  185a 

She  had  always  been  delicate.   Jtler  first  menstruation  was  at  the 


'\  m 


age  of  fourteen ;  but  it  was  quite  defective  in  quantity,  and  was 
imperfectly  rf>peated  two  or  three  times,  at  irregular  periods,  when  it 
stopped  altogether,  and  had  not  again  appeared  up  to  the  time  of  her 
being  brought  to  me. 

She  was  very  pale,  and  a  little  yellowinh;  —  her  lips  being  nearly 
white.  She  was  very  costive,- — habitually  so,  —  was  without  appe- 
tite, and  her  tongue  was  coated  white.  She  had  dizziness,  palpita- 
tion of  the  heart,  neuralgic  pains  in  various  parts,  and  was  extremely 
nervous  and  irritable.  Having,  in  addition  to  the  above  symptoms,  a 
pretty  constant  cough,  her  friends  feared  consumption,  and  brought 
her  to  me  from  some  distance  for  that  reason. 

I  found  no  physical  signs  of  lung  disease,  and  had  no  difllicult^K 
therefore,  in  makmg  it  out  to  be  a  case  of  cAtorosis,  —  particularly  as 
there  was  no  expectoration  attending-  the  cough. 

The  parents  were  chi'  fly  anxious  to  have  the  menses  brought  on. 
With  me,  this  was  of  minor  consequence ;  the  main  thing  was  to  rally 
the  prostrate  powers  of  life,  and  restore  the  blov>d  to  health. 

To  do  this,  it  was  necessary  to  rouse  the  liver,  for  which  I  gave 
leptandrin,  etc.  (34),  which  I  ordered  to  be  taken  once  a  day,  namely, 
at  bed-time.  This  not  only  caused  a  flow  of  bile,  but  the  scutelarine 
calmed  and  strengthened  the  nervous  system. 

It  was  necessary,  too,  to  correct  the  habit  of  costiveness.  To 
effect  this,  she  was  ordered  to  take  two  teaspoonfuls  of  Mettauer's 
aperient,  after  breakfast  a  d  dinner. 

To  restore  the  blood,  ir^  '  was  ordered,  particularly  the  citrate  of 
iron  and  strychnine  (316).  is  had  a  fine  effect  to  raise  the  blood 

and  support  the  nervous  system. 

She  was  ordered  a  generous  diet  of  tender  meats,  broths,  etc.,  and 
to  take  unrestrained  and  free  exercise  out  of  doors. 

Her  improvement  was  immediate  and  visible,  and  was  not  inter- 
rupted during  the  three  months  of  her  stay  in  Boston.  Soon  after 
her  return  home,  her  menses  appeared,  and  she  has  since  enjoyed 
pretty  good  health. 

Cessation  of  the  Menses.— Turn  of  Life. 

There  b  probably  no  period  in  woman's  earthly  existence  whioh 
she  approaches  with  so  much  anxiety  as  that  which  she  is  in  the 
habit  of  calling  "  the  turn  of  life."  The  anxiety  is  not  without  some 
reasonable  ground  for  its  existence.  She  has  been  accustomed,  foi 
thirty  years  or  more,  to  lose,  every  four  w<^'c;ks,  a  certain  amount  of 
blood.  "When  this  evacuation  stops,  disturbances  of  the  system  may 
well  be  expected.  So  well  is  this  understoo<l,  that  this  climacteric 
has  come,  by  general  consent,  to  be  called  the  ** critical  period"  in 
female  life. 

K  it  be  well  and  safely  passed,  the  health  is  generally  better  than 
before,  and  a  **  green  old  age "  is  likely  to  follow.  But  if  the  seeds 
of  disease  are  m  the  system,  —  'f  there  be  a  tendency  to  cancer  or 
other  malignant  disease,  which  has  been  hi'ld  in  check  by  the  monthly 
flow,  it  now  takes  up  its  destructive  woili,  and  shows  itself;  or,  if 


and  was 
Is,  when  it 
ime  of  her 

sing  nearly 
bout  appe- 
!S8,  palpita- 
extremely 
)rinptoms,  a 
nd  brought 

difl[icult}K 
ticularly  as 

brought  on. 

was  to  rally 

h. 

hich  I  gave 

lay,  namely, 

i  scutelarine 

ireness.      To 
f  Mettauer's 

le  citrate  of 
je  the  blood 

iths,  etc.,  and 

as  not  inter- 
Soon  after 
ince  enjoyed 


life. 

stence  which 
she  is  in  the 
vithout  some 
justomed,  for 
1  amount  of 
system  may 
3  climacteric 
U  period"  in 

f  better  than 
if  the  seeds 

to  cancer  or 
the  monthly 
itself;  or.  if 


FEMALE  DISEASES. 


363 


there  be  a  predisposition  to  a|)oplexy  or  congestion  of  any  organ,  it 
is  more  likely  to  become  active,  now  that  the  accustomed  waste-gate 
k  closed.  A  distinguished  writer  has  said  that  about  half  the  deaths 
among  women,  about  the  age  of  forty-four,  are  from  cancer. 

Nervous  Comiiliciitions.  —  It  is  the  duty  of  the  physician  to  look 
carefully  after  those  females  who  come  under  his  care  at  this  critical 
time.  For,  in  addition  to  the  organic  and  malignant  diseases  which 
attack  her  at  this  time,  she  is  exposed  to  a  host  of  nervous  iri'itations, 
which,  if  neglected  or  badly  managed,  make  her  life  a  cross  and  a 
burden.     The  symptoms  of  these  irritations  are  in  number,  legion. 

k^e  at  which  the  turn  of  life  comes.  —  As  a  general  rule,  the  turn 
of  life  comes  between  the  ages  of  forty  and  fifty ;  but  occasionally 
occurs  at  other  periods,  varying  from  thirty  to  seventy.  If  the  menses 
appear  early  in  life,  they  terminate  early. 

Symptoms.  —  When  there  is  a  tendency  to  corpulency  at  this  period, 
the  symptoms  arc  headache,  dizziness,  and  a  sense  of  suffocation.  It 
is  common,  when  the  period  of  cessation  approaches,  for  deviations 
from  regularity  to  occur.  At  one  time  the  menstrual  discharge  will 
be  profuse ;  at  another,  scanty.  It  will  now  disappear  for  a  time, 
and  be  replaced  by  the  whites.  Then  it  will  appear  for  a  few  times 
with  considerable  regularity.  Next  will  come  a  suspension  for  sev- 
eral months,  to  be  followed  by  a  flow  of  such  profusion  as  to  amount 
almost  to  flooding. 

Mixed  up  with  these  irregularities,  will  be  palpitations  of  the 
hearty  constipation  of  the  bowels,  a  variable  appetite,  and  broken 
sleep,  weakness  and  inquietude,  timidity,  a  dread  of  impending  evil, 
irritability  of  temper,  hysterical  attacks,  bad  feelings  in  the  head,  with 
sounds  in  the  ears,  as  of  the  rolling  of  carriages,  sparks  before  the 
eyes,  and  an  unsteady  gait. 

Treatment.  —  If  there  be  at  this  f>eriod,  fulness  of  habit,  with  diz- 
ziness, headache,  sparks  before  the  eyes,  a  sense  of  suflbcation,  etc., 
there  is  a  plain  indication  that  the  brain  is  oppressed  with  too  much 
blood.  I  am  not  much  in  favor  of  bleeding,  but  this  is  a  case  in 
which  from  a  gill  to  a  half  pint  of  blood  may,  if  ever,  be  drawn  from 
the  arm  with  positive  advantage.  Cups  applied  to  the  back  of  the 
nock  will  also  be  useful.  Give  at  night,  also,  three  of  the  compound 
cathartic  pills,  and  then  keep  the  bowels  regular  with  prescription 
(18),  —  a  wine-glassful  to  be  taken  occasionally.  The  diet  should  be 
spare,  and  strictly  vegetable:  —  to  which  should  be  added  much  daily 
exercise. 

Purging  should  not,  in  any  case,  be  carried  too  far.  If  nervous 
aflections  show  themselves,  with  disturbance  of  the  digestion,  and 
general  debility,  even  leeches  would  be  improper,  and  physic  should 
be  swallowed  very  sparingly. 

When  serious  organic  disease  is  suspected,  —  as  cancer,  —  it  is  the 
duty  of  the  physician  to  investigate  the  case  very  thoroughly,  and  to 
give  the  pati<'iit  the  advantage  of  the  most  prompt  and  decided 
treatment.  «t  treatment  is  spoken  of  in  the  proj>er  place. 


■^11 


^' 


Hysterics. — Hysteria. 

The  name  of  this  complaint  is  from  a  Greek  word,  signifying  the 
womb.  It  took  this  name  from  the  belief  that  thia  organ  is  the  seat 
of  the  irritation  which  protluces  the  hysteric  disturbance. 

This  belief  is  correct,  if  we  include  with  the  womb,  the  ovaries, 
and  the  other  sexual  organs.  The  sexual  system  is  doubtless  tho 
centre  of  the  reflex  nervous  derangement,  called  hysteria. 

It  has  been  sufficiently  demonstrated  that  hysterics  are  de|Kjndent 
for  their  existence  either  upon  organic  disease,  or  upon  simple  irrita- 
tion of  the  sexual  organs.  Sir  Benjamin  Brodie  mentions  cases  of 
the  hysteric  paroxysm,  produced  by  pressing  upon  an  inflamed  and 
tender  ovary. 

Symptoms.  —  An  attack  of  hysterics  is  generally  preceded  by  de- 

firession  of  spirits,  restlessness,  and  a  frequent  desire  to  pass  water, 
t  is  sometimes  marked  by  convulsions,  or  fits ;  at  other  times,  it  is 
not  At  times,  the  attacks  are  local,  and  are  manifested  by  spasms 
of  the  throat  at  the  top  of  the  windpipe,  or  in  the  bronchial  tnbes ; 
the  patient  feels  a  ball  rise  up  in  her  throat  (globus  hystericus),  her 
heart  beats  violently,  and  she  laughs  and  cries  by  turns. 
1  When  the  disease  is  more  general,  the  muscles  of  the  limbs  are 
;  thrown  into  spasms;  the  patient  struggles  violently;  rising  up  in  a 
sitting  posture,  and  then  throwing  herself  back;  twisting  the  body 
from  side  to  side,  clenching  the  hands,  and  throwing  the  arms  about, 
so  that  she  is  with  difficulty  held  by  jxjrsons  much  stronger  than  her- 
self. Soon  after  these  paroxysms,  the  patient  generally  passes  a  large 
quantity  of  very  pale  urine. 

The  Causes  of  this  complaint  are  as  numerous  as  the  causes  of 
female  diseases,  for  in  truth  theie  is  no  female  complaint  which  may 
not  produce  it  Whatever  develops  and  excites  the  sexual  system, 
and  at  the  same  time  weakens  the  constitution,  lays  the  foundation 
of  this  malady.  Nervous  women  are  much  inclined  to  it  In  large 
cities  there  is  more  of  it  than  in  the  country,  because  there  is  more 
excitement  and  luxury,  and  more  of  their  consequences,  —  nervous 
and  female  diseases. 

Treatment.  —  To  treat  this  complaint  successfully,  it  is  necessary  to 
search  out  its  cause,  and  remove  that  Like  the  whites,  it  is  not  so 
much  a  disease  in  itself,  as  a  symptom. 

The  first  inquiry  to  be  made  should  have  reference  to  the  reaV 
origin  of  the  complaint  Is  it  dependent  upon  inflammation  of  the 
ovaries  or  the  womb,  or  to  displacement  of  this  latter  organ  ;  or  does 
it  arise  from  the  low  state  of  the  blood,  and  the  weakened  condition 
of  the  nerves,  acted  upon  by  some  irritation  or  heightened  sensibility 
of  the  sexual  organs. 

If  dependent  upon  inflammatory  disease,  that  is  to  be  treated  ac- 
cording to  directions  elsewhere ;  if  upon  falling  of  the  womb,  no 
remedies  will  avail,  until  that  is  put  in  its  proper  place.     If  diluted 


T: 


fnifying  the 
is  the  seat 

the  ovaries, 
)ubtless  tho 

de|M;iulont 

imple  irrita- 

iis  cases  of 

lamed  and 


Bded  by  de- 
pass  water, 
r  times,  it  is 
I  by  spasms 
chial  tubes; 
itericus),  her 

16  limbs  are 
i\ng  up  in  a 
ig  the  body 
arms  about, 
er  than  her- 
asses  a  large 

le  causes  of 
which  may 
xual  system, 
3  foundation 
it.  In  large 
lere  is  more 


s,  —  nervous 

necessary  to 
if  it  is  not  so 

I  to  the  reaV 
lation  of  the 
jan ;  or  does 
led  condition 
;d  sensibility 

16  treated  ac- 
e  womb,  no 
.     If  diluted 


PI.  8 


:^1;:^^^-^^'^ 


FEMALE  DISEASKS. 


365 


blood  and  weakened  nerveo  be  the  cause,  iron  and  quinine  arc  th« 
r«'njcdie8.  When  the  complaint  arises  from  deficient  nionatruation, 
iron  and  aloes  (47)  will  be  Bcrviceablc.  The  nervous  spasm  can 
sometimes  be  broken  up  by  pouring  cold  water  ui)on  the  head,  ot 
face,  or  limbs  of  the  patient. 

The  Ilyiflenic  anil  Wonil  Treatment  are  of  great  ron»equence.  The 
coinpluiiit  is  very  iiau-h  under  the  control  of  the  will.  Whatever 
tones  the  moral  nature,  and  strengthens  the  will,  tends  to  subject  thia 
disorder  to  the  control  of  the  patient.  Plain  wholesome  diet,  exercise, 
bat  lung,  and  the  enforcing,  as  far  as  oossible,  of  a  rugged,  self-reliant 
haljit  generally  go  far  towards  breaking  its  force. 

Polypus  of  the  Womb. 

This  is  simply  a  foreign  body,  or  tumor,  growing  either  within  the 
womi),  or  in  ih(^  vagina,  and  attached  to  the  uterine  neck.  It  is  rather 
a  serious  affection. 

These  tumors  vriry  in  weight  from  half  an  ounce  and  less,  to  many 
pounds.  They  are,  in  color,  whitish,  red,  brown,  and  even  black. 
They  have  almost  every  consistence,  —  being  soft,  spongy,  gristly, 
and  hard. 

Tlie  Symptoms  of  polypus  are  various,  resembling  tho«'e  of  almost 
every  other  womb  complaint.  It  is  often  mistaken  for  displacement 
of  the  womb,  for  dropsy  of  this  organ,  and  for  pregnancy. 

These  tumors  are  apt  to  give  rise  to  dangerous  bleeding  frot.  the 
womb,  and  other  discharges  which  greatly  weaken  and  derange  the 
system.  They  are  liable  to  terminate  in  cancer.  In  pregnancy,  they 
may  produce  miscarriage.  When  they  are  suspected,  therefore,  the 
utmost  scrutiny  should  be  employed  to  search  them  out  This  is 
especially  desirable,  since  the  fallen  or  inverted  womb  may  carelessly 
be  taken  for  a  polypus,  and  be  operated  on  as  such. 

Treatment.  —  This  is  of  'wo  kinds,  medical  and  surgi'^al.  The 
first  consists  in  means  of  supporting  the  strength  of  the  patient,  and 
checking  the  dischargeii  by  means  of  injections,  rest,  etc.,  and  in  en- 
deavoring to  cause  the  removal  of  the  tumor  by  absorption. 

This  last  object  is  sometime  eflfected  by  an  unstimulating  diet; 
and  by  the  use  of  iodine  (101)  for  some  time.  This  treatment  does 
not  oft«n  succeed,  however,  and  cannot  be  relied  upon. 

If  the  polypus  be  within  the  womb,  of  course  it  cannot  be  reached. 
The  only  thing  to  be  done,  in  such  case,  is  to  cause  its  expulsion. 
This  is  sometimes  effected  by  causing  the  womb  to  contract  by  the 
use  of  spurred  rye  (267),  or  by  the  use  of  the  electro-magnetic 
machine.  This  latter  remedy  can  do  no  harm,  and  had  better  be 
tried  first. 

When  the  polypus  is  outside  the  womb,  the  methods  of  removing 
it  are  various.  It  is  sometimes  done  by  cauterization,  or  burning  it 
off  by  hot  iron  or  caustic.  This  is  a  harsh  method,  and  not  resorted 
to  by  skilful  surgeons.    Another  method  is  that  of  crushing  the  tumor 


360 


FEMALE  DISEASES. 


with  an  iriHtrument.  Another  stili  is  that  of  torsion,  or  twiwtinq  it 
oH".  And  still  anotiiej,  that  of  applying  a  ligature,  or  tying  a  string 
around  the  neck  of  the  tumor,  and  strangling  it  by  preventing  the 
blo(Kl  f.'oin  going  to  it.  By  this  means  it  falls  oft"  in  a  few  days. 
Tliere  is  one  oilier  method,  that  of  cutting  the  tumor  away  with  a 
knife,  or  with  a  pair  of  curved  scissors.  These  three  last  methods 
are  the  chief  ones  now  used  by  skilful  surgeons. 

Case  I.  —  Mrs.  ,T.  W.  IL,  from  one  of  the  cities  in  New  England, 
applied  for  treatment  for  an  affection  of  the  lungs,  from  whieh  slie 
had  suffered  for  several  months.  She  was  thin  in  flesh,  feeble,  and 
pale  from  loss  of  blood  ;  for  she  informed  me  that  her  courses  lisid 
been  upon  her  a  large  part  of  the  time  for  several  months.  1  tri<(l 
the  usual  remedies  for  profuse  menstruation  (for  she  at  first  declined 
an  examination),  but  without  effect.  The  hemorrhage  was  unabated, 
and  she  rather  lost  ground.  I  again  proposed  an  examination,  and 
apprized  her  that  upon  it  hung  the  only  hope  of  my  being  able  to  do 
anvtliing  for  her.     She  assented  without  further  hesitation. 

Upon  introducing  the  speculum,  a  pendulous  tumor,  hanging  from 
the  mouth  of  the  womb,  immediately  dropped  into  it,  precisely  like 
that  in  Plate  VIII.,  Fig.  3.  I  immediately  put  a  ligature  around  its 
neck,  and  in  a  few  days  it  came  away.  Upon  being  apprized  of  this, 
I  applied  to  the  root  a  small  amount  of  acid  nitrate  of  mercury,  with 
a  camel's  hair  pencil,  and  immediately  after  pressed  upon  the  cauter- 
ized surface  a  small  velvet  sponge,  thoroughly  wet  with  soap  suds. 
By  this  last  application,  the  acid  was  decomposed,  and  prevented 
from  spreading.  The  bleeding  stopped  at  once.  Under  the  use  of 
iron,  and  a  thoroughly  rallying  tuatment,  the  lady  began  to  come  up. 
The  affection  of  the  lungs,  no  longer  encouraged  by  the  drain  upon 
the  system,  gradually  yielded,  and  she  recovered. 

Case  11.  —  An  unmarried  lady,  from  an  interior  town  in  another 
state,  sought  relief  for  a  throat  disease,  complicated  with  a  slight 
affection  of  the  lungs.  As  my  custom  is,  I  inquired  respecting  her 
menses,  and  learned  that  her  "  turns,"  as  she  said,  came  upon  her 
every  two  weeks,  or  oftener,  —  indeed,  that  she  was  seldom  entirely 
free  from  some  flow.  Upon  making  an  examination,  —  to  which, 
like  a  sensible  woman,  she  assented  without  hesitation, —  I  found 
about  the  mouth  of  the  womb,  as  in  Plate  VIII.,  Fig.  2,  several 
small  projecting  tumors,  looking  like  ripe,  red  currants.  With  the 
ibrceps,  1  took  hold  of  them,  and  in  a  few  momenta,  without  pain  to 
the  patient,  I  twisted  them  all  off;  and  then  made  the  same  applica- 
tions as  in  the  preceding  case.  The  bleeding  was  ended  at  once;  and 
ibe  patient  got  well,  not  only  of  the  hemorrhage,  but  of  the  throat  and 
lung  complaints. 

Uterine  Hydatids. 

This  name  is  given  to  a  bladder-like  substance,  occasionally  found 
growing  in  the  womb.     It  is  filled  with  a  white  or  yellowish  fluid. 


-  .     .-rt.v  ^'^'.•.    -r"        ">-! . 


V 


(vviHtinq  it 
g  a  string 
iiting  the 
few  duys, 
ay  with  a 
incthuds 


England, 

Iwhic'h  she 

fcfble,  and 

•uraea   h;i(l 

Is.     1  tried 

Jst  declined 

unabated, 

lation,  and 

able  to  do 

iging  from 
eeisely  like 

around  its 
zed  of  this, 
rcury,  with 
the  cauter- 
8oa|)  suds. 
;  prevented 

the  use  of 
to  come  up. 
drain  upon 


in  another 
ith  a  slight 
meeting  her 
!  upon  her 
)m  entirely 

-  to  which, 

—  I  found 
J.  2,  several 

With  the 

out  pain  to 

ne  applica- 

;  once ;  and 

throat  and 


nally  found 
)wish  fluid. 


FEMALE  DISEASES. 


36/ 


Sometimes  a  bundle  of  them  grow  together,  like  a  bunch  of  grapes. 
Some  are  elongated,  like  a  bean,  and  liave  a  Hort  of  claw,  by  which 
they  are  attached  ;  others  are  hhaped  like;  an  egg. 

Those  with  a  claw  are  generally  supposed  to  be  living  I'cings,  like 
worms  ii\  the  bowels.  Wlien  expelled  from  the  womb,  they  move 
about  if  placed  in  warm  water. 

The  Causes  which  produce  these  singular  growths,  are  obseurn. 
probably  whatever  impro|M'rly  excites  or  irritates  the  uterine  organs 
may  produce  these  vesicular  bodies. 

Tlie  Symptoms  may  be  easily  mistaken  for  those  cither  of  preg- 
nancy, or  of  water  or  inllanmiation  in  the  womb. 

From  the  growth  of  these  bwlies,  the  bowels  may  enlarge,  the 
breasts  swell,  and  the  menses  stop.  If  to  these  symptoms  be  added 
sickness  at  the  stomach,  the  woman,  if  married,  feels  confident  she  is 
in  the  family  way.  There  is  no  certain  method  of  correcting  this 
mistake,  until  the  collection  of  bladder-like  bodies  is  expelled  from 
the  womb. 

It  is  rare  that  these  bodies  appear  in  the  virgin  woman.  They  are 
supposed  to  be  connectetl,  in  some  way,  with  imperfect  conception. 

Trentiiit'ilt.  —  No  very  exact  directions  can  be  given  in  regard  to 
treatment,  because  we  can  seldom  say  absolutely  that  hydatids  exii<t, 
until  we  see  thein  expelled.  Whatever  will  produce  contractions  of 
tiie  womb,  will  cause  their  expulsion  ;  but  it  will  not  do  to  give  these 
remedies  indiscreetly,  lest  the  cause  be  one  of  real  pregnancy  instead 
of  hydatids. 

Inflammation  of  "Womb. — Metritis. 

This  disease  very  often  follows  delivery,  and  is  connected  with 
child-bed  fever. 

Various  Causes  also  produce  it  in  the  unimpregnated  state.  The 
inflammations  of  the  ovaries,  or  of  the  uterine  neck,  may  extend  to 
the  womb.  Falling  of  the  womb  may  cause  it  to  be  irritated  by 
being  placed  in  a  new  position,  and  thus  bring  on  inflammation.  In 
some  tem|>eraments,  marriage  may  produce  this  disease ;  in  others, 
singleness.  It  may  also  be  brought  on  by  painful  menstruation,  by 
forcing  medicines,  by  constipation,  by  tight  corsets,  by  solitary  vices, 
and  by  excited  sexual  feelings. 

Symptoms. —  When  the  membrane  lining  the  womb  is  involved  in 
the  inflammation,  the  symptoms  are  dull,  constant  pain  in  the  region 
of  the  womb  and  in  the  loins.  The  passage  of  water  or  feces  causes 
pain.  There  is  a  sense  of  weight  which  causes  the  patient  to  bear 
down  and  strain,  as  in  labor.  The  belly  swells,  and  is  painful  and 
tender,  not  bearing  even  the  weight  of  the  clothes.  There  are  chills, 
fever,  and  sometimes  even  delirium. 

Treatment  —  In  this,  the  aim  must  be  to  redice  the  inflammation. 


/  ■    j.ii 


yp 


Mf 


The  bowels  must  bo  opened  vvith  some  saline  medicine  (18|,  perspi« 
ration  must  be  induced,  and  the  hand-s  and  feet  must  be  made  warm. 
A  lurgc  meal  poultice  should  be  put  upon  the  Lolly,  and  leeches  or 
cups  un  the  inside  of  th';  thighs.  The  patient  should  lie  upon  the 
buck  with  her  knees  raistnl  so  as  to  keep  the  clothes  from  pressing  on 
h(;r.  If  the  purgative  medicine  does  not  operate,  an  injection  (^9) 
should  be  used. 

The  food  nmst  be  reduced  almost  to  entire  abstinence,  and  no  stim- 
ulants whatever  should  be  taken.  The  room  must  be  well  ventilated, 
and  kept  still. 

Falling  oi  the  Womb. — Prolapsus  Uteri. 

The  womb  is  often  found  out  of  its  natural  and  proper  place. 
There  are  certain  ligaments  and  muscles  intended  to  act  as  stays, 
iind  hold  it  u|)  in  its  position.  These,  from  various  causes,  become 
rIaxeiL  It  then,  losing  its  support,  drops  down  into  the  vagina,  be- 
tween the  bladder  in  front  and  the  large  bowel  called  rectum,  behind. 
It  is  then  said  to  bo  fallen,  or  prolapsed. 

The  womb  of  married  women  is  more  apt  to  become  prolapsed 
than  that  of  the  unmarried,  because  it  is  more  liable  to  have  its  weight 
increased  by  congestions, 

Tlie  Symptoms  arc  dull  pain  in  the  small  of  the  back,  a  dragging 
sensation  in  the  groin,  and  a  feeling  of  fulness  around  the  funda- 
ment. 

Treiitment  —  The  complaint  is  easily  cured  if  the  remedies  be 
applied  early.  If  the  falling  be  occHsioned  by  a  relaxed  and  weak- 
ened condition  of  the  parts,  a  very  effectual  relief  may  sometimes  be 
derived  from  simple  injections  of  cold  water  into  the  front  passage, 
alternating  them  sometimes  by  an  infusioti  of  white  oak  bark,  or  of 
nut  galls,  or  a  solution  of  tannm. 

If  the  womb  have  been  long  dowfi,  these  simple  remedies  will  not 
be  sufficient  to  restore  it.     It  is  then  necessary  to  put  it  back  in  its 

{)lace,  and  employ  some  mechanical  means  to  keep  it  there,  until  the 
igaments  and  muscles  recover  their  strength  so  far  as  to  hold  it.    For 
this  purpose,  passaries,  of  various  styled  and  materials,  are  employed. 


Palling  Over  of  the  Womb. 

Aiiteversion.  —  The  womb  sometimes  falls  over  forward  upon  the 
bladder,  towards  the  pubes.  This  is  called  anteversion.  The  top  is 
turned  forward  to  the  bladder ;  the  mouth,  back  towards  the  large 
bowel.     (Fig.  137,  b.) 

Retroversion.  —  When  the  womb  falls  over  backward,  between  the 
rectum  and  the  vagina,  it  is  said  to  be  retroverted,  d.  This  is  just 
the  op(X)site  of  being  antevert^  d.  In  this  displacement,  the  mouth  is 
turned  forward,  the  top  backward. 

This  displacement  may  occur  suddenly  or  gradually.    If  the  former, 


FEMALE  DISEAHKS. 


369 


8i,  pcrspi. 
ul(!  warm. 
Ic'ches  or 
upon  the 
rcHtting  on 
:tion  (^9) 

1(1  no  Btim- 
V(;ntilated, 


per  place. 
t  as  staya, 
es,  become 
vagina,  be- 
iin,  behind. 

prolapsed 
its  weight 


a  dragging 
the  funda- 


emediea  be 

and  weak- 

metimes  be 

nt  passage, 

bark,  or  of 

ies  will  not 
back  in  its 
e,  until  the 
old  it.  For 
!  employed. 


i  upon  the 

The  top  is 

9  the  large 

etween  the 
["his  is  just 
'e  mouth  is 

the  former, 


there  i«  generally  great  difttrpss,  nnd  the  organ  should  be  immediately 
put  buck  in  itn  place  ;  if  th«!  latter,  the  pain  will  be  Ichh  intentjo,  nnd 
the  replacement  must  be  effected  by  pessaries,  —  particularly  with  the 
ring  pessary,  made  from  India  rubber. 


ria.  137. 


AnfeflcTion  and  Retroflexion. —  When  these  occur,  the  womb  is 
doubled  upon  itself,  the  :  uth  of  the  orgau  not  being  tilted  up  before 
or  behind,  but  retaining  its  natural  position.  These  flexions  are  rep- 
resented by  a,  c,  and  e. 

Beside  these  more  common  displacements  of  the  womb,  there  are 
peveral  slighter  deviations  which  it  is  scarcely  necessary  to  describe. 
There  is  the  obliquity  of  the  womb,  which  is  simply  a  leaning'  of  the 
organ  backward  or  forward,  or  to  one  side 

There  are  still  other  more  serious  troubles,  which  are  so  very  rare 
as  not  to  require  me  to  dwell  upon  them,  such  as  the  inversion  of 
the  womb,  or  turning  it  wrong  side  out,  like  the  finger  of  a  glove ; 
and  the  hernia  of  the  womb  (hyst^rocele),  which  is  like  that  of  the 
bowel. 

Inflammation  of  the  Vagina. 

This  may  be  produced  by  many  of  the  same  causes  which  induce 
inflammation  of  the  uterine  neck.  It  may  follow  tedious  child-bear- 
ing,—  especially  if  instruments  have  been  used.  Marriage  is  not 
an  infirequent  cause  of  it,  —  so  may  a  pessary  be,  if  an  improper 
one. 

The  Symptoms  are  pain  in  the  groins,  a  feeling  of  heat  and  tight- 
ness in  the  passage,  and  a  difficulty  in  passing  water.  In  a  few  days 
a  discharge,  like  gum  water,  begins  to  flow,  which  gradually  becomes 
thicker,  like  cream,  and  is  green  or  yellow.  Sometimes  the  disease 
gets  well  in  a  few  days;  at  other  times,  it  degenerates  into  the  chronic 
forms,  and  lasts  a  long  time.     It  should  be  cured  as  soon  as  possible, 

47 


-I — r 


370 


FEMALE  DISEASES. 


lest  the  inflammation  cause  the  walls  of  the  passage  to  grow  together, 
and  make  a  stricture,  as  in  Fig.  138. 

In  this  Figure,  b,  represents  the  mouth  ..      fi«.  i38. 

of  the  womb ;  %  is  the  lower  entrance  to  a 
narrow  passage  in  the  vagina,  called  a 
stricture.  It  is  caused  by  inflammation, 
which  so  thickens  the  walls  of  the  vagina 
as  to  bring  their  inner  surfaces  near  to- 
gether. In  examining  a  case  of  this  sort, 
a  practitioner  needs  to  be  on  his  guard  lest 
he  mistake  the  eiitrance  to  the  stricture,  a, 
for  the  mouth  of  the  womb,  ft,  —  a  mis- take 
which  might  lead  to  evil  consequences  as 
well  as  seriously  damage  his  professional 
character. 

Treatineilt.  —  The  diet  should  be  light 
and  unirritating.  The  bowels  should  be 
kept  open.  A.  cooling  wash  (207)  (218) 
should  be  used  several  times  a  day,  until 
the  discharge  becomes  thick, — then  employ 
injections  (232)  (202)  (244)  (243)  of  a  more 
astringent  nature.  Let  the  marriage  bed 
be  abandoned  till  the  recovery  is  complete. 

When  the  discharge  arises  from  small 
granular  elevations  upon  the  inner  surface 
of  the  vagina,  the  whole  diseased  surface 
should  be  painted  over  with  a  solution  of 
nitrate  of  silver,  twenty  grains  to  the  ounce 
of  water,  —  the  disease  being  brought  to 
view  by  the  use  of  a  speculum.  This  may 
be  done  every  other  day. 


Itching  of  the  External  Parts. — Prurigo  of  the  Vulva. 

This  complaint;  is  apt  to  attack  females  about  the  cessation  of  the 
menses,  though  they  are  liable  to  it  at  other  periods.  It  is  a  most 
annoying  and  distressing  affection.  So  terrible  and  tormenting  at 
times,  is  the  itching  of  the  external  genitals,  that  the  woman  is  una- 
ble to  avoid  rubbing  and  scratching,  a/id  she  is  occasionally  compelled 
to  absent  herself  from  all  society.  She  feels,  as  she  says,  as  though 
she  should  tear  herself  to  pieces. 

Sometimes  this  irritation  of  the  sexual  organs  excites  venereal 
thoughts  so  dominant  and  controlling  as  to  constitute  a  real  mania, 
called  nympho-maniay  from  the  name  of  a  part  involved. 

This  complaint  generally  indicates  some  disease  of  the  womb,  or 
its  appendages,  or  of  the  bladder.  When  this  is  the  case,  of  course 
it  cannot  be  cured  without  seeking  out  and  removing  the  disease,  of 
which  it  is  a  symptom.  -  .  ' 


"51 


FEMALE  DISEASES. 


371 


w  together, 


the  Vulva. 

ation  of  the 
^t  is  a  most 
rmenting  at 
man  is  una- 
y  compelled 
i,  aa  though 

bes  venereal 
real  mania, 

le  womb,  or 
je,  of  course 
e  disease,  of 


TretltTnent.  —  To  alleviate  the  local  suffering,  the  lotion  (223),  or 
the  ointment  (171),  may  be  applied  to  the  parts  several  times  a  day. 
I  prefer  <he  lotion.  A  weak  solution  of  nitrate  of  silver  (211)  will 
Bomotim'*'?  do  well. 

WlitMi  the  disease  is  brought  on  by  ma  turbation,  as  it  sometimes  is, 
this  habit  must  of  course  be  broken  off  before  a  cure  can  be  effected. 
In  this  case,  also,  cold  water  must  be  applied  to  the  parts  several 
times  a  day ;  some  of  the  preparations  of  iron  should  be  taken,  and 
pome  active  employment  be  engaged  in,  which  shall  absorb  the  ener- 
gies of  mind  and  body. 

Sterility  or  Barrenness. 

It  has  doubtlesfy  occurred  to  every  person  who  nas  thought  upon 
the  subject,  that  there  must  be  some  special  reasons  why  so  many 
womi'i  do  not  and  cannot  bear  children.  These  reasons  I  propose 
now  to  explain  as  simply  and  as  plainly  as  the  nature  of  the  subject 
admits.  To  this  explanation,  I  shall  add  some  remarks  upon  treat- 
ment ;  for,  in  nine  cases  out  of  ten,  barrenness  is  completely  curable. 

Reproduction.  —  Throughout  nature,  life  is  perpetuated  by  repro- 
duction. The  vegetable  and  the  animal  die;  but  before  death  cjmes, 
they  reproduce  the  ffcrm  of  a  new  thing  or  being,  which  lives  after 
them.  The  law  of  reproduction,  throughout  the  realm  of  nature,  is 
one,  and  but  one.  All  living  things  have  male  and  female  structures. 
Every  new  being  is  evolved  from  an  egg,  the  product  of  an  antece- 
dent parent. 

Keproduction  consists  in  the  growth  of  an  egg  or  germ  in  connec- 
tion with  some  living  part,  until  it  is  capable  of  independent  exist- 
ence. This  germ  or  egg  is  the  product  of  the  female  parent,  and  will 
abort  or  perish  unless  brought  in  connection  with  a  fructifying  fluid 
from  the  male.  Thus,  two  palm  trees,  growing  about  forty  miles 
from  each  other,  the  one  withe  't  stamens  (the  male  organs),  the  other 
without  pistils  (the  female  orgt  js),  bore  no  seed  for  many  years ;  but 
when  they  had  risen  in  heighi-  above  all  intervening  and  obstructing 
objects,  the  winds  bore  the  pollen  from  the  stamens  of  one  to  the 
pistillate  flowers  of  the  other,  which  immediately  began  to  produr-e 
fruit.  A  knowledge  of  this  great  law,  as  applicable  to  all  living 
things,  enables  horticulturists  to  raise  such  varieties  of  fruit  as  they 
wish,  by  shaking  the  blooming  male  branch,  which  has  stamens,  over 
the  female  flowers,  supplied  with  pistils.  Sometimes  the  male  and 
female  flowers  are  upon  the  same  plant, —  at  other  times,  upon  dill'er- 
ent  ones.  The  strawberry  is  of  the  latter  kind,  —  the  pollen  being 
found  only  on  the  plants  which  have  the  largest  flowers,  —  the  pistil- 
lated  flowers  being  only  on  the  smaller  plants.  The  pollen,  or  dust, 
is  carried  from  the  male  to  the  female  plant  on  the  feet  of  honey-bees, 
as  they  fly  from  flower  to  flower.  It  has  been  recently  discovered 
that  the  reason  why  many  beds  are  unfruitful  (strawberry  beds,  I 
mean)  is  chat  the  large  male  plants  are  allowed  to  monopolize  the 
beds  to  the  exclusion  of  the  smaller  female  plants.     The  plants  with 


372 


FEMiXE  DISEASES. 


l;;rge  flowers  should  be  thinned  out,  leaving  only  a  few  to  furnish 
pollen  for  the  females,  which  are  the  real  bearers. 

A  Kew  Branch  of  Industry.  —  It  is  only  quite  recently  that  this 
law  has  been  understood  in  its  wide  applicability.  How  wise  and 
merciful  an  arrangement  of  Providence  that  an  unseen  hand  should 
turn  for  man  the  mystic  leaves  of  knowledge  at  the  very  time  when 
he  is  most  in  need  of  the  instruction  imparted !  At  this  very  moment, 
t^  "  more  complete  knowledge  of  this  great  law  is  opening  a  nevr 
branch  of  industry  and  a  new  supply  of  food,  and  is  thus  helping  the 
solution  of  the  great  problem  of  how  the  increasing  inhabitants  of 
civilized  countries  are  to  be  worked  and  fed.  I  refer  to  the  propaga- 
tion and  culture  of  fish. 

A  committee  appointed  by  the  legislature  of  Massachusetts,  in  1855, 
reported  very  ably  upon  this  subject.  It  appears  that  the  eggs  of  the 
fish  may  be  fecundated  almost  as  easily  as  the  pistillate  flowers  of  the 
plant.  It  is  only  necessary,  when  the  eggs  of  the  female  are  mature, 
to  hold  her  over  a  basin  of  water,  and  make  gentle  pressure  upon  the 
belly,  when  the  eggs  will  pass  freely  into  the  water ;  then  to  pass  the 
milt  of  the  male  into  the  same  water,  and  shake  them  thoroughly 
together.  By  this  means,  the  eggs  art!  impregnated,  and  fish  may  be 
raised  to  any  extent. 

The  egg  of  the  higher  animals  is  more  difllcult  to  fecundate,  and 
that  of  the  human  female,  nost  difficult  of  all;  for  in  nature  as  in  art, 
the  move  perfect  structures  are  begun  and  reared  with  less  ease. 

Propriety  of  Iniptirtin^  this  Knowledge.  —  Men  are  naturally  curi- 
ous, and  love  to  understand  the  mystery  of  their  own  origin  ;  and  yet 
there  is  scarcely  any  subject  upon  which  they  have  so  little  reliable 
information.  It  has  been  held  that  this  is  a  kind  of  information 
which  it  is  not  proper  to  impart  to  the  multitude  ;  that  the  curiosity 
which  seeks  this  knowledge  is  baseJ.  upon  improper  feelings  ;  and 
that  to  gratify  it  by  imparting  what  is  sought,  would  Itmd  to  immov- 
aiity. 

I  do  not  believe  it.  Such  ideas  are  based  upon  a  shallow  philoso- 
phy. They  overlook  the  fact  that  nothing  excites  the  imagination 
like  that  which  is  covered  with  mystery.  It  is  because  the  immensely 
important  subject  of  the  procreation  of  the  race  is  so  carefully  hidden 
from  the  public  eye  ;  because  it  is  purposely  buried  so  deep  in  obscu- 
rity, that  any  allusion  to  it  excites  improper  thoughts.  If  the  subject 
be  properly  viewed,  it  is  no  more  indelicate  to  explain  the  mode  o£ 
reproducing  a  human  being,  than  to  explain  that  of  propagating  a 
plant  or  a  fish.  Both  are  effected  in  the  same  way,  under  precisely 
the  same  natural  law. 

True,  the  propagation  of  the  human  being  involves  moral  laws 
likewise ;  but  these  relate  only  to  the  social  ri'Uitions  in  which  it  may 
take  place,  and  do  not  affect  in  any  way  the  propriety  of  making  it 
understood  by  the  people. 

The  Germ  Furnislied  only  at  Certain  Periods.  —  These  general  re- 
marks bring  me  to  the  immediate  subject  in  hand.      Throughout 


to  furnish 


|y  that  this 
wise  and 
ind  should 
time  when 
Iry  moment, 
ling  a  nevr 
[helping  the 
labitanta  of 
le  propaga- 

tts,  in  1855, 
eggs  of  the 
wers  of  the 
are  mature, 
re  upon  the 
to  pass  the 
thoroughly 
fish  may  be 

undate,  and 
ire  as  in  art, 
>  ease. 

turally  curi- 
in  ;  and  yet 
ittle  reliable 
information 
he  curiosity 
elings ;  and 
1  to  immo*- 

low  philoso- 
imagi  nation 
:  immensely 
fully  hidden 
'p  in  obscn- 
the  subject 
le  mode  o£ 
>pagating  a 
er  precisely 

njoral  laws 
hich  it  may 
f  making  it 

general  re- 
Fhroughout 


FEMALE  DISEASES. 


373 


animated  nature,  the  female  furnishes  the  mature  germ  or  egg  only 
at  certain  periods.     The  healthy  human  female,  —  as  I  have  already 


ria.isa 


explained,  —  matures  a  germ 
once  in  four  weeks.  These 
germs  or  eggs  are  constantly 
advancing,  in  succession,  from 
the  rudest  beginning,  to  a  stfu« 
of  ripeness,  or  maturity.  Every 
person  must  have  seen  the  eggs 
taken  from  the  hen  when  killed 
in  the  laying  season.  Fig.  139 
furnishes  a  good  illustration 
They  are  in  all  stages  of  pro- 
gress, from  the  invisible  germ, 
up  to  the  nearly  mature  egg. 

Such  is  the  progress  of  the 
human  egg,  —  only  that  it  does 
not  attain  to  any  such  size. 
So  far  as  the  maturing  is  con- 
cerned, it  occurs  in  the  same 
gradual  way. 

Conception  or  Iin|(re|i;iinfion  can  take  place  only  when  a  germ  or 
egg  is  ripe;  and  as  an  egg  ripens,  bursts,  and  passes  into  the  fallopian 
tubes  leading  to  the  womb,  only  at  the  time  of  menstruation,  it  is 
plain  that  conception  must  happen  somewhere  in  the  neighborhood 
of  this  perio<l.  Intercourse  with  the  male  may  take  place  at  interme- 
diate times ;  but,  except  in  some  rare  instances,  conception  will  not 
occur,  because  there  is  no  mature  egg  to  be  im|)reguatecl. 

Now,  as  every  healthy  woman  brings  to  maturity  a  germ  or  egg  at 
the  time  of  every  monthly  flow,  and  as  every  ripened  egg  is  capable, 
under  favorable  circumstances,  of  being  fecundated,  it  follows  that 
every  woman  who  menstruates,  and  is  well,  can,  under  cfrtain  cir- 
cumstances, be  impregnated.  To  effect  it,  it  is  only  necessary  (hat 
the  vivifying  portion  of  the  male  semen,  called  spermatozoa,  come 
into  union  with  the  ripened  egg. 

This  union  (for,  that  men  and  women  may 
have  a  chance  to  know  as  much  about  them- 
selves as  they  do  about  fishes  and  plants,  I 
propose  to  make  the  wiiole  subject  plain)  takes 
place  in  the  following  way.  In  the  act  of 
copulation,  the  male  organ  penetrates  the  va- 
gina, and  deposits  the  sperm,  spermatic  fluid, 
semen,  or,  as  the  scriptures  call  it,  the  "  seed," 
directly  at  the  mouth  of  the  uterine  neck. 
Some  suppose  that  when  the  sensation  of  the 
female  is  at  its  height,  the  womb  opens  to 
receive  the  injected  semen.     But  this  is  uncertain. 

This  spermatic  fluid  is  composed,  in  a  large  part,  of  mucus.  A 
Bmaller  portion  of  it  is  secreted  by  the  testicles,  and  is  the  true  semen, 


Fm.  HO. 


■irnaTi*  -.-3*4.jt«.. 


— ll 


374 


FEMALE  DISEASES. 


or  life-giving  principle.  This  last  portion  is  composed,  almost  en- 
tirely, of  fertilizing  filaments  or  vesicles,  which  look  like  small  ani- 
mals (Fig.  140),  and  for  a  long  time,  were  supposed  to  be  animalcules. 
They  are  gcni'rally  called  s/termatozoa.  By  some  mysterious  law  of 
their  nature,  they  are  endowed  with  the  power  of  motion  ;  and  when 
deposited  near  the  mouth  of  the  womb,  they  immediately  begin  to 
move,  as  if  by  instinct,  in  search  of  fk,  141 

a  ri|K?ned  egg.  Passing  through  the 
uterine  neck,  they  enter  the  womb, 
and  thence  glide  onward  into  the  right 
and  left  fallopian  tubt-s,  and  through 
these  to  the  ovaries.  If  an  egg  be 
found,  in  its  ripened  condition,  either 
in  the  womb,  or  the  tubes,  or  about 
leaving  the  ovarian  bundle,  they  im^ 
mediately  embrace  it,  and,  in  some 
mysterious  way,  mingling  their  own 
fluid  contents  with  the  contents  of  the 
egg,  they  impregnate  or  fertilize  it. 
Fig.  141  shows  the  womb  divided 
lengthwise.  A,  is  the  irUernal  viuuth 
(03  internum),  or  point  where  the 
canal  through  the  uterine  neck  enters 
the  body  of  the  womb ;  B,  is  the  ex- 
ternal mouth  (  OS  externum) ;  the  space 
between  A.  and  B,  the  passage  through 
the  neck ;  and  C,  C,  the  points  where 
the  fallopian  tubes  begin.  By  looking 
back  now,  and  examining  Fig.  134, 
the  whole  thing  will  be  understood. 

This  is  a  very  brief  and  simple  account  of  impregnation.  It  ia 
supposed  to  be  capable  of  taking  place  either  a  little  before  or  a  little 
after  the  monthly  flow,  and  not  at  int«rmediat*i  times,  for  the  reason 
already  staled.  There  are  some  reasons  for  believing  that  the  same 
egg  or  gerin,  if  fertilized  just  before  the  courses,  will  grow  to  be  a 
male,  while,  if  fecundated  after  the  turns,  it  will  be  a  female.  One 
reason  for  this  supposition  is,  that  plants  may  be  made  to  bear  male 
or  female  flowers  by  simply  subjectmg  them  to  different  degrees  of 
heat.  If  there  be  more  heat  than  light,  male  flowers  are  produced ; 
if  more  light  than  heat,  female  flowers  are  the  result.  The  heat  of 
the  female  generative  organs  is  raised  to  its  highest  degree  about  the 
time  the  egg  bursts  its  covering,  which  is  just  before  the  beginning  of 
the  flow. 

It  has  been  thought  that  the  right  ovary  produces  males,  and  the 
left  ovary  females ;  but  this  theory  is  not  supported  by  any  facts,  and 
is  probably  not  true. 


Causes  of  Sterility.  —  From  what  has  been  said,  it  would  appear 
that  to  ensure  childbearing,  it  is  only  necessary  that  semen  or  seed, 
containing  spermatozoa,  come  in  contact  with  a  germ  vesicle  or  egg, 


'•i^-^ 


—  I 


(F= 


Mmost  en* 
Ismail  ani- 
liimalcules. 
bus  law  of 
I  and  when 
begin  to 


tion.  It  is 
e  or  a  little 

the  reason 
it  the  same 
>w  to  be  a 
aale.  One 
•  bear  male 
degrees  of 

produced ; 
he  heat  of 
;  about  the 
ginning  of 

js,  and  the 
facts,  and 


lid  appear 
n  or  seed, 
cle  or  egg, 


FEMALE  DISEASES. 


375 


at  the  right  time ;  that  there  be  no  hindering  disease ;  and  that  the 
parties  cohabiting  be  adapted  to  each  other. 

It  is  evident  enough  that  a  want  of  adaptation  between  the  parties, 
physical  or  moral,  or  both,  is  often  an  absolute  bar  to  conception. 
A  lack  of  moral  adaptation  was  probably  the  obstacle  in  the  case  of 
Napoleon  and  Josephine,  —  her  marriage  with  a  previous  husband, 
and  his  with  a  subsequent  wife  having  both  been  fruitful. 

It  is  certain  that  indifference  on  the  part  of  the  wife  towards  the 
husband,  and  especially  repugnance,  may  prove  an  obstacle.  A  mere 
lack  of  sexual  feeling  does  not  necessarily  prove  a  bar,  though  it 
probably  lessens  the  chances  of  a  fruitful  union. 

Conception  may  fail  to  take  place  from  the  diminutiveness  of  the 
male  organ,  —  the  semen  not  being  deposited  in  the  right  place;  or, 
from  its  excessive  largeness,  —  penetration  of  the  vagina  being  impos- 
sible. In  some  rare  cases,  the  womb  is  absent.  The  inflammation 
of  the  ovaries  often  prevents  the  ripening  of  eggs.  The  fallopian 
tubes  occasionally  get  diseased  and  plugged  up,  so  that  no  egg  can 
pass  to  the  womb.  Inflammation  in  the  cavity  of  the  uterine  neck 
is  probably  the  most  frequent  of  all  the  causes  of  sterility.  The 
viscid,  gluey  matter  which  is  secreted  in  inflammatory  conditions  of 
this  part,  plugs  up  the  passage,  so  that  no  spermatozoa  can  pass  up 
in  search  of  the  egg.  The  acrid  discharges  in  most  of  the  cases  of 
whites  destroy  the  fertilizing  spermato/  >a,  and  render  conception  im- 
possible. All  the  displacements  of  the  womb  may  act  as  bars  to 
impregnation.  If  it  fall  over  backward  or  forward,  the  mouth  is 
tilted  up  before,  or  down  behind,  and  is  not  in  the  right  position  to 
receive  t,ie  semen 

Treatment.  —  Judicious  treatment  will,  in  most  cases,  remore  ster- 
ility, and  open  that  "  well-spring  of  pleasure,"  which  the  poet  has  so 
felicitously  described  as  —  "a  baby  in  the  house." 

The  obstacles  to  conception,  stated  above,  are  chiefly  those  diseases 
which  had  been  previously  described.  To  cure  those  diseases,  is  to 
remove  the  obstacles.  When  it  is  dependent  on  the  causes  which 
produce  painful  menstruation,  or  profuse  menstruation,  or  a  suppres- 
sion of  menstruation,  the  remedies  are  the  same  as  are  pointed  out 
for  those  complaints.  If  inflammation  of  the  ovaries  be  the  cause,  a 
cure  may  be  effected,  provided  the  inflamed  condition  be  removed 
before  the  bundle  of  eggs  be  destroyed.  If  inflammation  or  ulcera- 
tion of  the  neck  of  the  womb  be  the  obstacle,  the  remedy  may  be 
found  in  the  treatment  recommended  for  those  affections. 

Sterility  depending  on  the  causes  just  mentioned,  I  have  had  the 
pleasure  of  curing  many  times.  When  dependent  on  a  lack  of  phys- 
ical or  moral  adaptation  between  the  parties,  it  does  not,  of  course, 
admit  of  relief.  It  is  a  misfortune  to  be  borne  in  silence.  It  has 
happened,  perhaps,  through  a  lack  of  judgment  or  care  in  selecting 
a  partner,  and  is  one  of  the  mistakes  of  a  lifetime  which  a  lifetime 
cannot  repair.  When  this  want  of  adaptation  is  not  complete,  a  renr*.- 
edy  may  frequently  be  found. 

Unfortunately,  many  females  do  not  regard  sterility  as  an  evil  to 


'  ll».l.-.JfiA.fiff  t^tmimiM^U.-:^.^^- 


876 


FEMALE  DISEASES. 


be  deplored,  but  rather  as  a  blessing  to  be  desired.  Life,  to  them, 
h'ls  no  high  aims  or  duties,  —  it  is  a  round  of  fashion  and  pleasure, 
^far  and  rear  children  interrupts  their  frivolities,  and  they  seek  to 
'.  such  abridgment  of  their  pleasures.  This  is  wrong.  Life  is 
a  t,  at  theatre,  in  which  all  should  strive  to  act  some  worthy  part, 
and  feel  that,  upon  retiring,  it  would  be  wrong  to  leave  their  garments 
upon  the  vacant  stage,  with  none  to  put  them  on,  and  continue  the 
drama. 

Case.  —  In  1854,  a  lady,  twenty-five  years  of  age,  was  brought  to 
me  by  her  husband,  in  tlie  hope  that  some  relief  might  be  obtained 
for  some  female  complaints,  from  which  she  had  suffered  for  a  num- 
ber of  years,  and  which  threatened  to  make  a  wreck  of  her  health,  if 
not  to  destroy  her  life. 

Having  come  with  the  full  purpose  of  having  the  case  properly  in- 
vestigated, both  herself  and  husband  readily  assented  to  an  examina- 
tion, which  revealed  a  highly  inflamed  and  swollen  condition  of  the 
neck  of  the  womb,  with  a  small  ulcerated  patch  immediately  around, 
and  extending  some  half  inch  within  the  cavity.  She  had  for  a  long 
time  suffered  severe  pain  at  her  monthly  turns,  with  great  and  dis- 
tressing bearing  down  both  before  and  after  her  menstrual  flow ;  her 
back  was  weak  and  painful,  making  it  impossible  to  walk  out  of 
doors,  or  to  stand  much  upon  her  feet.  She  had  become  nervous 
and  much  debilitated,  and  had  pains  at  times  in  her  chest,  her  liver, 
her  head,  and  limbs ;  was  distressed  by  all  sorts  of  disturbances  of 
the  stomach ;  and  had  become,  as  she  said,  about  as  thoroughly  un- 
fitted for  all  the  useful  purposes  for  which  human  beings  are  made, 
as  she  well  could  be. 

She  had  been  married  five  years ;  but,  as  might  be  expected  from 
the  condition  of  the  uterine  neck,  she  had  no  children. 

Introducing  a  glass  speculum,  1  took  a  caustic  holder,  with  a  piece 
of  stick  nitrate  of  silver  in  it,  and  touched  the  whole  surface  of  the 
ulcer  in  the  mouth  of  the  womb  as  far  as  it  could  be  reached.  I  di- 
rected her  to  take  one  to  two  teaspoonful  doses  of  the  tincture  of 
Bcullcap  every  night,  to  quiet  the  nerves  and  promote  sleep,  and  re- 
quested  her  to  come  to  me  again  in  a  week. 

At  the  next  visit  I  reached  the  upper  part  of  the  ulcer  in  the  uterine 
neck  with  a  delicate  silver  syringe,  and  threw  a  fine  shower  of  a 
strong  solution  of  nitrate  of  silver  upon  all  sides  of  the  ulcer,  and 
prescribed,  in  addition  to  the  scullcap,  pills  of  iron,  etc.  (75),  to  be 
taken  three  times  a  day. 

I  directed  her  to  see  me  once  a  week,  which  she  did  for  four 
months.  The  improvement,  after  the  second  week,  was  gradual  and 
steady,  —  so  much  so,  that  little  variation  was  required  in  the  treat- 
ment. At  the  end  of  four  months,  the  inflammation  and  ulceration 
had  both  disappeared ;  her  pains  and  aches  had  all  silently  with- 
drawn ;  she  could  walk,  ride,  and  stand  upon  her  feet ;  and,  in  brief, 
she  has  since,  to  the  delight  of  herself  and  husband,  borne  two  chil- 
dren, and  enjoyed  tolerably  good  health. 


to  them, 
pleasure, 
ley  seek  to 
g.  Life  is 
orthy  part, 
garments 
ntinue  the 


brought  to 
)e  obtained 
for  a  num- 
health,  if 

iroperly  in- 
n  examina- 
tion of  the 
ely  around, 
for  a  long 
at  and  dis- 
1  flow;  her 
alk  out  of 
ne  nervous 
5t,  her  liver, 
irbances  of 
roughly  un- 
s  are  made, 

pected  from 

dth  a  piece 
•face  of  the 
;hed.  I  di- 
tincture  of 
'ep,  and  re« 

the  uterine 

lower  of  a 

ulcer,  and 

(75),  to  be 

d  for  four 
radual  and 
1  the  treat- 
ulceration 
;ntly  with- 
id,  in  brief, 
!  two  chil- 


Midwifery. 

A  STOPPAGE  of  her  courses  is  most  commonly  the  first  notice  a 
woman  has  of  her  being  in  the  family  way-  This  is  perceived  two 
or  three  weeks  after  conception,  when  she?  bogins  to  experience  other 
feelings  peculiar  to  the  situation.  Thes<'  feelings  are  nausea  and  w>»t- 
t'/trtg",  or  a  decided  languor,  in  the  morning;  swelled  and  sometimes 
painful  breasts;  the  areolse, or  colored  rings  around  the  nipples  darker 
than  usual ;  pain  in  the  lower  part  of  the  back ;  and,  occasionally,  a 
good  deal  of  spitting  of  a  frothy,  cotton-like  substar.ce. 

These  symptoms  are  more  or  less  severe  in  difterent  ta^cr,,  and 
under  different  circumstances,  according  to  the  state  of  the  patient's 
bowels,  and  her  habits  of  exercise.  Ordinarily,  she  suffers  most 
during  the  second  and  third  months,  on  account  of  the 

Sinkiii(C  Down  of  the  Womb,  which,  from  soon  after  the  periixl  of 
conception,  is  gradually  increasing  in  size  and  weight.  As  it  grows 
larger  and  heavier,  it  sinks  lower  in  the  cavity  of  the  pelvis,  until 
about  the  fourth  month,  when,  becoming  so  large  that  it  cannot  longer 
be  accommodated  within  the  narrow  limits  of  this  unyielding  box  of 
bones,  it  is  obliged  to  mount  higher  to  find  room  in  the  ampler  and 
more  distensible  belly.  This  low  position  of  the  womb  in  the  early 
months  of  pregnancy,  occasions  many  disagreeable  sensations, — as 
pain  in  the  lower  part  of  the  back,  and  sickness  at  the  stomach. 

The  CostiveneM,  too,  from  which  women  sufTer  so  much  at  this 
time,  is  often  caused,  in  part  at  least,  by  the  pressure  of  the  enlarged 
womb  upon  the  lower  bowel.  Costiveness,  thus  induced,  at  length 
becomes  itself  a  cause  of  serious  mischief.  The  lower  bowel,  filled 
and  enlarged  with  itis  hardened  contents,  reacts  upon  the  womb, 
crowding  it  still  lower  in  its  narrow  quarters,  and  greatly  increasing 
its  excitability.  The  enlarged  bowel  and  womb  combined,  make 
constant  j)ressure,  sometimes  u\x>n  the  urethra,  or  water-pijjc,  causing 
pain  and  difficulty  in  making  water,  and  afioai/s  u|)o:)  the  ascending 
veins,  checking  the  return  of  blood,  and  producing  congestion  in  the 
lower  bowel,  manifested  by  troublesome  piles. 

Treatment  of  Presumicy.  —  When  the  pregnant  woman  first  recog- 
nizes her  situation,  she  should  detcriuiue  to  "observe  moderation  in 
all  things."  Let  lier  avoid  violent  and  sudden  exertion,  and  move 
about  more  calmly  and  evenly  than  usual.  By  this  is  not  meant  that 
she  should  give  up  her  customary  occupation  ;  but  that  she  should 
pursue  it  with  becoming  carefulness,  resolved  in  no  case  to  hazard 
over-exertion,  and  rather  leaning  to  the  side  of  indolence.  This 
would  not  be  real  indolence,  for  she  is  doing  a  grea/  work  internally, 
and  should  not  unduly  withdraw  her  energies  to  external  affairs. 

Let  her  not  be  too  much  in  the  erect  jwsition.  If  of  delicate 
constitution,  and  not  in  vigorous  health,  she  should  make  it  a  |XMnt 
to  lie  down  several  times  during  the  day.  The  standing  position, 
continued  for  a  long  time,  especially  if  it  be  under  circumstancts 


»»:::; 


378 


^       FEMALE  DISEASES. 


to  induce  fatigue,  greatly  favora  the  descent  of  the  womb,  —  while 
a  frecjuent  re^t  in  a  horizontal  position,  may  enable  it  to  kuup  itd 
place. 

All  Objection.  —  It  may  be  objected  by  some,  that  a  large  majority 
of  the  mothers  in  the  world  are  working  women,  and  obliged  to  eun- 
tribute  by  their  industry  to  the  support  of  their  families  ;  and  that 
they  cannot  aflbrd,  therefore,  to  lie  still,  and  mind  directions. 

To  this  it  may  be  answered,  that  it  is  a  great  advantage  to  under- 
stand the  best  way,  so  as  to  have;  the  privilege  of  at  least  aiming  at 
it.  Much  is  accomplished,  in  all  circumstances,  by  aiming  at  doing 
the  best  thing ;  and  few  women  are  so  situated  that  they  could  not 
so  favor  themselves  as  to  obey  the  laws  of  health  a  little  more  per- 
fectly, if  they  thoroughly  understood  them.  All  can  better  aflbrd  to 
avoid  sickness,  than  to  be  sick.  Many  occupations,  also,  unless 
money  tempt  to  excessive  application,  become,  when  steadily  fol- 
lowed, comparatively  easy  and  unexciting.  Thus,  most  people  can 
go  through  their  usual  round  of  duties,  becau»e  they  have  got  used 
to  it.  Indeed,  there  is  nothing  but  indolence  itself,  to  which  we  may 
not  become  accustomed.  The  diflerence  between  the  laboring  and 
the  privileged  classes  is  more  imaginary  than  real.  All  must  work. 
None  can  esi^ape  the  primeval  decree  — "  In  the  sweat  of  thy  face 
shalt  thou  eat  bread." 

Many  women,  when  they  find  themselves  in  the  family  way,  will 
observe  no  cautions,  but  work  all  the  harder,  and  even  use  other 
means  for  the  purpose  of  bringing  on  abortion,  and  preventing  an 
increase  of  children.  This  unnatural  and  wicked,  but  too  prevalent, 
dis[)osition,  results  sometimes  from  a  fear  of  the  pains  of  child-birth, 
sometimes  from  a  desire  to  avoid  the  necessary  c;ire  and  confinement 
connected  with  raising  children,  but  most  often  from  a  wish  to  escape 
the  expenses  which  the  prevailing  fashions  and  customs  of  soc  ,ty 
connect  with  a  large  family.  The  cost  of  a  shattered  nervous  sys- 
tem, and  of  a  body  weakened  and  poisoned  by  powerful  drugs,  is  not 
considered,  because  not  understood  I  Hence  the  success  of  those 
quack  advertisements,  impudently  professing  to  cure  female  diseases, 
but  whose  chief  object  is  disclosed  by  the  insertion  of  the  hypocritical 
caution  —  "Be  careful  not  to  take  this  medicine  during  pregnancy,  as 
it  will  be  sure  to  produce  abortion.''^ 

It  seems  as  if  the  world  would  never  learn  that  God  loves  children, 
although  since  Abraham's  day  he  has  said  so  much  about  them  in 
his  word,  —  although  His  Son,  sent  into  the  world  on  purpose  to 
show  the  disposition  of  the  Father,  took  them  up  in  his  arms,  and 
blessed  them,  —  and  although  He  has  implanted  a  most  wonderful 
iove  of  them  in  the  soul  of  man. 

Costlveuess  ond  Piles.  —  Let  the  pregnant  woman  use  all  proper 
means  to  keep  her  bowels  in  order.  She  will  thus  greatly  diminish 
the  distressing  nausea,  and  may  entirely  prevent  the  accession  of 
piles.  To  accomplish  this  object,  the  saline  aperients  (7)  (5),  or,  oc- 
casionally, other  mild  cathartics  (10)  (12)  (14),  may  be  used.  But 
more  important  than  either  or  all  of  these  is  the  frequent  use  of  a 


lb,  —  while 
to  keep  itd 

j-ge  majority 
jgfd  to  cuii- 
l-s ;  and  tliut 

lis. 

y.  to  under- 
let aitniiig  at 

iig  at  doing 
\vy  could  not 
le  more  |)cr- 
ter  afford  to 

alrto,  unless 

steadily  fol- 
;  people  can 
ive  got  used 
hich  we  may 
aboring  and 

must  work. 
;  of  thy  face 

lily  way,  will 
m  use  other 
reventing  an 

00  prevalent, 
n  child-birth, 
;  confinement 
ish  to  escape 
IS  of  80C  ,ty 
nervous  sys- 
drugs,  is  not 
ess  of  those 
lale  diseases, 
!  hypocritical 
iregnancy,  as 

>ves  children. 
lOut  them  in 

1  purpose  to 
is  arms,  and 
3t  wonderful 


le  all  proper 
itly  diminish 
accession  of 
')  (5),  or,  oc- 
used.  But 
iint  use  of  a 


FEMALE  DISEASES. 


379 


good  self-injecting  family  syringe.  An  injection  of  half  a  pint  of 
cold  water  every  morning,  will  do  nmch  towards  regulating  the 
bowels,  and  preventing  or  curing  piles. 

Nuuseu.  —  If,  as  somefimes  ha|)pens,  there  should  be  persistent 
nausea  aft«T  the  first  three  months,  it  will  need  to  be  eombattecl 
by  mild  tonics  and  stimulants,  as  chamomile  tea,  or  clove  tea  (o8) 
(114),  and  by  seeking  a  kind  of  diet  wliic-h  will  be  agreeable  both 
to  the  palate  and  the  stomach.  Dr.  Meigs  speaks  of  champagne 
as  a  remedy,  and  mentions  some  serious  cases  entirely  relieved 
by  it 

Tlie  i\l|)pl('S.  —  During  the  last  month,  particular  attention  nhould 
be  paid  to  the  nipples.  Untold  misery  often  results  to  the  young 
mother  froi'i  sore  nip/iles ;  and  it  is  well  worth  her  while  to  use  every 
precaution  against  them.  The  nip|)les  are  of  course  in  an  excitable 
state  during  the  whole  period  of  gestation,  and  at  length  frequently 
become  irritable  and  tender.  L<^t  them  be  daily  bathed,  for  three  or 
four  weeks  before  confinetnent,  with  some  astringent  and  cooling 
lotion,  as  oak-bark  decoction,  borax  water,  alum  water,  or  a  solution 
of  tannin  (•.->00)  (--201)  {^Oi)  (:iO:}). 

The  object  of  treatment,  in  this  case,  ia  to  toughen  them,  and  ren- 
der them  less  susceptible,  so  that  they  may  not  be  made  tender  by  the 
subsequent  application  of  the  child's  lips. 

When  a  woman  is  peculiarly  liable  to  this  trouble,  the  further  pre- 
caution of  having  them  gently  drawn,  by  some  friend,  every  day, 
during  this  last  uionth,  would  be  of  great  servifie. 

At  all  events,  let  no  pains  be  spared  to  guard  against  this  evil ;  for 
sore  nipples  make  sore  breasts;  and  sore  breasts  make  broken  breasts; 
and  broken  breasts  are  terrible  things.  They  make  the  mother  sick; 
and  if  the  mother  is  sick,  the  child  is  sure  to  be  sick ;  and  all  hands 
soon  get  sick  and  worried ;  and  the  whole  business  of  having  children, 
and  taking  care  of  thiMu,  is  deprived  of  its  peculiar  joys  and  consola- 
tions, and  brought  into  und(!serv«?d  disrepute.  Whereas,  under  wise 
and  prudent  management,  there  is  something  delightful  to  the  young 
mother  in  yielding  sustenance  to  her  dependent  ofispring.  For,  when 
her  nipples  and  breasts  are  in  a  healthy  state,  she  can  say  with  the 
pjct,  as 

"  The  starting  beverage  ineeta  ita  thirsty  lip, 
'T  is  joy  to  yield  it,  as  'tis  joy  to  sip." 

Swatlliiu^.  —  In  advanced  pregnancy,  much  assistance  in  supporting 
the  burden  is  sometimes  derived  from  swaihing  the  bowels.  Healthy 
and  vigorous  women,  however,  need  no  such  assistance ;  it  is  chiefly 
applicable  to  cases  of  debility,  either  constitutional,  or  resulting  from 
neglect,  or  from  over-exertion  during  former  pregnancies. 

Cramp  in  the  Stomach  is  sometimes  very  severe,  and  if  allowed  to 
continue,  may  kill  the  child.  The  best  remedies  are  warm  carmina- 
tives (114)  (115),  or  anodynes,  etc.  (121)  (122),  or  antispasraodicsa 
(90)  (94). 


■V    ■  r' 


j-ii.;- 


X'-au-jpi  'ti'ii  ■  -'.^ 


.v.r' 


38U 


FEMALE  DISEASES. 


Headaches.  —  These  may  be  relieved  by  anthpasmodica,  etc  (90) 
(94),  or  anodyries  (12]). 

Palpitation  of  the  Heart  may  prove  very  distressing  to  delicate 
women.  The  remedies  are  the  an  ispasmodics,  with  rest.  Some- 
times tonics  are  useful,  such  as  the  muriated  tincture  of  iron  (73). 
The  bowels  should  be  carefully  regulated. 

Fainting;,  which  occurs  before  or  at  the  time  of  quickening,  is  some- 
times very  troublesome.  The  proper  treatment  is  the  avoidance  of 
fatigue,  and,  during  the  fainting  fit,  the  recumbent  posture,  cool  air, 
application  of  cold  water  to  the  face,  and  amtnunia  to  the  nose. 

Coug^h  is  sometimes  present.  It  is  caused  by  the  upward  pressure 
of  the  diaphragm  against  the  lungs,  by  which  they  are  irritated  and 
convulsed.  The  remedies  may  be  selected  from  tiie  cough  prepara- 
tions among  the  prescriptions. 

Varicose  Veins. —  These  cannot  be  removed  during  pregnancy;  but 
they  may  be  relieved  by  great  care  of  the  bowels,  and  by  wearing 
tight  bandages,  or  elastic  stockings. 

8wellin|(  of  Lower  Limbs  is  caused  by  pressure  of  the  enlarged 
womb  upon  the  veins ;  and  may  be  relieved  by  care  of  the  bowels, 
and  diuretics  (130). 

Itchinji;  of  the  Genitals  may  be  much  relieved  by  borax,  morphine, 
etc.  (204). 

Miscarriage. —Abortion. 

When  a  woman  in  the  family  way  throws  off  the  contents  of  het 
womb,  or  loses  her  child,  during  the  first  six  months,  the  accident  is  a 
miscarriage,  or  abortion  ;  when  the  same  thing  happens  during  the 
last  three  months  of  her  term,  it  is  a  premature  labor. 

Symptoms.  —  If  abortion  occur  during  tne  first  month  after  concep- 
tion, the  symptoms  may  not  attract  much  attention,  or,  may  be  re- 
garded only  as  an  irregularity  of  menstruation.  Occnring  at  later 
periods,  it  is  frequently  indicated  by  some  feverisluiess,  coldness  of 
the  feet  and  legs,  a  puffed-up  condition  of  the  eye-lids  with  purpli^^h 
discolorations,  shooting  pains  in  the  breasts,  which  become  soir,  pains 
in  the  back,  bearing-down  pains  in  the  lower  part  of  the  bo'./els, 
which  come  and  go,  and  at  length  take  the  character  of  real  labor 
pains.  As  these  pains  increase,  blood  begins  to  appear,  and,  sooner 
or  later,  the  bag  of  water  breaks,  and  the  fetus  is  thrown  off. 

Causos.  —  These  are  very  numerous.  Some  of  the  principal  are, 
displacement  of  the  womb  ;  ulceration  of  its  neck  ;  syphilitic  disease 
of  the  fetus  received  from  the  parent ;  too  much  exercise  ;  heavy  lift- 
ing ;  falls,  particularly  when  the  woman  comes  down  upon  the  feet, 
and  is  heavily  jarred ;  emetics ;  powerful  purges ;  and  too  much  nup- 
tial indulgence. 


etc  (90) 

delicate 
|t.      Some- 
iron  (73). 


Ig,  13  BOine- 
bidaiice  of 
(e,  cool  air, 
nose. 

rd  prcHflure 
rituted  and 
h  prepara- 

lancy;  but 
>y  wearing 

e  enlarged 
he  bowels, 

morphine, 


;ents  of  he? 
Bcident  is  a 
during  tlie 

'ter  concep- 
tnay  be  re- 
ng  at  later 
uildiiess  of 
fli  purpii:<h 

soft,  pains 
he  bo'vels, 

real  labor 
md,  sooner 
.If. 

ncipal  are, 
tic  disease 
heavy  lift- 
n  the  feet, 
much  nup- 


FEMALR  DISEASES. 


381 


Trratment.  —  Where  the  symptoms  are  but  slight,  nothing  may  b« 
rp(|uired  more  than  a  little  caution  for  a  few  days,  and  rest  in  the 
iiorizontal  posture,  using  cold  drinks,  and  taking  for  two  or  three 
nights,  at  bedtime,  perhaps,  a  pill  composed  of  one  grain  of  opium 
and  two  grains  of  sugar  of  lead.  Beside  these  remedies,  it  may  be 
well  to  put  a  nmstard  poultice  low  down  upon  the  back. 

If,  notwithstanding,  flooding  comes  on,  and  the  symptoms  of  mis- 
carriage increase,  8.  napkin  wettcid  with  cold  water,  or  viiM'gar  and 
x.ater,  or  a  bladder  partly  filled  with  ice,  should  be  laid  upon  the  ex- 
fi-rnal  genitals,  and  pulverized  alum,  mixed  up  with  a  little  honey, 
iiiHut  be  given  internally,  every  half  hour ;  and  if  the  flooding  still 
iiK Tease,  it  may  be  proper  in  some  cases  to  resort  to  the  tam|)on  or 
|)lug.  To  do  this,  take  either  lint,  or  old  pieces  of  calico,  or  a  piece 
of  ime  sponge,  and  having  soaked  it  full  of  a  strong  solution  of  alum, 
or  tannin,  or,  still  better,  Monscl's  persalt  of  iron,  one  part  to  six 
parts  of  water,  —  till  the  vagina  full,  and  then  place  a  fold  of  linen  in 
the  genital  fissure,  and  apply  a  bandage.  This  will  generally  stop  the 
(low ;  but  the  plug  must  be  removed  in  from  five  to  ten  hours. 

If  the  abortion  cannot  be  prevented,  —  especially  in  the  latter 
months  of  gestation,  then  the  case  is  to  be  permitted  to  go  on,  and  to 
be  treated  the  same  as  a  natural  labor. 

Labor.— Delivery. 

The  expulsion,  at  full  term,  of  the  child,  the  after-birth,  the  mem- 
branes, and  the  fluids,  constitutes  labor,  or  delivery.  It  is  supposed 
to  occur  about  two  hundred  and  eighty  days  after  the  last  menstrua- 
tion ;  but  authors  reckon  it  differently ;  in  truth,  it  is  not  possible  to 
fix  it  exactly,  for  it  evidently  varies  in  different  cases. 

When  the  time  of  her  lying-in  arrives,  let  every  woman  meet  it 
with  calmness  and  undoubting  confidence.  There  is  every  reason  to 
encourage  this  state  of  mind.  Think  of  the  vast  multitudes  of  people 
in  the  world.  Each  one  once  existed  in  the  womb  of  a  mother,  and 
had  to  pass  through  its  narrov  portals  to  be  admitted  to  the  light 
Successful  delivery  is  the  r>  .e,  the  world  over;  and  it  should  be  the 
rule  to  confidently  expect  it 

In  the  midst  of  the  pains  of  labor,  nothing  does  more  to  bring  a 
favorable  result  than  courage  and  patience.  Patience  is  able  calmly 
to  survey  all  the  difficulties  oefore  her,  because  she  never  attempts  to 
encounter  but  one  at  a  time.  There  is  much  philosophy  in  the  story 
of  the  ^^  discontented  pendulum"  which  got  discouraged,  one  morning' 
from  reflecting  how  many  millions  of  times  it  would  have  to  swing 
during  succeeding  years,  but  became  reassured  upon  considering  that 
a  single  stroke  cost  but  a  very  trifling  effort,  and  that  it  really  had  to 
make  bvi  am  ai  a  time.  So  it  is  with  labor ;  its  pains,  which  are 
really  severe  and  agonizing,  will  become  comparatively  tolerable,  if 
the  whole  attention  of  the  woman  be  confined  to  present  suffering, 
and  her  whole  stock  of  courage  and  patience  be  brought  to  bear  upon 
one  pang  at  a  time. 

Let  her  resist  the  temptation  to  a  feeling  of  haste.     Nature  will 


:ij«i«»i»-*'iCX 


^im* 


382 


KEMALK  DISKASES. 


often  proceed  more  evenly,  and  more  Hpcedily,  if  allowed  to  take  her 
own  time.  A  hurry  to  gvt  through  is  a  great  obstacle  to  succeBsful 
delivery ;  it  always  puts  things  back. 

SyiiiptoiiiH. —  Onr  of  the  first  indications  that  labor  is  about  to 
begin  in,  that  flic  woman  linds  herself  smaller,  —  the  child  having 
sunk  down  lower  in  the  abdomen,  and  she  accordingly  breathes 
easier.  The  genital  organs  become  relaxed  and  moist,  and  mucus 
escapes,  which  is  called  "  the  shows."  'J'he  woman  finds  herself  dis- 
posed to  be  nervous  and  fidgety,  and  perhaps  a  little  depressed  in 
spirits. 

When  labor  has  fully  net  in,  it  is  marked  by  lowness  of  spirits, 
flashes  of  heat  and  cold,  a  great  desire  to  empty  the  bowels  and  to 
make  water,  and  grinding,  cutting  pains,  which  grow  stronger  and 
more  continuous,  with  intervals  of  ten  or  fifteen  minutes'  ease  be- 
tw<;en.  Vomiting  in  the  early  stages  of  labor  often  o<!cur8,  and  may 
be  regarded  as  favorable,  —  indicating  the  softening  and  opening  of 
the  mouth  of  the  womb. 

'^reatlHCUt  or  Lubur. —  When  labor  begins,  the  attention  should  bo 
directed  to  tla;  stale  of  the  bowels  and  bladder.  The  child's  head 
begins  early  to  press  u\wn  the  bladder  and  lower  bowel,  eiusing  the 
desire  to  make  water,  etc. ;  and  these  should  be  immediately  empti(;d 
to  make  room  for  the  head  to  pass  more  easily.  The  bowel  may  be 
freed  by  a  dose  of  castor  oil  (10),  if  there  is  time  for  it  to  operate, — 
but  more  surely,  and  more  satisfactorily,  by  an  injection.  Relief  in 
the  bladder  may,  perhaps,  be  obtained  by  a  difierent  position  of  the 
woman  in  the  act  of  making  water.  It  is  the  pressure  of  the  child's 
head  upon  the  water-pipe  which  causes  the  trouble  ;  and  to  relieve  it, 
the  woman  should  get  upon  her  hands  and  knees,  with  her  shoulders 
lower  than  the  hips,  so  as  to  throw  the  child  upward  and  forward 
towards  the  cavity  of  the  abdomen.  Thus  situated,  she  may  often 
find  it;  easy  to  make  water,  when  in  the  ordinary  position  it  would  be 
impossible.  If,  however,  this  manoeuvre  does  not  succeed,  and  the 
bladder  becomes  greatly  distended,  the  catheter  must  be  used. 

Tlie  Bed  and  Ilabiliments. —  In  the  next  place,  fix  the  bed,  and 
the  patient's  habiliments.  Reject  feather  beds ;  use  the  mattress. 
Cover  this  with  a  rubber  cloth,  if  convenient,  and  then  with  folded 
sheets  to  absorb  the  discharges,  and  protect  the  bed.  Let  the  woman 
be  arrayed  in  the  same  garments  she  expects  to  wear  after  the  com- 
pletion of  the  labor,  and  let  these  be  well  tucked  up  under  her  arms, 
and  let  the  lower  portion  of  her  body,  from  the  waist  downwards, 
be  enveloped  in  a  sheet.  This  sheet  can  be  easily  removed,  and  the 
clean  clothes  pulled  down  without  greatly  disturbing  the  patient  when 
in  the  exhausted  state  which  follows  labor,  and  when  it  would  subject 
her  to  great  fatigue  to  be  obliged  to  sit  up  in  bed  to  have  her  clothes 
changed.  Let  her  lie  upon  her  left  side,  with  her  body  shortened  by 
bending  forward,  so  that  the  muscles  may  be  relaxed ;  let  her  head  be 
placed  in  the  middle  of  the  bed,  and  her  feet  press  against  the  right 
foot-post.  Around  this  post  a  shawl  or  towel  may  be  fastened,  upon 
which  she  may  be  allowed  to  pull  during  the  pains. 


If)  tako  her 

IHUCCUBiiflll 

al)ont  to 

hrciltlir.s 
liiil  niiK  MS 
Icrsclf  (lis- 
||»rc«H(.'d  ill 

of  H|)irits, 

Is  tuid  to 

longer  and 

Is*  case  be- 

,  ;ind  may 

)|)eiii)ig  of 

sliould  be 

I i Id's  head 

lusing  tlie 

ly  emptied 

vel  may  be 

operate, — 

Relief  ill 

tioa  of  the 

the  child's 

o  relieve  it, 

r  shoulders 

lid  forward 

may  often 

t  would  be 

id,  and  the 

e  bed,  and 
?.  mattress, 
vith  folded 
the  woman 
r  the  coiu- 
r  her  arms, 
lownwards, 
•d,  and  the 
itient  when 
uld  subject 
her  clothes 
ortened  by 
ler  head  be 
t  the  right 
ened,  upon 


FEMALE  DISEASES. 


383 


The  Prfsenfrttlon.  —  An  examination  with  the  finger  is  to  be  mado 
to  learn  the  pri>seiitation,  —  that  is,  to  learn  which  part  of  the  child 
comes  first  into  the  mouth  of  the  womb. 

lleud  l*reHfntatloil. —  If  the  head  present,  the  labor  will  probably 
go  on  without  the  need  of  medical  aid.  But  in  all  labors  there  is  a 
liability  to  dangers  from  unforeseen  accidents,  which  rciideis  the  at- 
tendance of  an  intelligent  physician  highly  prudential. 

Brcrcll  or  Feet  PreMCIlttlthMI. —  If  the  feet  or  bnrech  present,  it  i» 
desirable  to  have  the  lir.sl  \r.\ri  of  the  labor  proceed  slowly,  so  tl'at 
the  passage  may  become  well  dilated,  and  prepared  for  a  more  ra| 
d<'livery  of  the  head.  If  the  breech  present,  do  not  pull  down  tin. 
feet;  let  the  child  come  double:  it  will  make  more  room  for  the  head. 
If  the  feet  present,  let  there  be  no  ]>ulling  upon  them  to  hasten  the 
birth  of  the  breech. 

After  the  f»'et  and  breech  have  fully  cleared  the  external  orifice, 
the  delivery  may  be  judiciously  haetened  for  the  purpose  of  prevent- 
itig  the  death  of  the  child  from  pressure  on  the  umbilical  cord,  ticfore 
its  head  is  brought  to  the  air,  and  the  act  of  breathing  thus  permitted. 
For  after  the  pulsations  of  the  cord  cease,  the  child  must  either 
breathe  or  die. 

Ill  this  kind  of  presentation,  therefore,  the  child's  life  is  in  great 
danger.  Alter  llie  birth  of  the  lower  half  of  the  body,  the  cord  ex- 
periences severe  |)ressnre,  suflicient  to  interrupt  if  not  wholly  prevent 
its  pulsations.  It  then  b  "comes  necessary  to  hasten  the  birth  of  the 
upper  extremities  and  hi-ad  by  all  prudent  means.  Violence  is  never 
ill  order  in  midwifery;  but  considerable  force,  skilfully  directed,  may 
sometimes  be  safely  used.  After  the  'loulders  are  delivered,  the  pas- 
sage of  the  head  may  be  facilitated  by  carefully  pulling  down  the 
arms.  Then,  as  soon  as  possible,  introduce  the  linger  into  the  mouth 
of  the  child.  This  will  serve  the  double  purpose,  perliaps,  of  |)er- 
mitting  a  little  air  to  make  its  way  into  the  child's  lungs,  and  of  fur- 
nishing a  hold  by  which  its  head  may  be  gently  drawn  along  into  the 
world.  -. 

If  there  ia  much  delay  at  this  juncture,  perhaps  in  some  cases  the 
child's  life  may  be  preserved  by  inserting  into  its  mouth  one  end  of  a 
male  catheter,  —  thus  furnishing  an  open  tube  for  the  passage  of  air, 
until  more  vigorous  pains  shall  introduce  it  into  the  full  liberty  of  the 
atmosphere.  While  the  head  is  yet  undelivered,  great  care  should  be 
used  to  keep  the  child's  body  warm  by  covermg  it  with  flannel,  and 
also  to  keep  it  in  a  correct  relative  position  with  the  head.  If  the 
body  be  incautiously  turned  round,  of  course  the  neck  will  be  twisted ; 
and  the  child's  subsequent  delivery  with  a  broken  neck  will  be  the 
miserable  result,  —  bringing  confusion  to  the  msdical  attendant,  and 
unhappiness  to  all  concerned. 

Arm  or  Shoulder  Presentation.  —  If  the  arm  or  shoulder  present 
the  child  will  probably  have  to  be  turned.  In  case  this  cannot  be 
eflfected,  its  chest  must  be  opened  and  emptied  of  its  contents,  that 
there  may  be  room  to  bring  down  the  head.  It  is  barely  possible  to 
avoid  a  resort  to  art  in  this  presentation. 


m 


384 


FEMALE  DISEASES. 


Flooding  or  Hemorrhage,  occurring  to  an  alarming  extent,  is  hap« 
pily  one  of  the  rare  incidents  or  consequences  of  labor.  But  when  it 
does  occur,  it  demands  the  most  serious  and  prompt  attention. 

Profuse  bleeding  from  the  womb  is  most  commonly  owing  to  a 
partial  separation  of  the  placenta,  or  after-birth,  from  its  attachment 
to  the  internal  cavity ;  and  it  has  recently  been  observed  that  the  flow 
proceeds  more  rapidly  from  the  detached  portion  of  the  after-birth 
than  from  the  corresponding  exposed  surface  of  the  womb.  A  knowl- 
edge of  this  fact  has  an  important  practical  bearing;  for  if,  in  severe 
cases  of  flooding,  the  partially  detached  after-birth  can  be  entirely 
separated,  the  bleeding  will  often  be  speedily  arrested. 

The  most  dangerous  floodings  occur  in  cases  of  placenta  previa, 
when  the  after-birth  is  over  the  mouth  of  the  womb.  In  such  cases, 
when  the  labor  commences,  and  the  womb  begins  to  open  itself,  the 
after-birth  must  of  course  be  partially  separatod.  These  cases,  unless 
promptly  relieved  by  art,  may  prove  fatal  in  a  few  minutes.  Yet, 
there  is  ordinarily  sufficient  time,  if  it  be  improvedj  calmly  to  choose 
and  pursue  the  proper  treatment.  If  the  flooding  be  immediately 
dangerous  to  life,  the  child  must  be  turned  and  delivered,  or  the 
tampon  or  plug  ba  applied,  as  directed  under  the  head  of  abortion. 
This  expedient  is  used  when,  through  rigidity  of  the  mouth  of  the 
womb,  the  delivery  is  inadmissible. 

Before  Delivery.  —  In  all  cases  of  flooding,  we  prescribe  quiet,  the 
recumbent  posture,  cold  applications  to  the  abdomen  and  the  external 
genitals,  and  the  internal  administration  of  astringents  and  anodynes 
(152). 

After  Delivery,  our  object  is  to  promote  contraction  of  the  womb 
by  cold  applications  and  frictions  externally,  or,  if  necessary,  by  the 
introduction  of  the  hand  into  the  womb,  for  the  purpose  of  removing 
the  after-birth,  clearing  out  clots,  or  stimulating  it  to  shut  itself  up  for 
the  expulsion  of  the  offending  substance.  Until  this  contraction  is 
secured,  the  plug  should  not  be  used,  lest  internal  bleeding  int>  the 
enlarged  and  expanded  womb  should  be  profuse,  and  fatally  exhaust 
the  patient. 

After  the  Child  is  Bom,  our  first  duty  is,  if  possible,  to  see  that  it 
breathes.  In  the  vast  majority  of  cases,  the  well-known  cry,  which 
salutes  the  ear,  gives  proof  that  the  duty  is  unnecessary.  But  some- 
times we  fail  to  hear  this  welcome  sound.  The  umbilical  cord  may 
be  once  or  repeatedly  wound  around  the  child's  neck,  and  must  be 
immediately  removed  to  prevent  strangulation  ;  or,  the  child's  mouth 
may  be  filled  with  phlegm,  or  some  sticky  mucus,  which  must  be 
poked  out  with  the  finger,  and  its  exit  favored  by  turning  the  face 
downward ;  or,  after  tedious  labors,  the  child  may  be  born  in  a  very 
feeble  state,  and  may  need  the  stimulus  of  cold  wat«r  thrown  sucl- 
deiiij,  in  small  quantities,  upon  its  chest  and  body,  with  considerable 
rubbing,  and  perhaps  the  inflation  of  its  lungs  with  air  blown  into  its 
mouth. 

Tyinjf  the  Cord. — When  breathing  is  established,  a  piece  of  narrow 


nt,  is  hap< 
ut  when  it 
on. 

wing  to  a 
ttachment 
it  the  flow 
after-birth 
A  knowl- 
in  severe 
je  entirely 

>Ua  previa, 
mch  cases, 
itself,  the 
ises,  unless 
iites.  Yet, 
f  to  choose 
nmediately 
•ed,  or  the 
if  abortion. 
)uth  of  the 


;  quiet,  the 
he  external 
d  anodynes 

the  womb 
iary,  by  the 
•f  removing 
itself  up  for 
ntraction  is 
iig  intj  the 
illy  exhaust 

see  that  it 


cry, 


which 


But  some- 
1  cord  may 
nd  must  be 
lild's  mouth 
3h  must  be 
(ig  the  face 
rn  in  a  very 
hrown  suu- 
!onsiderable 
)wu  into  its 

e  of  narrov/ 


FLMALE  DISEASES. 


385 


tape  or  common  twine  is  to  be  tied  tight  around  the  navel-string, 
about  two  inches  from  the  child's  navel,  and  the  cord  is  then  to  be 
cut  off,  with  a  pair  of  sharp  scissors,  from  half  to  three  quarters  of 
an  inch  outside  the  place  w  here  it  is  tied.  The  child  is  then  to  be 
delivered  to  the  nurse. 

Washing^  the  Child.  —  The  child  is  now,  while  the  physician  is  at- 
tending to  the  mother,  to  be  washed  and  dressed  by  the  nurse.  Its 
skin  is  at  this  time  covered  with  a  suet-like  substance,  called  the 
vernix  caseosa.  To  remove  this,  it  should  be  washed  all  over  gently 
with  warm  water  and  castile  soap.  It  is  not  material  that  this  coat- 
ing should  be  absolutely  all  removed  at  the  first  washing ;  but  the 
soap  and  water  should  be  again  gently  applied  in  eight  or  ten  hours 
from  their  first  use.  It  is  improper  to  use  spirits  foi  this  cleansing. 
All  rough  rubbing  must  be  avoided  as  injurious  to  the  delicate  skin 
of  so  tender  an  infant.  "Washing  with  cold  water  would  lower  the 
temperature  to  a  dangerous  degree,  and  should  in  no  case  be  allowed. 

Removal  of  the  After-Birth.  —  The  woman  having  rested  fifteen  or 
twenty  minutes,  a  little  gentle  soliciting  or  pulling  with  the  cord  will 
generally  bring  away  the  after-birth.  If,  however,  any  serious  obsta- 
cle prevent  its  expulsion,  it  may  be  slowly  and  cautiously  taken  away 
by  the  hand  introduced. 

Cleansing  the  Bed,  and  Applying  the  Swathe.  —  Upon  the  removal 
of  the  after-birth,  a  cloth  is  immediately  applied  to  the  external  or- 
gans, a  drink  of  water  or  tea  is  administered,  and  another  rest  of  an 
hour  or  more  allowed.  The  woman  m{\y  then  be  conveyed  to  a 
neighboring  bed,  sofa,  or  easy-chair,  for  the  purpose  of  cleansing  the 
bed,  adjusting  her  clothes,  and  applying  the  swathe.  This  last  men- 
tioned application  may  consist  of  a  towel  pinned  sr.agly  around  the 
body,  or  of  a  cloth,  cut  and  fitted  exactly  for  the  purpose.  Its  object 
is  to  afford  a  firm  and  steady  support  to  the  contracting  womb. 

If  a  chair  is  occupied  while  the  bed  is  being  arranged,  it  should  be 
well  tipped  back,  and  the  woman's  feet  supported  on  a  high  stool,  as 
it  is  of  great  importance,  so  soon  after  delivery,  to  keep  her  either 
entirely  or  very  nearly  in  the  recumbent  posture,  to  avoid  dangerous 
fl  codings. 

Tlie  Dressing  for  the  Child's  IVavel  should  be  so  fixed  that  the 
navel-string  or  cord  will  not  be  left  in  contact  with  the  healthy  skin. 
To  effect  this,  make  a  hole  large  enough  to  admit  the  cord  in  the 
centre  of  a  piece  of  linen  cloth  four  inches  square  ;  pull  the  cord 
through  this  hole,  leaving  the  c'rth  lying  flat  upon  the  child's  belly  ; 
then,  having  bandaged  the  cord  down  to  the  belly,  fold  the  cloth  over 
it,  and  apply  the  belly-band.  The  interposition  of  these  dressings 
will  thus  keep  the  cord,  which  is  dead  and  in  process  of  decomposition, 
from  irritating,  and  perhaps  excoriating  the  living  flesh,  with  which  it 
must  otherwise  be  in  close  contact. 

IVonrishnient  of  the  Child,  etc.  —  After  being  dressed,  the  child 
sh'.  uld  be  kept  next  the  body  of  the  mother  or  nurse,  that  it  may 

49 


.»*■■' 


•■v#^ 


.'  ,V>i, 


"    III  J— 


38fi 


FEMALK  DISEASES. 


receive  the  natural  warmth  thus  to  be  derived.  Its  nourisiinieiit 
should  be  obtained  exclusiv(!!y  from  the  mother's  breast.  If  it  is 
hungry,  be  sure  and  keep  it  so.  There  is  nothing  more  appropriate 
than  a  hungry  child  all  ready  to  take  hold  and  exhaust  the  full  and 
almost  bursting  breast  on  the  third  day,  when  the  milk  has  come. 
Alas  !  How  many  children  have  been  fed  on  sweetened  water,  and 
on  milk  and  water,  till  they  have  lost  all  instinctive  idea  of,  and  all 
appetite  for,  nursing!  and  how  many  bowel  complaints  and  broken 
breasts  have  been  the  miserable  consequence !  But  meddlesome 
friends  are  afraid  the  "  little  dears "  will  starve ;  and  therefore  they 
must  first  be  made  sick  by  unnatural  diet,  and  then  for  their  cure  be 
treated  to  that  filthy,  harsh,  and  indecent  substitute  for  medicine, 
"  chamber-lye  and  molasses.^'' 

But  it  may  be  asked,  "  must  not  the  child  be  fed  at  all,  if  it  is  hun- 
gry, and  cries  a  great  deal,  and  there  is  nothing  in  the  mother's  breast 
for  it?"  Such  cases  will  be  exceedingly  rare,  if  the  breasts  have 
been  properly  solicited  from  the  first  by  a  hungry  child.  When  they 
do  occur,  being  themselves  exceptions,  their  treatment  must  be  ex- 
ceptional ;  but,  even  then,  only  so  far  as  is  absolutely  necessary.  If 
fed  at  all,  the  child  should  not  be  fed  to  satiety,  but  as  little  as  the 
circumstances  will  possibly  permit.  The  great  rule  remains:  keep  the 
child  as  hungry  as  possible  till  the  milk  comes.  When  it  has  to  be 
fed,  imitate  the  mother's  milk  as  nearly  as  possible  in  the  preparation 
of  the  artificial  diet.  A  little  sweet  cream,  warm  water  and  sugar, 
should  be  so  mingled,  that  in  warmth,  richness,  and  sweetness,  the 
mixture  may  closely  resemble  human  milk. 

Diet  of  the  Mother.  —  For  the  first  few  days  after  confinement,  the 
most  appropriate  diet  for  the  mother  is  gruel,  cocoa,  rice-water,  crust 
coffee,  or  some  similar  liquid  nourishment.  Different  constitutions, 
however,  need  somewhat  diflferent  management. 

A  woman  naturally  robust,  and  of  full  habit,  should  confine  herself 
more  strictly,  and  for  a  longer  time,  to  this  light  diet,  than  one  who 
is  more  slender  and  feeble.  In  some  cases,  weakly  women  require 
the  juice  of  meat,  and  even  wine  or  ale,  as  early  as  the  second  or  third 
day.  If  she  be  subject  to  canker,  or  nursing-sore  mouth,  a  generous 
diet  is  particularly  serviceable.  After  the  first  week,  she  may  gradu- 
ally return  to  her  customary  diet. 

Costiveness  may  be  treated  with  the  usual  remedies.  It  was  an 
old  rule  to  give  a  dose  of  castor  oil  on  the  third  day,  when  there  is  a 
little  increase  of  excitement  in  the  system,  from  the  filling  of  the 
breasts.  This  is  not  always  necessary,  and  in  most  cases  an  injection 
would  be  far  better. 

The  Perpendicular  Position. — During  the  first  month,  let  the  woman 
avoid  being  often  or  long  on  her  feet.  This  is  a  very  essential  caution 
to  avoid  prolapsus,  or  falling  of  the  womb,  with  all  its  attendant  weak- 
nesses and  pains,  and  to  ensure  a  good  "  getting  up,"  with  a  sound 
womb,  in  the  right  place,  and  subsequent  months  of  health  and  enjoy- 
ment. 


vrv-.  ,f  j<-\; ,   .  .'ife^  i'j 


jurishnient 
If  it  is 
ippropriate 
he  full  and 
has  come, 
water,  and 
of,  and  all 
md  broken 
leddlesome 
refore  they 
leir  cure  be 
medicine, 

if  it  is  hun- 
iher's  breast 
reasts  have 
When  they 
nust  be  ex- 
cessary.     If 
little  as  the 
IIS :  keep  the 
it  has  to  be 
preparation 
and  sugar, 
veetness,  the 

finement,  the 
;-water,  crust 
constitutions, 

anfine  herself 
;han  one  who 
amen  require 
icond  or  third 
b,  a  generous 
e  may  gradu- 

s.     It  was  an 

hen  there  is  a 

filling  of  the 

!3  an  injection 

let  the  woman 
lential  caution 
tendant  weak- 
'  with  a  sound 
ilth  and  enjoy- 


Milk  Leg.  —  Phlegmasia  Dolens.  —  Crural  Phlebitis. 

Thk  popular  idea  is,  that  in  this  disease  the  woman's  milk  has  fallen 
into  Ikt  leg,  which  has  inflamed.  This  is  of  course  absurd.  As  to 
the  real  nature  of  the  complaint,  there  are  various  opinions,  —  some 
holding  it  to  consist  in  inflammation  along  the  sciatic,  crural,  and 
pubic  nerves ;  others,  that  it  is  an  inflan:imation  of  the  lymphatics  of 
the  groin  which  causes  it ;  others,  that  it  is  an  inflammation  of  the 
crural  veins.     Probably  this  latter  view  is  the  correct  one. 

Syiiiptoins.  —  The  disease  begins  in  from  two  to  seven  weeks  after 
delivery,  with  pain  in  the  lower  bowel,  groin,  or  thigh.  The  pain  is 
more  violent  when  the  thigh  is  extended.  In  a  day  or  two,  the  pain 
diminishes,  and  the  limb  begins  to  swell,  frequently  in  the  calf  of  the  leg 
first,  thence  extending  upward,  but  generally  in  the  groin,  and  extend- 
ing gradually  down.  The  skin  becomes  entirely  white,  smooth,  and 
glossy,  does  not  pit  when  pressed,  is  painful  to  th^  touch,  and  is  hotter 
than  the  skin  upon  the  other  limb.  In  connection  with  this  local 
disease,  there  is  general  fever,  with  small  and  rapid  pulse,  thirst,  etc. 

Treafilieut. —  The  patient  must  lie  flat  upon  her  back,  with  the 
swelled  limb  placed  u|)on  pillows,  or  a  bolster,  raised  so  that  the  foot 
shall  be  a  little  higher  than  the  hip,  and  th(!n  charged  not  to  put  her 
foot  down  upon  the  floor,  until  she  is  very  nearly  well. 

Apply  a  narrow  blister  along  the  course  of  the  crural  vein.  When 
this  is  removed  take  a  large  piece  of  flannel,  —  Dr.  Meigs  says  an  old 
flannel  petticoat,  with  the  hem  and  the  gathers  cut  off", — and  dip  it  in 
vinegar  and  hot  water,  equal  parts;  wing  it  out,  and  cover  the  whole 
limb  with  it.  Put  a  piece  of  blanket  o.  oiled  silk  over  it  to  keep  it 
from  wetting  the  bed.  Repeat  this,  and  keep  it  up  for  six  hours. 
When  it  becomes  tedious  to  the  patient,  remove  it,  and  bathe  the 
limb  with  warm  sweet  oil,  two  parts,  and  laudanum,  one  part,  and 
cover  it  with  flannel.  In  two  or  three  hours,  return  to  the  first  appli- 
cation of  hot  water  and  vinegar.  Continue  this  for  five  or  six  hours, 
and  then  take  warm  sweet  oil  and  laudanum ;  and  thus  pass  from 
one  to  the  other  until  the  inflammation  is  subdued,  or,  as  Dr.  Meigs 
says,  till  the  calf  of  the  leg  can  be  shaken. 

K  the  bowels  are  confined,  let  them  be  gently  moved  by  some  gen. 
tie  physic  (13)  (14)  (18)  (25)  (27)  (41). 

In  many  cases,  diuietics  and  cathartics  combined  will  be  proper 
(302),  or  diuretics  only  (128)  (130). 

While  the  inflammation  lastj,  and  there  is  fever,  the  tincture  of 
veratrum  viride  must  not  be  forgotten. 

If  recovery  does  not  take  place  after  the  active  inflammation  has 
subsided,  the  limb  should  be  bandaged  from  the  toes  to  the  grom. 

.    Child-Bed  Fever. — Puerperal  Fever. 

Few  complaints  more  justly  excite  the  dread  of  the  practitioner 
than  this.     It  cuts  down  woman  at  a  time  when  she  can  least  of  all 


'■§ 


ririiin  --■■■-"  - 


ii\ ;    r  i^-.. 


liSS 


FEMALE  DISEASES. 


be  spared  by  her  young  ofTspring,  and  at  a  moment  when  she  most 
excites  the  love  and  sympathy  of  her  whole  family.  It  is  a  terrible 
disease. 

It  consists  of  inflammation  of  the  peritoneum  or  lining  of  the  ab- 
domen ;  also,  frequently  inflammation  of  the  ovaries,  of  the  womb, 
of  the  veins  of  the  womb,  or  of  the  absorbent  vessels  of  the  womb. 

Its  symptoms  have  already  been  described,  on  page  277,  under  the 
head  of  inflammation  of  the  peritoneum.  The  treatment  is.  'ikewise^ 
there  given.  I  may  mention  here,  however,  that  an  infusion  ui  cham- 
oiiiile  flowers  is  lately  spoken  of  as  a  pov^erful  means  of  preventing 
.V  i/ipurcUion  in  this  complaint. 

There  is  a  diversity  of  opinion  as  to  whether  this  disease  is  conta- 
gi«)us,  though  the  best  medical  testimony  seems  now  to  be  on  the 
ullirmative  side  of  the  question.  The  physician  or  midwife  having  a 
case  of  child-bed  fever  in  charge,  should  not  for  some  time  attend 
cases  of  midwifery. 

Nursing  Sore  Mouth. 

Nursing  women  sometimes  suffer  terribly  with  this  complaint  It 
begins  with  a  scalding  sensation  upon  the  tongue,  a  pink  color  in  the 
roof  of  the  mouth,  and  a  hot,  watery  discharge  from  the  mouth. 
After  a  few  days,  small  ulcers  appear  on  the  tongue,  and  in  the 
throat.  Costivenesd  is  generally  present ;  but  when  the  ulceration 
extends  to  the  bowels,  diarrhoea  occurs.  It  comes  to  an  end  upon 
weaning  the  child. 

Treatment. — To  relieve  costiveness,  give  some  gentle  cathartic  (12) 
(lo)  (25)  (34)  (36).  

Iron  in  some  of  its  forms  and  combmations  is  highly  necessary  (61) 
(71)  (73)  (349). 

Gargles  will  frequently  do  much  good  (227)  (229)  (230)  (235)  (243) 
(244)  (347)  (350). 

The  diet  must  be  simple,  nourishing,  and  r^'gestible,  consisting  of 
stale  bread,  potatoes,  tender  beef  steak,  roast  oeef,  broths,  etc. 

Inflammation  of  the  Breast.— Broken  Breast. 

Mammary  Abscess. 

The  mammary  gland,  or  gland  which  secretes  milk  in  the  human 
breast,  consists  of  a  number  of  ducts,  passing  inward  from  their  ter- 
mination in  the  nipple,  and  then  spreading  around  like  the  roots  of  a 
tree,  and  terminating  in  miimte  glands.  The  mammillary  tubes  are 
straight  ducts,  ten  or  twelve  in  number,  having  their  mouths  at  the 
centre  of  the  nipple,  dilating  at  its  base  into  larger  reservoirs,  which 
extend  some  distance  into  the  gland.     (Fig.  142.) 

When  milk  is  first  formed,  after  confinement,  these  tubes  and  res- 
ervoirs sometimes  get  so  full  and  hard  that  they  crowd  and  compress 
each  other,  making  it  difficult  to  remove  the  milk,  and  under  these 
circumstances,  the  breast  will  inflame. 


i.r-;wffr...:;i;.^. 


n  she  most 
ia  a  terrible 

g  of  the  ab- 
the  womb, 
he  womb, 
under  the 
'ikewiae^ 
on  of  cham- 
preventing 


is. 


se  is  conta- 

be  on  the 

nfe  having  a 

time  attend 


)mplaint  It 
c  color  in  the 

the  mouth. 

and  in  the 
he  ulceration 
an  end  upon 

cathartic  (12) 

lecessary  (61) 

0)  (235)  (243) 

consisting  of 
#,  etc. 

3reast. 


n  the  human 
roni  their  ter- 
the  roots  of  a 
lary  tubes  are 
aouths  at  the 
ervoirs,  which 

ubes  and  res- 
and  compress 
i  luider  these 


FEMALE  DISEASES. 


389 


Via.  142. 


Sjmptoiiis.  —  The  inflammation  generally  begins  with  a  chill,  fol- 
lowed by  fever,  and  pain  of  a  shooting  kind,  which  is  much  increased 
by  pressure.  An  examination  will  generally  reveal 
a  circumscribed,  hard,  and  painful  tumor,  even  be- 
fore there  is  any  redness  on  the  surface.  After  a 
time,  the  swelling  spreads,  the  skin  becomes  of  a 
dusky  red,  is  hot  and  siiiniiig,  will  frequently  pit  a 
little  on  pressure,  and  soon  gives  a  sense  of  fluctua- 
tion. Upon  the  formation  of  matter,  the  fever  is 
increased,  the  breast  is  enlarged,  and  there  is  local 
tenderness  and  throbbing  pain. 

This  com|ilaint  may  be  caused  by  taking  cokl 
irregularities  in   diet,  or  by  mental   emotion ;   but 
more  commonly  it  is  caused  by  accumulation  of 
milk  within  the  ducts. 


Trerttliieilt.  —  These  afllictiona  may  generally  be 
prevented  by  keeping  the  breasts  well  drawn.  It  is  the  duty  of  a 
nurse  to  look  well  after  this  matter,  and  see  that  the  breasts  do  not 
get  hard  and  distended  with  milk. 

But  when  the  inflammation  has  fairly  set  in,  the  first  aim  should 
be  to  prevent,  if  possible,  the  formation  of  matter. 

Active  purging  should  be  resorted  to  at  once  (29)  (32).  Sweating 
should  be  encouraged  by  the  tincture  of  veratrum  viride.  If  the 
object  be  to  prevent  the  formation  of  matter,  cold  lotions,  or  cold 
water  compresses,  should  be  used  freely  ;  but  if  two  or  three  days 
have  passed  before  active  treatment,  the  suppuration  will  go  on,  and 
it  is  better  to  use  warm  applications.  Dewees  says  warm  vinegar  is 
the  most  beneficial  as  well  as  the  most  comforting.  Poultices  and 
warm  fomentations  are  much  used.  Some  apply  stimulating  lini- 
ments, made  of  essential  oils,  etc.  (195)  (198).  Leeches  are  often 
used  with  advantage.  They  should  be  applied,  not  upon  the  breast^ 
but  just  below  it. 

During  the  progress  of  the  disease,  especially  after  he  abscess  is 
opened,  the  breast  should  be  supported,  and  prevented  from  hangi)ig 
down,  by  long  strips  of  adhesive  plaster  carried  below  and  around  it 
By  this  means  a  gentle  pressure  is  kept  up  by  which  the  matter  is 
more  easily  evacuated. 

The  breast  should  be  opened  with  a  lancet  as  soon  as  the  abscess 
points,  or  fluctuation  is  discovered.  Should  the  ulcer  not  heal,  an 
astringent  wash,  as  a  weak  solution  of  nitrate  of  silver  (211)  may  be 
applied  to  it  once  or  twice  a  day. 

Duning  the  discharge  of  matter,  the  system  of  the  patient  should 
be  supported  by  a  nourishing  diet,  and  by  wine,  tonics,  etc. 

Sore  Nipples. 

Women  suffering  from  excoriated  nipples  are  apt  to  keep  the  infant 
chiefly  to  the  healthy  breast,  and  only  to  apply  it  to  the  tender  side 
for  the  purpose  of  obtaining  present  ease  from  the  pain  of  over-dis- 


■■v;,;--?'/  .^,:,.,-, 


tension.  In  this  way  the  ducts  remain  always  full,  and  are  apt  to 
get  inflamed.  Sore  nipples,  therefore,  are  to  be  attended  to  as  much 
on  account  of  the  evils  to  which  they  lead,  as  of  the  suffering  they 
directly  occasion. 

The  excoriation  of  the  nipples  begins  as  a  chap.  This  shows  no 
tendency  to  heal ;  and  the  child's  mouth  being  often  applied,  rubs  off 
the  skin  around  the  crack,  and  this  naked  surface  soon  becomes  an 
ulcer.  These  ulcers  are  sometimes  only  on  the  surface ;  at  other 
times  they  are  profound,  going  deep  into  the  substance  of  the  nipple. 

Treatment.  —  These  excoriations  and  ulcers  might  be  easily  healed, 
were  it  not  that  the  newly-formed  skin  is  apt  to  be  continually  rubbed 
off  by  the  child's  mouth  in  the  act  of  snckin*?.  Two  things  are  there- 
fore to  be  done,  —  to  favor  the  healing,  and  to  protect  the  tender  part 
from  renewed  injury. 

For  the  first  object,  a  strong  infusion  of  green  tea  or  port  wine  may 
answer  very  well  in  ordinary  cases.  A  little  alum  or  borax,  dissolved 
in  rose  water,  or  water  (201)  (202),  is  often  used.  A  weak  solution 
of  sulphate  of  zinc,  or  sulphate  of  copper,  or  nitrate  of  silver  (209) 
(211)  But  one  of  the  very  best  articles  is  composed  of  glycerine  and 
tannin  (306). 

To  protect  the  teat  from  injury  in  the  act  of  sucking,  use  a  shield 
made  of  India  rubber.  "When  the  infant  is  not  at  the  breast,  the 
nipple  should  be  covered  by  a  metal  shield. 


Whites.  —  Leucorrhwa.  —  Fluor  Albus. 

Though  leucorrhoea  is  only  a  symptom  of  disease,  —  as  I  have 
stated  on  page  353,  —  yet  I  think,  on  further  reflection,  remedies  should 
be  given  for  it,  and  I  accordingly  insert  them  here. 

If  the  discharge  be  of  a  ropv,  tenacious  character,  one  of  the  best 
remedies  is  a  strong  solution  of  nitrate  of  silver,  used  as  an  injection 
with  a  female  sy.mge,  once  a  day  (254).  Of  this,  not  more  than  two 
teaspoonfuls  sKould  be  used  at  a  time ;  and  great  care  should  be  ob- 
served not  to  stain  the  under-clothes  with  it.  When  the  discharge  is 
either  yellow  and  thick,  or  lighter  colored  and  watery,  some  one  of 
the  following  (200),  (202),  (203),  (207),  (209),  (220),  (230),  (232), 
(243),  (244),  may  be  used  with  advantage  as  an  injection,  twice 
a  day.  An  infusion  of  the  white  pond  lily,  one  ounce  to  the  pint  of 
water,  or  two  drams  of  the  fluid  extract  of  the  same  in  four  ounces 
of  water,  makes  a  very  excellent  injection,  which  may  be  used  twice 
a  day.  A  very  sim'ple  injection,  and  sometimes  quite  effectual,  is  a 
strong  infusion  of  green  tea.  * 

Some  one  of  the  above  remedies  will  generally  afford  some  relief; 
but  if  whites  exist  in  a  somewhat  aggravated  form,  they  furnish  evi- 
dence of  some  serious  disease  in  the  vagina,  or  neck  of  the  womb, 
and  the  case  ought  to  be  submitted  to  a  competent  physician. 


■are  apt  to 

lo  as  much 
feriiig  they 

shows  no 
id,  rubs  off 
Jecomes  an 
1 ;  at  other 
Ihe  nipple. 

pily  healed, 
illy  rubbed 
are  there- 
bender  part 

;  wine  may 
:,  dissolved 
ik  solution 
ilver  (209) 
cerine  and 

ise  a  shield 
breast,  the 


as  I  have 
idles  should 

of  the  best 
in  injection 
re  than  two 
ould  be  ob- 
iischarge  is 
me  one  of 
230),  (232), 
tion,  twice 
the  pint  of 
our  ounces 
used  twice 

ectual,  is  a 

• 

)rae  relief; 
'urnish  evi- 
the  womb, 
in. 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


Pare  Air.  —  The  first  want  of  a  child  is  a  plenty  of  fresh  air ;  and 
this  want  never  ceases  to  the  end  of  life.  Impure  air  kills  thousands 
of  infants.  Out  of  7,650  born  in  the  lying-in  hospital  of  Dublin, 
2,944  were  destroyed  by  impure  air  within  two  weeks  after  birth. 

Children  should  be  kept  in  the  open  air  as  much  as  possible,  and 
in  well-ventilated  rooms  when  indoors.  It  is  wrong,  when  infants  are 
sleeping,  to  cover  their  faces  with  bed-'^'othes,  or  draw  curtains  around 
their  cots,  or  to  envelop  their  heads  in  blankets  and  shawls  when 
carried  in  the  open  air. 

The  Skin. — The  health  of  infants  requires  that  their  skin  should  be 
kept  clean.  Unless  this  is  done  they  are  liable  to  suffer  much  from 
cutaneous  and  other  diseases.  The  skin  of  a  new-born  child  is  cov- 
ered with  a  white,  unctuous  matter,  called  the  vernix  caseosa.  It  is 
injurious  to  let  this  remain  for  any  length  of  time  after  birth.  To 
remove  this,  Dr.  Dewees  recommentis  that  the  child  be  smeared  with 
hog's  lard,  and  then  washed  with  soap  and  water.  Dr.  Eberle  says, 
smear  with  yolk  of  eggs,  and  then  wash  with  simple  warm  water. 

The  young  child  should  be  washed  every  day  with  warm  water,  — 
then,  after  a  time,  with  tepid  water,  then  with  temperate,  and  finally, 
after  it  is  some  months  old,  with  cold  water.  This,  if  persevered  in 
through  childhood  and  youth,  will  ward  off  a  thousand  ills  and  sick- 
nesses to  which  the  young  are  liable. 

Tlie  Clotliiimf  of  Cllildreil  should  be  so  adjusted  as  to  give  their 
limbs  ample  play,  and  should  be  thick  enough  to  keep  them  warm. 
They  ought  to  have  flannel  next  the  skin  in  winter,  and  cotton  in 
summer.  At  the  risk  of  wounding  some  nice  people's  feelings,  I 
must  add  that  the  fashion  of  a  child's  clothes  is  not  important. 

The  Food.  —  The  natural  and  proper  food  of  a  young  child  is  its 
mother's  milk.  To  this  it  should  be  confined,  unless  prohibited  by 
imperative  circumstances,  until  a  portion  of  the  teeth  are  cut.  When 
the  mother  cannot  nurse  her  child,  the  breast  of  a  suitable  nurse 
should,  if  possible,  be  supplied.  If  the  infant  need  any  more  food 
than  is  supplied  by  the  breast,  give  cow's  milk  and  water,  sweetened 
with  a  litUe  loaf  sugar.  The  sucking-bottle,  if  used,  must  never  b« 
permitted  to  get  sour. 


I 


^^4 


v^j^C-'sf.'jj^'tT;-' 


392 


CAUK  OF  CHILDUKN  AND  THEIU  DISKASES. 


Health  of  a  Nlirsinir  Wuimiii.  —  During  nursing  the  gntatcst  atten- 
tion to  health  is  recjuired  by  the  mother  or  the  nurse.  A  woman  of  u 
consumptive  constitution  should  never  nurse  an  infant.  Nourished 
at  the  breast  of  such  a  mother,  the  ehild,  who  has  inherited  her  con- 
stitution, will  be  the  more  likely  to  fall  a  victim  to  her  disease. 

Pnssioiis  of  ft  Nursing:  Woiiiini. —  Let  the  woman  who  nurses  a 

young  child  be  careful  of  her  passions.     An  irritable  ci 


ion, 


ing  rise  to  gusts  of  violent  |)assion,  may  so  alter  the  character  of  flic 
milk  as  to  throw  the  child  into  convulsions.  Grief,  envy,  hatred,  fe;ir, 
jealousy,  and  peevishness,  unfit  the  milk  for  nourishing  the  child,  and 
often  cause  the  child's  stomach  to  be  much  disordered. 

The  Diet  of  the  Nurse  should  receive  strict  attention.  It  should  be 
plain  and  wholesome,  and  the  amount  should  never  be  excessive. 
Her  drink  should  be  simply  water.  She  should  take  gentle  daily  ex- 
ercise in  the  open  air. 

Weaning;.  —  At  the  end  of  twelve  months,  the  first  set  of  teeth  are 
generally  so  far  cut  that  the  child  can  manage  most  kinds  of  plain 
food ;  and  it  may  now  be  taken  from  the  breast.  Should  the  teeth 
appear  earlier,  and  the  infant  be  healthy,  it  may  be  weaned  even  at 
the  end  of  the  tenth  month.  Never  take  the  child  from  the  breast  in 
the  midst  of  summer  heat.  A  disordered  state  of  the  bowels,  or 
cholera  infantum,  would  be  likely  to  be  ihe  result.  The  spring  and 
the  autumn  are  the  proper  periods  for  weaning. 

If  for  some  months,  it  have  been  accustomed  to  other  food  beside 
the  milk  of  the  mother,  it  may  be  taken  suddenly  from  the  breast 
It  must  not  have  any  amount  of  solid  food  it  may  crave  immediately 
after  weaning.  It  should  still  be  kept,  for  some  time,  upon  a  simple, 
bland,  half-fluid  aliment,  taken  in  moderate  quantities,  and  at  proper 
intervals.  At  first,  the  food  should  be  bread  and  milk,  boiled  rice  and 
milk,  soft-boiled  eggs,  roasted  potatoes  and  milk,  oat-meal  gruel,  plain 
rice  pudding,  preparations  of  arrow-root,  tapioca  and  sago,  simple 
meat  broths,  mixed  with  crums  of  bread  or  grated  crackers,  or  in 
which  rice  or  barley  has  been  well  boiled.  From  this  it  may  pass 
(iraduallv  to  a  more  solid  diet ;  though,  until  the  age  of  puberty,  the 
p;incipal  part  of  the  diet  should  be  milk,  the  farinaceous  articles,  and 
vegetables.  Sugar  has  been  thought  to  be  injurious  to  children.  It 
is  not  so.     If  taken  moderately,  at  meal  times,  it  is  wholesome. 

W*^  3ver  be  the  food  allowed  to  children,  it  should  never  be  taken 
in  ex  js;  and  to  prevent  this,  they  ought  not  to  take  their  meals  alone; 
for  they  have  very  keen  appetites,  and  if  permitted  to  do  so,  they  will 
generally  form  habits  of  gluttony.  Three  or  four  light  meals  a  day  is 
enough. 

Their  drink  should  be  water  simply,  —  nothing  else. 

If  parents  would  observe  these  rules,  and  enforce  them  strictly,  they 
would  confer  blessings  upon  their  children  greater  than  riches.  They 
would  send  them  into  the  world  with  health  and  good  constitutions, 
and  would  save  them  from  untold  misery  and  an  early  death.  Such 
a  course  would  evince  more  love  for  their  children  than  those  weak 


st  atten- 
)Tnan  of  a 
Vourisliod 

her  cua- 


H(\ 


iiursert  !i 
tioii,  giv- 
er of  (!k' 
red,  fear, 
liild,  aiul 


should  b<; 
excessive. 
5  daily  ex- 
teeth  are 
s  of  plain 
the  teeth 
ed  even  at 
breast  in 
Jowels,  or 
spring  and 

)od  beside 

he  breast. 

imediately 

1  a  simple, 

at  proper 

:d  rice  and 

;ruel,  plain 

go,  .simple 

ters,  or  in 

may  pass 

iberty,  the 

tides,  and 

ildren.     It 

)me. 

r  be  taken 
jals  alone; 
,  they  will 
[s  a  day  is 


ictly,  they 
es.  They 
stitutions, 
th.  Such 
lose  weak 


CARE  OF  CHILDIIEN  AND  THEIR  DISEASES. 


393 


concessions  which  allow  tea  and  cofFee,  and  all  sorts  of  food,  in  quan- 
tities to  suit,  which  occasion  early  disord«'rs  of  the  stomach  and 
bowels,  and  bring  later  derangements  of  the  nervous  system,  with 
all  its  regrets  and  horrors. 

Sleep  of  Clliidreil.  —  During  the  first  period  of  its  existence,  an  in- 
fant sleeps  a  large  portion  of  the  time.  This  is  a  wise  provision  of 
nature.  It  withdraws  the  young  child,  for  a  tiiuf,  from  those  outward 
exciting  agents,  which  would  t<K)  mu(Mi  distuil>  the  nervous  system  of 
so  tender  a  being.  Whenever  a  young  infant  is  restless  or  wakeful 
much  of  the  time,  we  may  feel  sure  it  has  had  too  much  food,  or  is 
in  some  way  disturbed  by  it,  or  by  tight  clothes,  or  that  some  other 
cause  is  giving  it  uneasy  sensations. 

Its  sleep  should  be  the  promptings  of  nature,  and  should  never, 
except  in  rare  instances,  be  brought  about  by  opiates.  It  is  wrong 
and  sinful  for  a  mother  or  nurse  to  put  an  infant  to  sleep  with  an 
opiate,  merely  that  she  may  gain  time  for  pleasure,  or  even  for  other 
duties. 

The  Infant  should  he  kept  warm  while  Sleepin^^.  —  During  the  first 
few  w«eks  it  should  sleep  with  its  mother,  —  especially  if  the  weathet 
be  cold.  After  that,  it  may  be  in  a  cradle  or  cot.  The  covering  should 
be  warm,  but  lig'ht,  so  as  not  to  press  heavily  upon  its  tender  limbs. 
If  laid  upon  its  back,  the  fluid  of  its  mouth  and  throat  may  get  into 
the  windpipe,  and  obstruct  the  breathing,  or  produce  coughing.  It  is 
better,  therefore,  to  lay  the  infant  upon  its  side,  —  taking  care  not  to 
produce  distortion  of  the  spine  or  limbs  by  always  laying  it  upon  the 
same  side. 

Children  should  not  be  allowed  to  sleep  either  with  the  aged,  oi 
with  sick  persons.  It  is  not  healthful  for  them  to  breathe  the  exhala- 
tions from  the  bodies  of  such.  For  a  somewhat  similar  reason,  some 
kinds  of  plants,  and  flowers  generally,  should  be  excluded  from  their 
sleeping  rooms.  Their  beds  should  be  so  placed  as  to  turn  their  faces 
away  both  from  the  sun-light  which  comes  in  at  the  windows,  and 
from  the  artificial  light  in  the  room. 

They  should  be  taught  to  retire  early  at  night,  and  to  rise  imme- 
diately after  waking  in  the  morning.  This  habit  will  be  worth  much 
to  them  through  life.  After  the  meconeum  has  passed,  the  bowels  of 
an  infant  should  be  opened  from  two  to  four  times  in  twenty -four 
hours.  If  the  stools  are  less  frequent  than  twice  a  day,  or,  if  they  are 
lumpy,  some  gentle  cathartic  is  called  for.  From  half  a  dram  to  a 
dram  of  fresh  castor  oil,  or  a  dessert-spoonful  of  mixture  (24)  an- 
swers a  good  purpose.  Duri'ig  child/iood,  the  bowels  should  be  moved 
once  or  twice  a  day.  When  a  cathartic  is  required,  a  table  spoonful 
of  mixture  (25),  or  a  teaspoonful  of  (17),  will  be  found  very  excel- 
lent. 

Exercise.  —  During  the  first  few  weeks  of  an  infant's  life  it  requires 
but  little  exercise ;  indeed  its  organisation  is  not  sufficiently  settled 
and  compacted  to  permit  much  without  injury.  A  little  gentle  rub- 
bing with  the  hand  over  the  whole  body,  is  about  all  it  needs  or  will 


f'^ 


'm 


•    N 


394 


CARE  OF  CIIILDUKN  AND  THKIR  DISEASES. 


bear.  To  dandle  and  toss  it  about,  and  especially  to  act  it  uprigh^^  is 
injurious  and  wrong.  Its  bones  are  all  soft,  and  will  not  endure  ;■> 
be  much  twisti;d  about,  and  its  spine  is  not  stiff  enough  to  bear  uy 
the  weight  of  its  head. 

After  a  few  weeks,  riding  in  a  carriage  drawn  by  a  careful  and 
trusty  nurse,  is  both  a  healthful  and  pleasurable  exercise  for  children. 

Learning^  to  Walk. —  At  the  end  of  the  ninth  or  tenth  month,  a 
child  may  begin  to  learn  to  walk.  It  h  not  safe  to  teach  it  this  exer* 
cise  much  earlier  than  this,  as  the  bones,  being  soft,  may  be  bent  by 
the  weight  of  the  body,  and  the  limbs  be  permanently  deformed. 

As  soon  as  the  child  has  learned  to  walk  alone,  it  should  be  allowed 
jjcrfect  freedom  of  exercise.  Thenceforward,  the  open  air  is  its  pro|H;r 
place  during  the  day ;  and  such  an  unrestrained  use  of  its  limbs  as 
its  own  instincts  may  dictate,  is  its  proper  calling.  For  five  years 
after  it  has  learned  to  walk,  it  siiould  do  little  else  than  to  use  its 
limbs  out  of  doors,  as  it  pleases.  The  books  and  the  school-room 
will  be  in  season  after  that.  First  compact  the  body,  —  then  bring 
out  the  mind.  The  mind  is  of  no  use  without  the  body,  —  the  body 
must  be  developed  first,  or  never. 

Moral  Treatment.  —  We  charge  upon  nature  many  of  the  bad  pa.s- 
sions  which  we  ourselves  implant  in  children.  The  moral  treatment 
of  children  is  generally  bad.  We  are  apt  to  begin  by  either  making 
them  our  masters  or  our  slaves.  Sometimes  we  do  both,  —  allowing 
them  to  govern  us  for  a  time,  and  then,  getting  into  a  passion,  or  a 
mood  for  playing  the  tyrant,  we  turn  upon,  and  govern  them  as  if  we 
were  autocrats.  We  submit  to  their  whims  until  we  grow  irritable, 
and  then,  by  way  of  retaliation,  we  compel  them  to  submit  to  ours. 

This  is  all  wrong.  Children  should  be  governed  always,  but  with 
an  even,  a  gentle,  and  a  loving  hand.  They  should  early  be  subjected 
to  habits  of  self-control,  and  of  regularity  in  eating,  and  sleeping;  and 
should  be  taught  absolute  and  continued  obedience.  All  thij;  can  be 
brought  about  only  by  firmness,  self-control,  and  great  gentleness  on 
the  part  of  the  parents.  If  they  would  make  a  child  cheerful  and 
happy  in  its  disposition,  they  must  themselves  be  cheerful,  and  never 
let  it  see  anger,  passion,  and  fretful-ness,  marring  their  conduct. 
Nothing  is  more  injurious  to  the  health  of  a  child  than  a  peevish, 
complaining,  and  soured  disposition ;  and  these  vices  are  seldom  ac- 
quired, unless  seen  in  the  lives  of  parents. 


How  to  Narse  Sick  Children. 

As  the  education  of  the  young,  whether  religious,  moral,  or  intel- 
lectual, is  more  important  than  that  of  adults,  so  is  the  care  of  their 
physical  life  of  more  importance.  Death  aims  to  "out^ Herod  Herod," 
and  seeks  the  life  of  all  infants,  male  and  female,  and  in  fact  destroys 
one  half  of  all  below  the  age  of  five  years. 

But  few  know  how  to  train  and  take  carr  of  children.  It  is  a  still 
more  rare  gift  to  know  how  to  nurse  them  when  sick.     No  persons 


it  upright  is 

Jt  endure  ;•) 

Ih  to  bear  u|) 

careful  and 
[for  children. 

til  month,  a 
it  thia  exer* 
be  bent  by 

formed. 

|d  be  allowed 
is  its  |)ro|)«r 
its  limbs  as 
r  five  years 

lan  to  use  its 
school-room 

—  then  bring 

,  —  the  body 

the  bad  pas- 
ral  treatment 
ither  making 
11,  —  allowing 

passion,  or  a 
Ihem  as  if  we 
|row  irritable, 
mit  to  ours. 
mys,  but  with 
■  be  subjected 
sleeping;  and 
.11  this;  can  be 
gentleness  on 
cheerful  and 
'ul,  and  never 
leir  conduct, 
in  a  peevish, 
re  seldom  ac- 


3ral,  or  intel- 
care  of  their 
erod  Herod," 
fact  destroys 

It  is  a  »till 
No  persons 


CAUK  OF  ClIILDUKN  AND  TIIEIIl  DISKASKS. 


:}U6 


can  properly  nurse  sick  children  who  are  in  feeble  health,  or  havi? 
fretful  tempers,  or  are  low-spirited ;  for  they  can  neither  endure  the 
fiitigue,  nor  bear  the  trials,  nor  hear  tht;  prattle  which  such  a  respon- 
sibility would  bring.  Some  will  lUiinage  a  well  child  very  well,  who 
are  not  fit  to  have  the  care  of  a  sick  one ;  for  there  is  a  great  differ- 
ence between  a  child  when  well,  and  the  same  child  when  sick. 
When  well,  and  full  of  fun,  and  frolic,  and  life,  laughing,  and  jum(>- 
ing,  and  shouting  aloud  for  very  joy  at  being  alive,  it  is  an  easy  thing 
for  a  person  of  even  a  morose  temper  to  attend  upon  them.  But 
when  sickness  comes,  and  the  child's  playfulness  is  all  laid  aside ; 
■when  it  becomes  so  fretful  t^-H  nothing  goes  right  with  it ;  when  it 
cj-i*>B  to  be  laid  down,  and  then  cries  to  be  taken  up ;  stretches  out  its 
hand  for  drink,  and  jjushes  away  the  cup  when  it  is  presented, — 
apparently  made  more  angry  by  your  attempts  to  serve  it ;  —  when 
these  things  are  re|)eated,  day  and  night,  until  the  nurse  is  weary  and 
exhausted,  and  even  a  change  of  disease  and  amendment  only  brings 
a  cross  and  fractious  temper,  it  is  only  by  possessing  jx^culiar  qualifica- 
tions, that  the  nurse  can  maintain  an  even  and  unrullled  disposition. 

While  passing  through  such  scenes,  it  is  hard  for  the  nurse  to  re- 
member that  si(!kness  does  not  destroy  the  little  loving  heart,  but  only 
hides  its  atiection  for  a  short  time. 

Sljfns  of  Disease  In  Cliililreii.  —  It  is  important  that  the  nurse  of 
sick  children  should  know  what  to  observe,  and  the  meaning  of  the 
signs  of  disease.  A  baby  has  only  cries  to  express  its  sick  feelir^s. 
To  one  person,  these  cries  mean  no  more  than  that  the  baby  has  some 
sort  of  illness.  To  another,  with  more  experience  and  better  powers 
of  observation,  they  point  to  the  head,  or  chest  or  stomach,  as  the 
disorder.  A  baby  with  the  stomach-ache,  utters  loiifr^  loud,  and  pas- 
sionate cries,  and  sheds  tears  plentifully.  Suddenly  it  stops  for  a  mo. 
ment,  and  then  begins  ag-;in,  —  drawing  up  its  legs  to  the  stomach, 
and  as  the  pain  passes  otf,  stretching  them  out  again,  and  with  many 
sobs,  passing  off  into  a  gentle  sleep. 

If  there  be  inflammation  in  the  chest,  it  neither  cries  aloud,  nor 
sheds  tears,  but  after  every  long  breath,  or  hacking  cough,  it  utters  a 
short  cry,  which  is  cut  off  before  it  is  half  finished,  —  apparently  be- 
cause crying  is  painful. 

If  the  disease  be  in  the  head,  the  cries  will  be  sharp,  piercing  shrieks^ 
with  low  moans  and  wails  between.  Or,  there  will  be  quiet  dozing, 
interrupted  by  startlmg  pains. 

When  a  child  is  taken  ill,  whatever  the  disease  which  is  impending, 
there  is  always  a  change  of  some  sort,  which  soon  attracts  attention. 
It  either  loses  its  appetite,  or  is  fretful,  or  soon  tired,  or  sleepy,  or 
restless,  or  thirsty,  or  has  a  hot  skin,  or,  rather,  has  a  number  of  these 
symptoms.  It  vomits,  or  is  purged  or  bound  in  its  bowels.  It  loses 
its  merry  laugh  and  cheerful  look ;  it  no  longer  watches  its  mother's 
or  its  nurse's  eye,  as  before,  but  clings  to  her  more  closely,  and  will 
not  be  out  of  her  arms  a  moment.  If  lulled  to  sleep  in  her  arms,  it 
wakes  immediately  on  being  placed  in  its  cot. 

Such  symptoms  often  continue  a  day  or  two  before  it  can  be  de- 


sm 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


termincd  what  disease  \^^  impending.  An  intelligent  nurse  may  do 
much  towards  solving  the  ({ticHtion.  It  is  frec|uently  proper  at  such 
times  to  plaee  the  child  in  a  warm  bath.  When  stripped  lor  the  balh, 
it  should  be  carefidly  examined  to  see  if  there  is  any  rash  upon  its 
body.  If  it  be  a  rash  from  which  it  is  about  to  sutler,  tim  bath  will 
help  bring  it  out.  The  rash  should  be  looked  for  at  least  every  twelve 
hours,  until  the  nature  of  the  disease  is  determined. 

The  A]i|M'iiriiiU'e  of  the  IMflVrent  KiimUch  may  be  distinguished  with 
a  little  care  and  experience.  Measles  has  a  number  of  dark  red  spots. 
in  many  places  ruiming  into  each  other,  and  is  generally  seen  lirnt 
about  the  face,  and  on  the  foreliead,  near  i\u'  roots  of  tin;  hair,  and  is 
preceded  by  ruiming  at  the  eyes  and  nose,  and  all  the  signs  of  a 
severe  cold.  Hcarlet  fever  does  not  show  separate  spots,  but  piesents 
a  general  bright  red  color  of  the  skin,  much  like  a  boiled  lobster.  At 
first  there  is  more  of  it  about  the  neck  and  chest  than  on  the  face, 
and  it  is  preceded  by  a  sore  throat.  Chicken  pox  is  attend(!d  by 
fever,  but  not  so  much  running  at  the  nose  and  eyes  as  in  measle.-*, 
nor  is  there  so  much  cough.  The  spots,  too,  are  smaller,  and  are  not 
so  much  run  together ;  and  they  cotne  out  more  over  the  whole  btwly. 
They  appear  a  few  hours  earlier  on  the  body  than  elsewhere  ;  and  in 
a  day  or  two  they  are  found  to  be  enlarged,  arid  turn  into  little  blad- 
ders of  water  as  big  as  the  head  of  a  shawl-pin. 

And  now  a  few  Words  as  to  what  sliould  be  Done  in  the  sick-room 
of  a  child.  The  room  should  be  kept  coof,  and  its  temperature  should 
be  measured  by  a  thermometer.  This  instrument,  when  hung  away 
from  the  fire,  should  show  a  temperature  of  about  55°.  That  is  about 
the  right  degree  of  warmth.  Sick-rooms  are  generally  kept  too  hot. 
The  room  should  be  darkened;  not  made  totally  dark,  but  its  light 
shaded  down  by  closing  the  outside  blinds,  or  by  dropping  the  cur- 
tains, so  as  to  give  a  kind  of  twilight;  and  the  cot  should  always  be  so 
placed  as  to  turn  the  little  one's  face  away  from  the  light.  The  room 
should  be  kept  quiet;  and  this  requires  attention  in  the  whole  housr, 
as  well  as  among  the  persons  in  the  room.  Those  present  should 
never  whisper,  but  speak  in  low  and  gentle  tones,  —  should  not  walk 
on  t'  ut  move  about  carefully.    There  is  a,  fussy  quietness  which 

d'"  ^  sick  far  more  than  noise.     The  child  must  be  spoken  to, 

jd  from  its  slumbers,  and  turned  from  side  to  side,  and  raised 
.d  food  or  medicine,  with  a  soothing  tenderness,  and  a  delicacy 

,iich  never  forgets  itself. 

In  applying  leeches  or  cold  to  a  child,  judgment  is  needed,  to  suc- 
ceed well.  Ihe  leeches  should  be  put  either  behind  the  ear  or  on  top 
of  the  head,  so  that  the  child  cannot  see  them.  Cold  is  best  applied 
by  means  of  a  couple  of  bladders  half  filled  with  powdered  ice,  and 
wrapped  in  two  large  napkins ;  one  of  them  should  be  placed  under 
the  child's  head,  the  corner  of  the  napkin  being  pinned  to  the  pillow- 
case to  prevent  its  being  disturbed,  while  the  other  is  allowed  to  rest 
upon  the  head,  with  the  corner  of  the  napkin  again  pinned  to  the 
pillow,  to  tak      '^  the  greater  part  of  its  weight    In  this  way  the  child 


rse  may  do 
kr  at  Hncli 
|ir  tlio  buih, 
li  upon  its 
biitli  will 
k'<Ty  twflvt' 


lislii'tl  Willi 
\i  red  H|)()ts. 
Mt'fii  lirst 
hair,  and  is 

nigna  of  u 

Ut    piCHCIltM 

)listcr.  At 
M  the  lace, 
tt(Mid«'d  by 
ill  tM«'a«lt's, 
and  an;  not 
I'hoie  body. 
're  ;  and  in 
little  blad- 


e  slck-rootn 
iture  uhouid 
hung  away 
lat  is  about 
!pt  too  liof. 
lut  its  light 
ng  the  cui- 
Iwaya  be  .so 
The  room 
'hole  house, 
«'nt  should 
Id  not  walk 
tness  whieh 
:  spoken  to, 
and  raised 
a  delicaey 

led,  to  sue- 
r  or  on  top 
ist  applied 
:^d  ice,  and 
aced  under 
;he  pillow- 
ved  to  rest 
led  to  the 
y  the  child 


rARK  OP  ClIILI)RK^f  AND  TIIKIU  DISKASES. 


35)7 


will  not  bo  wetted,  or  irritated,  ad  by  thi;  changing  of  wet  cloths, 
nor  will  the  cold  applications  get  displaced  by  its  uiovetnents. 

A  word  should  be  said  respecting  the  nursing  of  childnn  in  ca.seii 
(if  lung-inllainrnation,  —  an  alTection  from  which  they  often  HutFcr. 
'The  lungs  are  much  like  two  large  sponges,  and  tht!  air  enters  them 
through  the  windpipe;  and  passing  through  smaller  and  yet  smaller 
lubes,  it  comes  at  last  into  tiny  cells,  so  small  that  they  can  only  be 
scvi\  by  a  magnifying  glass.  When  the  l.mgs  are  iullamed,  some  of 
the  tubes  become  stopped  up  ;  and  the  very  small  c'lls  are  pressed 
on  by  the  flow  of  more  blood  than  natural  to  the  part ;  and  so  the 
uir  enters  less  easily,  and  in  srmiller  quantities,  than  it  should.  If 
now  you  let  the  child  lie  flat,  it  is  not  only  less  able  to  dra\/  a  deep 
breath,  and  fill  the  lungs,  but  the  blood  also  flowing  to  the  in(lam(>d 
portion  of  the  lung,  returns  less  easily  than  if  the  child  were  prop|>«;d 
up  in  bed.  When  a  whitlow  is  on  the  finger,  if  the  hand  be  hung 
down,  the  inflamed  finger  will  become  redder,  and  will  beat  and 
throb  8o  as  hardly  to  be  endured,  while,  if  the  hand  be  raised,  the 
pain  will  abate.  I'he  same  increase  of  pain  does  not  follow  an  accu- 
mulation of  blood  in  an  inflamed  lung,  because  the  lung  is  not  as 
sensitive  aa  the  finger ;  ))ut  the  consetiuences  are  very  serious.  The 
air-celU  being  more  and  more  pressed  upon,  the  admission  of  air  is 
more  and  more  diflieult,  until,  at  length,  a  large  part  of  the  lungs  is 
rendered  useless,  and  the  child  dies. 

In  this  disease,  the  temperature  of  the  room  needs  attention.  The 
air  should  not  be  quite  bo  cool  as  in  other  diseases.  From  60°  to  65° 
is  about  right. 

Of  course  crying  will  irritate  inflamed  lungs,  and  it  is  all  important 
that  a  child  sick  with  this  disease  should  be  soothed  and  quieted  as 
much  as  possible.  Every  good  nurse  knows  how  to  do  this  better 
than  any  rules  can  teach  her. 

Sometimes  sickness  and  vomiting,  from  which  a  child  may  suflfer, 
are  increased  by  want  of  judgment  in  giving  food  and  drink.  When 
there  is  nausea,  the  stomach  will  bear  only  very  small  quantities  of 
food  at  a  time,  while  cold  drinks  are  almost  always  borne  much  bet- 
ter than  warm.  When  there  is  nausea,  it  is  best,  for  an  hour  or  two, 
not  to  attempt  to  give  any  food  or  drink.  After  the  stomach  has  been 
thus  completely  rested,  give  a  single  teaspoonful  of  cold  water.  If 
this  is  not  thrown  up,  it  may  be  succeeded,  in  ten  or  fifteen  minutes, 
by  a  second  or  a  third.  If  this  is  borne,  give  a  little  water  thickened 
with  isinglass,  or  cold  barley  water,  or  cold  milk  and  water ;  and 
then,  with  the  same  precautions,  and  in  very  small  quantities,  beef 
tea,  or  chicken  broth,  or  whatever  else  the  doctor  in  attendance  may 
direct.  The  smallness  of  quantity,  the  coldness  of  the  articles,  and 
the  giving  it  without  moving  or  disturbing  the  child,  if  possible,  are 
the  'mportant  points  to  be  attended  to. 

It  is  of  great  consequence  that  children  suffering  from  diarrhoea 
should  have  their  skin  kept  very  clean.  The  pores  should  be  kept 
well  open,  so  that  the  fluid  matter  which  is  passing  off  by  tlie  bowels, 
and  through  the  mucous  membrane  or  inner  skin,  may  Ik;  diverted  to 
the  outer  skin.     In  this  disease,  the  skin  of  children  is  apt  to  become 


398 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


^ 


irritable,  or  even  sore.  In  these  cases,  soap  and  water  arc  quite  apt 
to  increase  the  soreness,  while  a  little  starch,  made  as  for  use  upon 
clean  clothc^s,  though  much  thinner,  will,  if  used  in  place  of  soap,  very 
much  soothe  the  inflamed  skin. 

A  child  much  exhausted  by  dlarrhcca,  or  other  disease,  should  be 
moved  or  lifted  out  of  its  cot  or  cradle  as  little  as  possible.  Suddenly 
moving  it  when  very  weak,  may  cause  fainting,  or  even  convulsions. 
Let  it  be  sponged  and  cleaned  by  merely  turning  it,  with  great  gentle- 
ness, from  side  to  side. 

In  such  cases,  too,  the  child  should  be  supported  with  proper  nour- 
ishment. When  worn  down  by  diarrhoea,  its  desire  for  food  may  be 
nearly  lost.  Though  at  one  time  it  cried  much,  and  seemed  to  suHi'r, 
it  will,  in  this  condition,  grow  quieter,  and  doze,  and  even  sleep  on 
for  hours,  ar  earing  fretful  only  when  roused.  If,  in  such  cases,  the 
child  be  ah^  ..  ^d  to  go  without  food  because  it  does  not  seek  it,  or 
declines  it  when  offered,  it  will  sink  into  a  deeper  and  deeper  sleep, 
and  finally  into  a  stupor  which  will  end  in  death.  To  give  a  little 
arrow-root,  or  wine,  or  broth,  may  now  require  trouble  and  persever- 
ance ;  but  it  must  be  done,  for  upon  it  depends  the  child's  life,  "^'he 
effort  to  administer  food  must  not  be  abandoned  because  onr'e  c* 
twice,  or  several  times  unsuccessful,  for  the  food  which  is  refusea  Cie 
minute,  may  be  accepted  five  minutes  after. 

In  the  various  rashes  from  which  children  suffer,  there  is  a  very 
general  fear  of  washing  the  surface  lest  the  rash  be  driven  in.  There 
is  no  ground  for  this  fear,  unless  it  be  in  measles ;  and  even  in  this 
complaint,  there  is  no  danger  if  luke-warm  water  be  used.  If  only  a 
small  part  ^f  the  body  be  sponged  at  a  time,  there  is  nothing  to  fear 
even  from  frequent  washing;  and  the  passing  of  a  wet  sponge  fre- 
quently over  the  surface  is  a  great  comfort  when  the  skin  is  burning 
with  fever.  The  same  remark  applies  to  the  changing  of  the  linen. 
The  same  kind  of  objection,  and  with  no  better  reason,  is  often  urged 
against  cold  water  in  fevers,  though  it  is  most  refreshing,  and  if 
taken  in  small  quantities,  and  often,  never  does  harm,  but  often  much 
good. 

The  Wann  Biitli.  —  The  best  method  of  giving  a  child  a  warm 
bath  is  a  matter  of  importance.  There  should  be  as  little  parade 
about  it  as  possible.  If  the  child  sees  the  bath  prepared,  is  taken  out 
of  bed,  undressed  and  put  'nto  it  smoking  before  its  eyes,  it  may  be 
much  alarmed,  and  cry  so  passionately  as  to  be  really  injured  by  it. 
The  bath  sliould  be  prepared  out  of  its  sight,  and  brought  to  the  bed- 
side with  a  blanket  spread  over  it  to  hide  the  steam.  The  child 
should  then  be  laid  upon  the  blanket,  and  gently  let  down  into  the 
water,  and  then  set  to  play  with  a  couple  of  corks  with  feathers  stuck 
in  them. 

Inflammation  of  the  Mouth. — Erythematic  Stomatitis. 

This  is  a  simple  inflammation  of  the  mucous  membrane  of  the 
mouth  ;  and  is  very  common  during  ii-^ancy.  It  may  be  confined  to 
the  tongue,  or  spread  over  the  whole  mouth.     It  is  sometimes  very 


quite  apt 

use  upon 

soap,  vfry 

should  be 
Suddenly 

biivulsion.s. 

n-at  gendc- 

lopor  Mour- 
'od  may  ho 
d  to  suHIt, 
I  sleep  on 
cases,  the 
seek  it,  or 
eper  sleep, 
ive  a  little 
i  perse  ver- 
ife.  The 
i^e  onr'e  c" 
efusea  c.g 

;  is  a  very 
in.  There 
ven  in  this 
If  only  a 
ling  to  fear 
jponge  fre- 
is  burning 
"  the  linen. 
>ften  urged 
ng,  and  if 
>ften  much 

d  a  warm 
tie  parade 
1  taken  out 
it  may  be 
ured  by  it. 
;o  the  bed- 
The  child 
'n  into  the 
hers  stuck 


matitis. 

ne  of  the 
onfined  to 
imes  very 


CARE  OF  CHELDBEN  AND  THEIR  DISEASES. 


399 


severe,  going  down  into  the  gullet  and  stomach,  and  into  the  wind- 
pipe. It  occasions  redness  and  pain  in  the  mouth,  and  fretfulness  of 
the  infant,  —  causing  it  to  quit  the  nipple  suddenly  when  sucking. 
A  frequent  result  of  this  inflammation  is  the  secretion  and  exudation 
upon  the  surface,  of  a  white,  matter-like  curd.  It  appears  in  small 
points  and  patches.  This  is  the  thrnsh,  or  what  nurses  call  c/ii/dreri's 
tore  mouth.     It  ia  commonly  confined  to  the  period  of  suckling. 

Treatment.  —  For  the  simple  inflammation  of  the  mouth,  a  wash 
made  by  infusing  the  inner  bark  of  slippery  elm  in  water,  answers  a 
good  purpose ;  and  in  more  severe  cases,  a  wash  made  of  sugar  of 
lead  (aa?)  will  be  found  useful. 

In  some  mild  cases  of  curdy  exudation,  this  last  wash  will  do  well, 
if  united  with  the  daily  use  of  the  warm  bath,  and  proper  care  of  the 
diet.  But  in  the  more  severe  cases,  a  little  pulverized  borax  and 
white  sugar  or  honey  (274)  (275),  placed  occasionally  on  the  infant's 
tongue,  will  do  good  service.  A  decoction  oi  equal  parts  of  blue 
cohosh  and  golden  seal  is  a  good  remedy.  V/hen  the  curdy  patche 
are  large,  touch  them  with  a  mixture  of  hyd;ochloric  acid  and  honey 
(27G).  If  the  exudation  have  a  look  as  it'  mortification  were  taking 
|)liice,  use  a  wasii  of  chloride  of  lime  (228),  or  chloride  of  soda,  etc. 
(229),  or  creosote  and  mucilage  (230),  o:  alcohol  and  vinegar  (231),  or 
nitrate  of  silver  (211).  When  diarrhcpi  is  present,  with  acidity,  give 
(20).  In  the  more  severe  cases,  when  appearances  of  mortification 
are  seen,  quinine  (69)  should  be  administered. 

Follicular  Inflammation  of  the  Mouth. — Apthce. 

This  disease  attacks  the  little  glands  of  the  mouth,  called  follicles, 
and  appears  about  the  time  of  cutting  teeth.  Small  white  specks,  a 
little  elevated,  first  show  themselves  on  the  lips,  insides  of  the  cheeks, 
and  under  side  of  the  tongue,  etc.  The  specks  enlarge,  3  whitish, 
curdy  matter  flows  out  from  their  centre,  and  ulcers  are  formed,  with 
elevated  edges,  surrounded  by  a  red,  inflamed  circle.  Sometimes, 
instead  of  curdy  matter,  a  bloody  exudation  takes  place,  and  dark- 
colored  crusts  are  formed  which  are  mistaken  for  mortification.  In 
bad  cases,  there  is  great  restlessness,  with  hot  mouth,  dry  skin,  thirst, 
and  diarrhoea,  with  green  stools,  and  sometimes  salivation. 

Treatment.  —  The  milder  forms  of  this  disease  are  treated  like 
simple  inflammation  of  the  mouth.  If  there  is  thirst,  give  several 
times  a  day,  a  spoonful  of  cold  water,  with  a  little  gum  arable  dis- 
solved in  it.  If  the  child  be  weaned  at  this  time,  its  food  should  be 
barley  or  rice-water,  swee'  ^ned  with  loaf  sugar.  An  occasional  dose 
of  magnesia,  with  or  without  a  little  rhubarb,  will  remove  the  acid 
which  abounds  in  the  bowels.  Af  er  ulceration  has  taken  place, 
borax  (274)  will  do  well.  When  watery  discharges  from  the  bowels, 
and  griping  pains  appear,  preparation  (28)  should  be  used.  If  th« 
strength  be  reduced,  give  (69). 


1M 


m 

iXtt 


Inflammation  of  the  Gums. —  Gengivitis. 

During  the  cutting  of  teeth,  the  guma  are  apt  to  be  inflamed,  red 
or  livid,  swelled  and  painful.  The  child  is  languid,  with  a  hot  and 
dry  skin,  small  and  quick  pulse,  little  appetite,  much  thirst,  and  a 
tongue  covered  with  a  thick,  yellowish  fur.  When  ulceration  takes 
place,  and  is  allowed  to  go  on,  the  teeth  become  loose,  black,  and 
rotten,  and  often  soft  and  pulpy  ;  a  flow  of  fetid  spittle  takes  place; 
the  breath  of  the  child  becomes  offensive,  and  its  countenance  pale 
and  sallow.  The  gums  bleed  under  the  least  pressure,  and  a  profuse 
diarrhoea  fills  up  the  list  of  ills. 

Treatment  —  In  the  first  stages,  mild  washes  to  the  gums,  such  as 
(227),  will  do  well.  Clear  out  the  bowels  once  with  magnesia  and 
rhubarb  (26).  After  ulceration  has  taken  place,  use  oak  bark  (232), 
or  chloride  of  lime  (228),  or  diluted  hydrochloric  acid  (233).  A  daily 
tepid  bath.  If  the  strength  be  reduced,  use  an  infusion  of  Peruvian 
bark,  or  quinine  (69), 

Gangrene  of  the  Mouth.— Canker. — Cancrum  Oris. 

This  disease  attacks  weakly  children,  of  a  lymphatic  temperament, 
and  having  inflamed  gums.  It  often  follows  intermittent,  remittent, 
or  bilious  fever,  and  is  also  frequently  connected  with  disease  of  the 
stomfich  and  bowels. 

Symptoms.  —  It  is  attended  with  languor,  listlessness,  indisposition 
to  play  or  move  about,  thirst,  loss  of  appetite,  peevishness,  and  ina- 
bility to  sleep.  The  countenance  is  paJe  and  sunken,  and  there  is  a 
peculiar  puckering  of  the  cheeks  about  the  corners  of  the  mouth. 
The  breath  is  bad,  the  gums  have  the  appearance  of  salivation,  the 
teeth  become  loose  and  fall  from  their  sockets,  or,  if  they  remain,  they 
become  covered  with  a  thick  coating  of  a  dirty  white  or  ash  color. 
A  few  ash-colored  water  pimples  appear  upon  the  gums,  which  en- 
large, run  together,  and  finally  break,  —  presenting  a  black  appearance 
of  mortification.  The  gangrene,  sooner  or  later,  goes  to  the  lips  and 
cheeks. 

Treatment  —  When  bowel  complaints  exist,  they  are  to  be  treated 
with  the  usual  remedies,  such  as  (70)  or  (156).  If  there  be  active 
inflammation  of  the  gums,  at  first,  leeches  may  be  applied,  after 
which,  the  inflammation  being  subdued,  a  wash  of  oak  bark  (232), 
will  be  in  place,  with  quinine  given  internally  (69)  to  ward  off"  the 
mortification.  As  a  wash,  too,  a  strong  solution  of  sulphate  of  cop- 
per (234)  is  excellent,  —  so  is  white  vitriol  (235),  and  nitrate  of  silver 
(219),  and  creosote  (236). 

The  diet  should  be  beef-tea,  plain  beef  or  mutton  broth,  with  rice, 
milk  and  rice,  tapioca,  sago,  and  the  like.  .  ^ 


CARE  OF  CHILDllKN  AND  THEIIt  DISEASES. 


401 


flamed,  red 
a  hot  and 
irst,  and  a 
itioi)  takes 
black,  and 
kes  place; 
nance  pale 
I  a  profuse 


ns,  such  as 
gnesia  and 
bark  (232), 
).  A  daily 
)f  Peruvian 


tm  Oris. 

mperament, 
remittent, 
ieasc  of  the 


ndisposition 
ss,  and  ina- 
id  there  is  a 
the  mouth, 
livation,  the 
emain,  they 
r  ash  color. 
,  which  en- 
appearance 
he  lips  and 


)  be  treated 
B  be  active 
plied,  after 
bark  (232), 
^ard  off  the 
ate  of  cop- 
ite  of  silver 

1,  with  rice, 


Difficult  Teeth-Cutting. 

Teeth-cutting  generally  begins  between  the  ages  of  five  and  seven 
months.  It  is  indicated  by  redness,  heat,  and  tenderness  of  the  gums, 
an  increase  of  saliva,  and,  occasionally,  redness  of  the  cheeks,  water- 
ing of  the  eyes,  thirst  and  fever,  with  fretfulness,  disturbed  sleep,  and 
more  frequent  motions  of  the  bowels,  a  little  more  fluid  than  usua^ 
and  sometimes  of  a  greenish  hue.  As  the  tooth  comes  near  the  sur- 
face, Ihe  child  holds  its  fingers  in  its  mouth,  and  presses  the  gums 
harder  upon  the  nipple  when  sucking.  Beside  these  milder  symp- 
toms, there  are  sometimes  ulceration  of  the  mouth,  gangrene,  exten* 
sive  and  long-continued  diseases  of  the  bowels,  —  and  even  disorders 
of  the  brain,  convulsions,  and  palsy. 

Treatment.  —  Watch  the  gums,  and  the  moment  they  are  swollen 
by  the  teeth  pushing  them  up,  lance  them  at  the  elevated  points,  cut- 
ting entirely  down  to  the  advancing  teeth,  —  so  that  no  tough  mem- 
brane shall  cause  pain  by  impeding  their  growth.  These  incisions 
often  prevent  fatal  disease  of^  the  brain,  and  sometimes  almost  in- 
stantly relieve  the  most  threatening  symptoms.  Before  the  teeth  are 
far  enough  advanced  for  lancing,  some  soothing  wash  may  be  applied 
to  the  gums,  or  a  leech  or  two  to  the  angle  of  the  jaw.  For  obsti- 
nate diarrhoea,  with  watery  stools  and  griping,  use  prescription  (157). 
If  the  child  be  drowsy  and  starts  from  sleep,  and  has  heat  and  red- 
ness, with  enlargement  of  the  blood  vessels  about  the  head,  put  three 
or  four  leeches  behind  the  ears,  and  make  cold  applications  to  the 
head.  At  the  same  time,  open  the  bowels  with  castor  oil  (17). 
When  there  is  difficulty  of  passing  the  water,  give  flax-seed  tea ;  and 
if  the  pain  be  considerable,  an  opiate  (351). 

Croup. 

This  is  one  of  the  scourges  of  childhood.  In  ten  years  previous 
to  1845,  no  less  than  1150  children  were  destroyed  in  Philadelphia  by 
croup.  During  the  year  1840,  the  large  number  of  4,336  died  of  the 
same  disease  in  England. 

Croup  is  an  inflammation  of  the  mucous  membrane  of  the  larynx 
and  windpipe.  It  causes  to  flow  out  upon  the  surface  of  the  mem- 
brane, a  peculiar  fluid,  which  stiffens  into  a  membrane,  or  skin-like 
substance,  and  adheres  to  the  inner  surface  of  the  wind-pipe,  and 
sometimes  extends  through  the  whole  of  the  bronchial  tubes.  This 
is  membranaus  croup,  —  the  worst  and  most  fatal  form  of  the  disease. 
Dr.  John  Ware  of  Boston  has  shown  that  there  are  other  forms  of 
croup,  not  so  fatal,  because  not  attended  by  the  formation  of  a  mem- 
brane upon  the  mucous  surfaces. 

The  Symptoms  of  croup  are,  difficulty  of  breathing,  hoarseness,  and 
a  peculiarly  loud  and  ringing  cough,  with  fever.  In  the  membranous 
and  worst  form  of  the  disease,  the  breathing  is  not,  at  first,  so  labo- 
rious, and  the  symptoms  generally  not  so  violent  and  alarming  as  in 

51 


n 


402 


CARE  OF  ClIILDllKN  AND  TIIEIU  DISKASKS. 


the  less  fatal  but  more  inflammatory  type.  This  latter  kind,  though 
generally  causing  great  alarm,  like  a  highway  robber,  by  the  sudden 
fierceness  with  which  they  seize  the  throat,  are  yet  much  less  fatal, 
and  of  course  less  to  be  feared,  than  the  membranous  form.  The 
disease  is  pretty  much  confined  to  children  between  the  ages  of  one 
and  eight  years. 

Treatment. —  The  old  and  usual  mode  of  treatment  is  first  to  bleed, 
and  then  to  place  the  patient  in  a  warm  bath ;  and,  after  the  child  ia 
returned  to  the  bed,  to  give  nauseating  doses  of  tartar  emetic  (lOo). 
In  Boston,  this  treatment  is  now  nearly  discarded,  as  being  too  active, 
and  possibly  a  cause  of  evil  rather  than  good.  The  following  is  a 
safer  and  more  successful  treatment. 

Give,  every  three  hours,  Dover's  powder  and  calomel  (352).  Sponge 
the  neck  often  with  water,  and  apply  a  liniment  (192).  It  is  some- 
times proper  to  give  a  gentle  emetic,  —  say,  two  drams  of  wine  of 
ipecac.  A  flax-seed  poultice  applied  to  the  neck  is  also  excellent.  If 
the  child  be  large  enough,  let  it  inhale  frequently  from  an  old  tea-pot, 
the  vapor  of  hot  water  and  mullein  leaves  ;  and  if  it  be  too  young  to 
do  this,  keep  the  room  full  of  watery  vapor,  by  throwing,  water  upon 
hot  bricks.  If  the  bowels  need  moving,  give  a  dose  of  castor  oil  (17). 
In  addition  to  these  measures,  a  strong  solution  of  nitrat«  of  silver 
(219)  should  be  thrown  into  the  throat  with  one  of  my  laryngeal 
shower  syringes,  and  repeated  every  two  hours  till  the  membrane  is 
discharged. 

Spasm  of  the  Glottis. — Laryngismus  Stridulus. 

This  disease  consists  in  a  sudden  shutting  up  of  the  glottis,  or  pas- 
sage to  the  windpipe,  which  creates  a  feeling  of  strangulation,  and  a 
difficulty  of  breathing  so  great  that  the  drawing  in  of  the  breath 
causes  a  peculiar  crowing  sound.  There  is  no  fever.  The  child,  upon 
taking  food  or  drink,  or  upon  being  irritated  or  teased,  is  taken  sud- 
denly with  an  impossibility  of  drawing  in  its  breath.  After  struggling 
convulsively  for  a  time,  its  head  thrown  back,  its  nostrils  dilated,  its 
mouth  open,  its  eyes  rolled  up,  its  face  pale,  its  legs  and  arms  stiff, 
it  begins  to  breathe  with  a  shrill  crowing  sound.  The  disease  is 
sometimes  mistaken  for  croup,  and  for  hooping  cough.  It  is  strictly 
spasmodic  in  its  nature. 

Treatment  —  During  the  paroxysm,  set  the  child  in  an  upright  pos- 
ture, with  the  head  leaning  forward,  exposed  to  a  full  draft  of  cool, 
fresh  air,  and  sprinkle  cool  water  upon  the  face.  Let  nothing  be  tight 
about  the  neck.  Slap  the  child  slightly  on  the  back,  and  apply  fric- 
tion along  the  spine.  If  these  means  do  not  succeed,  place  it  in  a 
warm  bath  ;  while  in  the  bath,  sprinkle  cold  water  on  the  face. 

When  the  fit  is  over,  examine  the  gums.  If  they  are  8W'ji;en,  lance 
them  down  to  the  coming  teeth.  The  bowels  should  be  rr  jved  daily 
with  some  gentle  physic,  but  not  irritated  by  severe  purging.  If  the 
stools  are  light  colored,  use  prescription  (142),  with  warm  water  in* 
jections. 


CARE  OF  CHILDUKN  AND  TIIKIU  DISEASES. 


4oa 


lul,  though 

he  suddPM 

leP3  fatal, 

orrn.     The 

igea  of  one 

■st  to  bleed, 
he  cl)ild  is 
netic  (lOo). 
[  too  active, 
owing  is  a 

!).  Sponge 
It  is  some- 
of  wine  of 
ccellent.  If 
old  tea-pot, 
oo  young  to 
water  upon 
}tor  oil  (17). 
ite  of  silver 
»y  laryngeal 
nembrane  is 


dulus. 

ottis,  or  pas- 
lation,  and  a 
f  the  breath 
le  child,  upon 
a  taken  sud- 
er  struggling 
Is  dilated,  its 
nd  arms  stiff, 
iie  disease  is 
It  is  strictly 

I  upright  pos- 
draft  of  cool, 
hing  be  tight 
id  apply  fric- 
place  it  in  a 
e  face. 

jwoi;  en,  lance 
s  rr  jved  daily 
ging.  If  tha 
irm  water  in* 


Hooping  Cough.  —  Purtussis. 

This  is  a  contagious  disease,  peculiar  t  '"'dhood,  and  occurring 
but  once  in  the  same  individual.  It  is  charaelerizcd  by  a  convulsive, 
paroxysmal  cough,  which  is  attended  by  long-continued  hissing,  con- 
vulsive breathing,  with  rattling  in  the  windpipe,  which  is  succeeded 
by  several  short  efferts  to  expel  the  breath,  following  each  other  in 
quick  succession.  The  long,  convulsive  breathing,  attended  by  the 
hooping  sound,  is  immediately  repeated  ;  and  these  paroxysms  coii- 
tinne  until  a  quantity  of  thick,  slimy,  ropy  mucous  is  thrown  up,  by 
expectoration  or  vomiting,  when  the  breathing  is  again  free.  These 
paroxysms  have  all  the  appearance  of  impending  suffocation,  redness 
of  the  face,  shedding  of  tears,  sweating  about  the  head  and  forehead, 
and  such  agitation  of  the  whole  body  that  the  child  lays  hold  of 
.something  for  support.  Blood  sometimes  starts  from  the  nostrils, 
and  the  child  involuntarily  passes  water,  or  evacuates  the  bowels. 
In  spring  and  autumn,  the  disease  most  prevails.  It  is  not  generally 
dangerous. 

Treatment,  —  First  give  an  emetic,  —  say,  two  drams  of  wine  of 
ipecac.  Afterwards,  give  small  doses  of  ipecac  and  sulphur  (277). 
From  six  to  fifteen  grains  of  sulphur  alone,  three  times  a  day,  is  an 
excellent  remedy.  A  liniment  of  olive  oil,  oil  of  amber,  etc.  (193), 
applied  to  the  spine,  is  useful.  Belladonna  (278)  is  a  good  remedy. 
Prussic  acid  (96)  is  strongly  recommended  by  many,  and  is  worthy 
of  a  trial.  Lobelia  (106)  is  a  valuable  remedy.  Alum  (279)  is  well 
recommended.  Sulphuric  ether,  a  little  being  spilled  in  the  nurse's 
hand  and  held  to  the  child's  nose,  generally  shortens  the  paroxysm, 
and  frequently  abridges  the  disease.  A  solution  of  nitric  acid  in 
water,  as  strong  as  lemon  juice,  and  sweetened,  is  a  very  valuable 
remedy,  —  breaking  up  the  disease  in  two  or  three  weeks.  The  child 
may  drink  it  freely,  a  little  further  reduced  with  water. 

Looseness  o^  the  Bowels. — Diarrhoea. 

Infants  and  chilhren  are  more  liable  to  diarrhoea  than  adults,  and 
this  is  the  reason  for  speaking  of  the  disease  here  as  well  as  else- 
where. It  may  be  caused  by  inflammation  of  the  stomach  and 
bowels,  by  irritation  produced  by  too  much  or  improper  food,  by  cold 
and  damp  weather,  or  by  teething.  The  discharges  from  the  boweU 
may  be  more  or  less  thin,  of  a  dirty-white  color,  of  a  curdled  appear- 
ance, and  acid  smell,  or  they  may  be  watery,  yellow  or  green  in  color, 
and  often  mixed  with  blood.  Sometimes  they  are  mixed  with  por- 
tions of  undigested  food,  are  very  acid,  and  when  the  looseness  has 
been  caused  by  unripe  vegetables  and  fruit,  in  a  state  of  fermentation, 
like  yeast.  At  other  times,  especially  while  teething,  they  are  a  kind 
of  thick  mucus,  like  jelly. 

If  pressure  on  the  bowels  causes  pain,  the  diarrhcea  is  the  result  of 
inflammation.    When  the  disease  has  become  chronic,  the  skin  is  dry, 


M. 


Iiarah,  and  4iscolored,  the  face  wrinkled,  luukiiig  yellowish,  dirty,  and 
old. 

Treatment. —  First,  regulate  the  diet.  Thia  is  very  important.  In 
fhe  case  of  older  children,  take  away  evi^ry  kind  of  solid  food,  as  well 
as  pastry,  confectionery,  sweetmeats,  and  fresh  vegetables.  Give 
l)iain  boiled  rice  and  milk,  —  sometimes  boiled  milk,  —  water  gruel, 
jrackers  and  milk,  tapioca,  etc.  At  the  begiimiiig  of  the  attack,  give 
o<ime  mild  physic,  as  castor  oil,  or  syrup  of  rhubarb.  A  warm  bath 
at  this  period  is  excellent.  If  the  discharges  arc  very  sour,  dissolve 
a  teaspoonful  of  bicarbonate  of  soda  in  .  ilf  a  tumbler  of  water,  and 
give  a  teaspoonful  every  hour,  or  the  same  amount  of  lime  water, 
mixed  with  an  equal  quantity  of  new  milk,  or  prepared  chalk  and 
ipecac  (158),  some  sligiit  astrmgent  being  used  al.so  (159).  But  bet- 
ter than  all  other  astringents  for  this  complaint,  is  a  decoction  of  the 
r:ranesbill  or  spotted  geranium,  with  milk,  or  of  the  bark  from  the 
lOot  of  the  common  blackberry  which  is  armed  with  strong  prickles. 


T' 


The  Summer  Complaint  of  Infants. —  Cholera  Infantum. 

This  is  confined  to  the  North  American  continent.  It  occurs  in 
large  cities  during  the  hot  season.  Its  subjects  are  infants  between 
the  ages  of  four  and  twenty  months,  —  occurring  most  frequently 
about  the  time  of  cutting  the  first  teeth.  It  is  one  of  the  most  fatal 
diseases  of  infants. 

Symptoms.  —  It  begins  with  a  profuse  diarrhcea,  —  the  stools  being 
green  or  yellow,  or  more  often  light  colored,  and  very  thin.  The 
stomach  soon  becomes  very  irritable,  --rejecting  everything  with  vio- 
lence. In  some  cases,  vomiting  and  |)urging  set  in,  —  the  discharges 
from  the  bowels  being  without  color  or  smell.  The  infant  rapidly 
loses  flesh,  and  is  soon  reduced  to  groat  languor  and  prostration. 
The  pulse  in  the  beginning  is  quick,  small,  and  oftcii  tense.  The 
tongue  is  covered  with  a  white,  slimy  mucus.  'J'lie  skin  is  >  .y  and 
harsh.  The  head  and  belly  are  hot.  The  feet  and  hands  are  either 
of  the  natural  temperature,  or  cold.  There  is  great  thirst,  and  tow- 
ards evening,  fever.  The  belly  is  often  a  little  swollen,  and  tender  to 
the  touch.  Occasionally  there  is  delirium,  a;i  indicated  by  wild  and 
bloodshot  eyes,  violent  tossing  of  the  head,  and  aUenipts  to  bite  and 
scratch  the  nurse. 

Treatment.  —  If  possible,  remove  the  child  at  once  from  the  impure 
and  heated  air  of  the  city  to  the  cooler  and  purer  air  of  the  country. 
If  this  cannot  be  done,  keep  it  in  as  large  and  dry  a  room  as  can  be 
had,  and  take  it  often  into  the  open  air,  in  clear  weather.  Confine 
the  infant  entirely  to  the  breast,  or,  if  weaned,  let  its  food  be  tapioca, 
pure  arrow-root,  rice  flour,  and  milk,  and  put  it  daily  in  a  warm  or 
tepid  bath,  according  as  the  skin  is  hot  or  cold.  Give  it  gum-water, 
or  rennet  whey,  with  a  little  gum  arable  added  to  it. 

These  measures,  if  used  early,  will  often  cure  the  disease,  without 
medicine.     If  the  vomiting  be  obstinate,  camphor  and  sulphuric  ether 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


405 


dirty,  and 

»rtaiit.     In 

od,  as  well 

(es.      Give 

kter  gruel, 

Lttack,  give 

Iwartn  bath 

ir,  dissolve 

J  water,  and 

|itne  water, 

chalk  and 

But  bet- 

!tion  of  the 

k  from  the 

prickles. 

Infantum. 

t  occurs  in 
its  between 
frequently 
e  most  fatal 


stools  being 
thin.  The 
ng  with  vio- 
B  discharges 
fant  rapidly 
prostration, 
tonsf*.  The 
I  is  I  y  and 
Js  are  either 
st,  and  tow- 
nd  tender  to 
jy  wild  and 
i  to  bite  and 


I  the  impure 
the  country, 
ma-*  can  be 
;r.     Confine 

be  tapioca, 
I  a  warm  or 

gum-water, 

ase,  without 
phuric  ether 


(280)  will  generally  give  relief.  "When  everything  else  faiLs,  in  re- 
lieving the  sicknesK,  sugar  of  lead  (160)  is  generally  Bucccssfui. 
When  the  vomiting  is  stopped,  the  most  prompt  remedy  for  the  dis- 
ordered bowels  is  the  compound  syrup  of  rhubarb  and  potassa. 
When  the  disease  has  become  chronic,  treat  it  the  same  an  children's 
diarrhoea.  But  if  the  discharges  are  sour,  ofiensive,  and  dark  colored, 
pulverized  charcoal  (42),  with  tartrate  of  iron  (71),  will  be  suitable 
remedies.  Rhubarb,  leptandrin,  etc.  (28),  will  often  answer  a  good 
purpose. 

Colic. 

Infants  are  very  much  subject  to  colic,  from  over-feeding  and  con 
seijuent  acidity  of  the  stomach,  from  giving  them  solid  food  at  too 
tender  an  age,  and  from  some  improper  thing  ate  or  drunk  by  the 
mother  or  nurse.  They  often  suffer  intensely  from  these  pains,  toss- 
ing their  legs  up  and  down,  and  screaming  vehemently.  "When  it 
arises  from  costiveness,  the  bowels  are  often  hard  and  swollen. 

Treatment.  —  When  it  arises  from  costiveness,  give  an  injection  of 
a  tablespoonful  of  castor  oil,  and  an  ounce  of  warm  infusion  of  pep- 
permint or  spearmint.  At  the  same  time,  administer  internally  an  in- 
fusion of  one  of  the  same  herbs,  with  a  small  portion  of  bicarbonate  of 
soda  dissolved  in  it,  and  sweetened  with  loaf  sugar.  Or,  if  the  bowels 
need  to  be  acted  upon,  the  syrup  of  rhubarb,  or  the  sweet  tincture  of 
rhubarb,  with  a  little  soda  in  it,  will  do  well.  Paragoric  generally 
brings  relief,  but  should  not  be  used,  if  simple  carminatives  will  an- 
swer the  purpose.  Ciiildren  are  often  relieved  by  covering  them  with 
a  hot  flannel,  laying  them  upon  the  belly  on  the  knee,  and  trotting 
them,  at  the  same  time  tapping  them  gently  upon  the  back.  This 
should  be  done  cautiously  ;  for  if  unsuccessful,  it  miglit  increase  the 
suffering  ;  and  the  infant  has  no  language  but  screams  to  tell  its  dis- 
tress. 

Falling  of  the  Bowel. — Prolapsis  Ani 

In  cases  of  long-continued  looseness,  the  lower  bowel  of  children 
sometimes  gets  so  weakened,  that  it  drops  down,  and  projects  through 
the  fundament.  Occasionally,  only  the  mucous  membrane  which 
lines  it  comes  down,  in  the  shape  of  a  small  tumor,  causirig  a  sense 
of  bearing  down  and  smarting.  These  fallings-down  occur  when  the 
child  goes  to  stool.  Whether  it  be  the  bowel  or  the  lining  membrane 
which  has  come  down,  if  it  be  allowed  to  remain  long  down,  inflam- 
mation will  take  place,  and  to  return  it  will  then  be  very  diflicult 

Treatment. —  Place  the  child  upon  his  back,  and,  having  smeared 
the  thumbs,  or  fore  fingers,  with  lard  or  sweet  oil,  press  them  gently 
upon  the  tumor  in  such  direction  as  «haU  tend  to  return  it  within  the 
body.  If  this  does  not  succeed,  push  the  forefinger  into  the  gut,  so 
as  to  relax  the  circular  muscle  which  contracts  upon  and  holds  it.  If 
the  falling  is  caused  by  straining  at  stool,  made  necessary  by  costive- 


;  (i 


C.VUK  OF  CHILDREN  AND  THEIU  DISEASES. 


ufss,  Botne  ripe  fruit  stewed  in  molanses,  or  rye  hasty-pudding  and 
molasses,  should  be  given  to  the  child  daily,  and  it  should  be  caused 
to  empty  the  bowels  while  standing  up.  To  strengthen  the  bowel, 
6'W  things  are  better  than  cold  water,  applied  to  the  fundament  sev- 
eral times  a  day.  An  astringent  wash  of  oak  bark  (232),  is  also  val- 
uable. Should  the  bowel  become  so  much  relaxed  that  these  means 
fail,  a  tight  bandage  must  be  applied  to  support  the  fundament  Be 
careful  that  some  ignorant  pretender  does  not,  —  as  has  happened,— 
apply  the  ligature  or  the  knife,  and  cut  off  the  tumor,  instead  of  re» 
turning  it  into  the  body. 


Gastric  Fever  of  Infancy. 

Thk  inflammatory  affections  of  the  bowels,  which  happen  aftei 
teeth-cutting,  are  frequently  accompanied  by  remittent  fever,  —  the 
fever  showing  itself  very  distinctly  towards  evening,  and  subsiding,  oi 
nearly  disappearing,  in  the  morning.  It  is  a  sympathetic  fever,  and 
is  generally  the  result  of  a  reaction  prodin-ed  by  inflammation  of  the 
stomach,  or  ileum,  or  colon.  The  attack  is  aoiuutimea  sudden,  though 
generally  gradual. 

Symptoms.  —  For  several  days,  the  child  will  be  languid  and  fretful, 
with  loss  of  appetite,  increased  thirst,  and  some  heat  of  skin.  Tow. 
ards  night  these  symptoms  are  more  intense ;  the  skin  is  more  hot, 
the  thirst  and  restlessness  are  greater,  the  pulse  more  rapid.  In  the 
morning,  the  skin  is  more  moist  and  cool,  and  the  child  falls  into  a 
short,  disturbed  sleep.  Early  in  the  attack,  the  bowels  are  constk 
patcd,  —  though  there  is  sometimes  diarrhoea,  or  a  frequent  desire  td 
go  to  stool  without  much  being  passed.  The  evacuations  are  alwaya 
unnatural  and  very  offensive.  They  are  dark-colored,  or  clay-like,  oi 
of  the  consistency  of  tar,  —  sometimes  mixed  with  mucus,  and  occai 
sionally  with  blood.  There  is  tenderness  of  the  belly,  and  pressure 
upon  it  causes  pain.  It  is  also  hot  to  the  touch,  while  the  feet  are 
cold.  The  face  is  flushed,  and  the  breath  has  a  decidedly  sickly 
smell.  The  stomach  is  irritable,  and  vomiting  is  frequent  The 
tongue,  after  a  time,  becomes  coated,  dry,  and  pointed. 

In  the  chronic  form  of  the  disease,  there  is,  frequently,  diarrhoea, 
the  passages  being  unhealthy  and  fetid ;  the  tongue  is  covered  with  a 
brownish-yellow  mucus,  the  teeth  with  sordes ;  the  lips  are  parched 
and  cracked ;  the  urine  is  scanty  and  high-colored,  with  a  white  sedi- 
ment ;  the  skin,  dry,  harsh,  and  dirty-looking ;  the  countenance  con- 
tracted and  wrinkled  ;  and  there  is,  frequently,  a  dry,  hacking  cough. 

Treatment.  —  Regulate  the  diet.  This  is  '.mportant  In  recent  and 
acute  cases,  withhold  all  food,  except  some  cold  mucilaginous  fluid 
as  drink,  as  rice-water,  gum-water,  infusion  of  slippery-elm  bark,  or 
milk  diluted  with  barley  water.  Give  a  warm  or  tepid  bath  daily. 
Purgatives  should  be  used  sparingly.  The  bowels,  when  costive,  had 
better,  generally,  be  opened  by  injections  of  tepid  water,  or  thin  gruel. 
If  any  laxative  be  used,  let  it  be  the  compound  rhubarb  powder,  or 


iing  and 
le  cauHed 
le  bowel, 
Inent  sev- 
J  also  val- 
iae  meana 
lient  Bo 
Ipened, — 
>ad  of  re> 


pen  aftei 
vet,  —  the 
isiding,  or 
fever,  and 
on  of  the 
;n,  though 


nd  fretful, 
Tow, 

more  hot, 
1.     In  the 

alls  into  a 
ire  constu 
t  desire  td 
ire  always 
lay-like,  oi 
and  occa< 
i  pressure 
e  feet  are 
dly  sickly 
3nt     The 

diarrhoea, 
red  with  a 
e  parched 
irhite  sedi- 
ance  con- 
g  cough. 

■ecent  and 
lous  fluid 
n.  bark,  or 
ath  daily, 
•stive,  had 
;hin  gruel, 
(owder,  or 


CAIIK  OF  CIULDUKN  AND  TIIKIK  DISEASES. 


407 


cither  of  the  following,  (28)  (281).  When  the  discharges  have 
become  healthy,  and  the  tongue  clean  and  moist,  some  light  bitter, 
as  the  infusion  of  Peruvian  bark,  or  Colombo,  in  combination  with 
diluted  sulphuric  or  hydrochloric  acid,  may  be  given.  These,  care- 
fully given,  with  the  daily  tepid  bath,  and  exercise  in  the  open  aif 
will  soon  restore  the  strength. 

Mesenteric  Disease. 

This  attacks  scrofulous  children  bet  een  the  ages  of  three  and  ten 
years.  Its  symptoms  are  a  prominent  elly  and  loss  of  llesh,  —  par- 
ticularly up>on  the  arms  and  legs.  To  be  able  to  feel  the  enlarged 
and  hardened  glands,  through  the  walla  of  the  belly,  is  the  surest  sign 
of  this  disease.  When  the  complaint  is  long-continued,  the  child 
loses  all  its  flesh,  and  dies  in  almost  a  complete  skeleton  state. 

Treatment.  —  If  there  is  inflammation  or  other  disorder  in  the 
stomach  or  bowels,  attend  to  this  first.  Then  put  the  patient  on  a 
generous  diet,  su^h  as  meat  broths,  etc.  Give  bicarbonate  of  potassa, 
dissolved  in  the  infusion  of  columbo  or  quassia,  and  when  there  is 
costiveness,  add  rhubarb  to  the  preparation.  For  the  enlargement  of 
the  glands,  apply,  externally,  an  ointment  (184)  of  the  iodide  of  lead, 
or  of  the  iodide  of  potassium  (185).  Give  an  ioduretted  bath,  daily, 
which  is  formed  by  adding  one  grain  of  iodine  and  two  grains  of 
iodide  of  potassium  to  each  gallon  of  warm  water. 

The  syrup  of  iodide  of  iron  should  be  given,  internally,  three  times 
a  day,  in  a  little  water,  or  the  iodide  of  potassium,  and  compound 
infusion  of  gentian.  Daily  sponging  the  body  in  salt  and  water,  and 
exercise  in  the  open  air,  are  important. 

Rickets. 

This  is  also  a  disease  of  scrofulous  children.  By  some  bad  process 
of  nutrition  in  such  children,  there  does  not  enough  phosphate  of  lime 
enter  into  the  bones  to  harden  them,  and  the  weight  of  the  body,  or 
the  pulling  of  the  muscles,  or  the  pressure  of  the  clothing,  bends  and 
distorts  them  in  all  manner  of  ways.  The  heads  of  the  thigh  bones 
are  pushed  nearer  together,  making  the  lower  belly  narrow  ;  the  back 
bone  is  so  curved  as  to  lessen  the  height ;  the  shoulder  blades  stand 
up  like  wings  when  flying  is  contemplated  ;  and  the  shoulders  are  so 
lilted  up  that  the  head  seems  only  a  1.  j  higher  than  the  elevations 
oii  each  side. 

Treatment —  A  good,  generous,  wholesome  diet,  properly  regulated; 
out  door  exercise  ;  the  tepid  or  cold  salt  water  sponge  bath,  with  fric- 
tion, and  but  little  medicine.  The  hypo-phosphite  of  lime,  in  two- 
grain  doses,  given  in  a  little  sweetened  water,  three  times  a  day,  or  the 
syrup  of  the  hypo-phosphites,  in  half-teaspoonful  doses,  three  times  a 
day,  may  be  given  with  advantage. 


■V  f* 


408 


CAKR  OF  ClllLDUKN  AM)  THRIK  DISEASES. 


The  Blue  Disease. — Cyanosis. 

This  disease  is  known  by  a  blue,  purple,  or  leaden  tinge  over  tlie 
whole  body.  The  warmth  of  the  body  is  reduced,  ihere  is  diificult 
breathing,  which  is  increased  by  quick  motion  or  by  crying.  The 
disease  is  generally  fatal.  The  blueness  is  occasioned,  either  by  the 
passage  between  the  right  and  left  side  of  the  heart  remaining  open 
after  birth,  so  as  to  let  the  blue,  venous  blood  run  through  and  mix 
with  the  red  arterial  blood,  thus  making  the  whole  blue,  or  by  the 
obstruction  of  the  pulmonary  artery,  which  withholds  the  blood  from 
the  lungs,  and  does  not  allow  it  to  be  arterialized  and  reddened. 
This  latter  opinion  is  the  more  general  one  now. 

Treatment — Keep  the  patient,  as  much  as  possible,  in  a  state  of 
rest,  so  that  the  circulation  may  not  be  hurried.  Allow  a  pure  fresh 
air,  easily-digested  food,  and  protect  the  body  from  cold  and  damp- 
ness. Hold  the  infant  near  the  fir'?,  and  apply  gentle  friction  over  the 
head  and  body  with  a  warm,  soft  cloth. 


Pits. 

Most  persons  have  seen  a  baby  in  fits ;  and  it  is  a  sad  sight,  —  its 
little  face  all  distorted  and  livid ;  its  eyes  rolling  and  squinting  fright- 
fully ;  its  hands  clenched,  and  arms  bent,  and  legs  drawn  up,  and  body 
arched  backward,  and  limbs  twitching  violently,  —  itself  insensible, 
and  unable  to  see,  or  swallow,  or  move.  After  a  time,  the  fit  ceases, 
sometimes  by  degrees,  at  other  times  suddenly,  —  the  child  fetching  a 
deep  sigh,  and  then  lying  quiet  and  pale,  as  if  it  had  fainted.  From 
this  state  it  passes  mto  a  sleep,  and,  on  waking,  some  hours  after, 
seems  quite  well. 

Fits  may  attack  a  child  which  is  appare.itly  well,  and  "  .il  it  im- 
mediately, or  it  may  have  fits  daily,  or  evei?  acveral  tiraes  a  day, 
and  linger  on  for  weeks.  A  child  may  have  fits  from  a  great  vari- 
ety of  causes.  Fits,  therefore,  have  a  different  meaning  in  differenv 
cases.  But  they  always  show  that  the  brain  has  in  some  way  been 
disturbed. 

Treatment.  —  As  fits  are  not  a  disease  in  themselves,  but  only  a 
symptom  of  some  disease,  the  treatment  must  have  reference  to  the 
cause.  Sometimes,  while  the  fit  lasts,  it  is  wise  to  do  nothing.  But, 
if  a  fit  come  suddenly,  in  the  case  of  a  child  previously  healthy,  it  is 
generally  safe  to  place  it  in  a  hot  bath,  and  at  the  same  time,  to  dash 
cold  water  on  its  face,  or  to  pour  cold  water  on  its  head,  or  hold  on 
it  a  large  sponge  dipped  in  cold  water.  The  hot  bath  will  draw  the 
blood  to  the  skin,  and  away  from  the  over-loaded  brain.  It  will  quiet 
the  disturbance  of  the  system,  and  if  scarlet  fever  or  measles  ar« 
about  to  appear,  it  will  bring  them  out 


over  tlio 

la  diiricult 

]»Jg.     The 

(ler  by  the 

Jiiiig  o|)cii 

and  mix 

Jr  by  the 

Bond  from 

rcddciKid. 


a  state  of 
pure  fresh 
nd  damp- 
II  over  the 


ight, —  its 
ing  fright- 
and  body 
insensible, 
fit  ceases, 
fetching  a 
!d.  From 
ours  after, 

'  .il  it  im- 
ea  a  day, 
;reat  vari- 
i  differeni 
way  been 

ut  only  a 
ce  to  the 
ng.  But, 
lithy,  it  is 
e,  to  dash 
r  hold  on 
draw  the 
will  quiet 
iasles  ars 


WSEASES   OF  THE  GENERAL  SYSTEM. 


Havino  now  treated  of  those  disorders  which  affect  the  skin,  the 
brain  and  nerves,  the  throat,  the  lungs  and  their  appendages,  the  heart 
and  its  covering,  the  abdominal  cavity  and  its  lining  membrane,  the 
sexual  organs,  and  those  complaints  peculiar  to  females  and  children, 
it  remains  to  speak  of  those  others,  —  fewer  in  number,  —  which  are 
not  specially  developed  in  any  particular  part,  but  disturb  the  whole 
■ystem. 

Fever. 

Fever  is  a  disease  which  affects  the  system  generally,  and  is  char- 
acterized by  more  or  less  excitement  of  the  circulation,  increased  heat, 
diminished  strength,  and,  oftentimes,  unnatural  thirst.  The  degree 
of  excitement  is  measured  by  the  state  of  the  pulse.  Of  this  state, 
there  are  two  characteristic  indications:  name\y^ frequency  and  hnrd- 
ness.  A.  pulse  is  frequent  when  its  rapidity  exceeds  that  of  health ; 
it  is  hard  when  its  stroke  resists  the  pressure  of  the  finger  with 
unusual  force. 

In  health,  the  pulse  of  an  adult  beats  from  sixty  to  eighty  times  in 
a  minut«  ;  that  of  children  is  more  frequent.  The  pulsations  of  the 
heart  of  the  unborn  infant,  as  heard  through  the  body  of  the  mother, 
are  one  hundred  and  fifty  in  a  minute.  After  birth,  the  pulse  varies 
from  one  hundred  and  forty  down  to  the  standard  of  adult  age.  To 
appreciate  hardness  of  pulse,  experience  is  absolutely  necessary. 

The  great  activity  of  the  circulation,  in  fever,  is  intimately  con- 
nected with  the  heat  and  thirst,  and  tends  directly  to  waste  the  ener- 
gies, and  consume  the  strength  of  the  patient.  The  heat  of  fever 
lessens  or  dries  up  the  secretions,  or  different  fluids  of  the  body, 
which,  in  a  state  of  health,  are  separated  from  the  blood  for  various 
purposes.     This  is  the  cause  of  the  dry  skin,  scanty  urine,  etc. 

A  crisis  of  fever  is  that  period  in  its  course  when  unfavorable  symp- 
toms give  place  to  those  of  returning  he  .1th. 

A  course  of  fever,  or,  in  common  language,  a  run  of  fever,  is  dis- 
tinguished by  a  great  variety  of  symptoms,  which  will  be  more  par- 
ticularly spoken  of  in  the  pages  which  follow. 


«l 


V  i 


410 


DISEASES  Of 


GENERAL  SYSTEM. 


Typhoid  Fever. 

Of  the  diflferent  kinds  of  fever,  this  is  one  of  the  most  common  nnd 
widely  prevalent.  The  name  typhoid  ia  from  two  (Jreek  words  which 
moan  like  typhus,  or  similar  to  typhus.  The  word  typhus,  from  a  (Jreek 
word  signifying  stupor,  means  stupid,  dull,  or  lotc ;  and,  when  applied 
to  a  fever,  implies  that  it  is  UrWi  or  characterized  by  great  nervatu 
dejtres.rion. 

Typhus  and  typhoid  fevers,  if  not  identical,  are  so  similar  in  hiftorjf 
and  treatment  as  to  make  unnecessary  their  consideration  under  sep. 
arate  heads.  The  following  is  one  of  the  dift'erences  claimed  to  exist 
between  the  two :  namely,  in  typhus  fever,  the  belly  is  Hat ;  there  ia 
no  marked  disease  of  the  bowels,  and  generally  no  diarrhoea  until  the 
second  or  third  week.  In  typhoid  fever,  on  the  contrary,  some  small 
glands,  called  Peyer's  glands,  situated  in  the  lower  part  of  the  small 
intestines,  are  always  inflamed,  and  sometimes  ulcerated  ;  and,  con- 
sequently, among  the  symptoms  most  frequently  notict.d,  are  diar- 
rhoea, and  drum-like  swelling  of  the  belly,  called  tympanites. 

Symptoms. —  The  disease  often  has  precursory  symptoms.  For 
several  days  before  its  actual  beginning,  the  patient  droops.  He  may 
attend  to  his  various  duties,  but  does  not  seein  well;  he  is  low-spirited 
and  languid ;  is  indisposed  to  any  exertion  of  body  or  mind ;  has 
pains  in  the  head,  back,  and  extremities ;  loses  his  appetite ;  and 
although  dull  and  perhaps  drowsy  in  the  day  time,  his  sleep  is  inter- 
rupted and  unrefreshing  at  night.  The  immediate  harbinger  of  the 
fever  is  a  chill,  often  so  marked  as  to  cause  violent  shivering. 

The  history  of  the  first  week  shows  increased  heat  of  the  surface ; 
frequent  pulse,  ranging  from  eighty  to  one  hundred  and  twenty; 
furred  tongue  ;  restlessness  and  sleeplessness ;  headache  and  pain  in 
the  back  ;  sometimes  diarrhoea  and  swelling  of  the  belly ;  and  some- 
times nausea  and  vomiting. 

The  second  week  is  frequently  distinguished  by  an  eruption  of 
small,  rose-colored  spots  upon  the  belly,  and  by  a  crop  of  little  watery 
pimples  upon  the  neck  and  chest,  having  the  appearance  of  minute 
drops  of  sweat  standing  on  the  skin,  and  hence  called  sudamina,  or 
sweat  drops  ;  the  tongue  is  dry  and  black,  or  red  and  sore  ;  the  teeth 
are  foul ;  there  may  be  delirium  and  dulness  of  hearing ;  and  the 
symptoms  generally  are  more  serious  than  during  the  first  week. 
Occasionally,  at  this  period,  the  bowels  are  perforated  or  ate  through 
by  ulceration,  and  the  patient  suddenly  sinks. 

If  the  disease  proceeds  unfavorably  into  the  third  week,  there  is 
low  muttering  and  delirium ;  great  exhaustion ;  sliding  down  of  the 
patient  towards  the  foot  of  the  bed ;  twitching  of  the  muscles ;  bleed- 
ing from  the  bowels  ;  and  red  or  purple  spots  upon  the  skin. 

If,  on  the  other  hand,  recovery  takes  place,  the  countenance  bright- 
ens ;  the  pulse  moderates ;  the  tongue  cleans,  and  the  discharges 
assume  the  appearance  they  have  in  health. 

Treatiiieut. —  Give  the  patient  goo<l  air,  and  frequent  spongmgs 


3ommoii  and 
word.i  which 
mm  a  (ircrk 
vUvn  applied 
ri;at  nervmu 

iir  in  hiftorj 
under  wp. 
iiu^d  to  exirtt 

at;  then;  is 
Kjca  until  the 
,  some  stiiall 
of  the  small 
d ;  and,  con- 
■(  d,  are  diar- 
ites. 

ptoms.      For 
ps.     He  may 
low-spirited 
r  mind ;  has 
ppetite ;  and 
leep  is  inter- 
binger  of  the 
ring, 
the  surface ; 
and  twenty; 
and  pain  in 
y ;  ana  some- 
eruption  of 
f  little  watery 
ice  of  minute 
sudamina,  or 
>re ;  the  teeth 
ing ;  and  the 
e  first  week, 
r  ate  through 

reek,  there  is 
down  of  the 
iscies ;  bleed- 
kin. 

nance  bright- 
le  discharges 

nt  spongings 


DI8EA8K8  OF  TIIK  UKNKHAL  SYSTKM. 


411 


with  water,  cold  or  tepid,  art  shall  be  most  agreeable  to  his  feelings. 
Keep  t'  '.  bowels  in  order;  by  which  is  meant,  bo  more  afraid  of 
diarrhn  than  of  costivi'iiess.  Diarrhani  should  be  restrained  by  a 
little  brandy,  or  by  small  and  repeated  doses  of  Dover's  powtler  (l.)J}). 

For  eostiveness,  give  injections,  or  the  mildest  aperients  (7)  (10)  (12). 

To  lessen  the  frecjumcy  of  the  pulse,  reduce  the  fcrver,  and  pro- 
duce perspiration,  give  from  three  to  ten-<lrop  doses  of  the  tincture  or 
lliiid  extract  of  veratrum  viridc,  every  hour.  This  remedy  has  great 
powt-r  in  fever. 

(ireut  wind-swelling  of  the  bowels  may  be  relieved  by  fomenta- 
tions, or  hot,  steaming  applications.  Sometimes  the  wind  may  be. 
let  oir  by  introducing  into  the  bowels  a  long  gutta  percha  tube, — 
thus  reducing  the  swelling,  and  greatly  promoting  the  patient's  com- 
fort. 

If  pain  in  the  head  be  severe  and  constant,  let  the  hair  be  cut  short, 
and  the  head  be  frecpicntly  bathed  with  cold  water. 

Let  the  stn'i.gjh  b(!  supported  by  light  nourishment;  and  in  case 
of  bleeding  from  the  bowels,  or  gr  'at  debility,  by  broth  and  wine. 

For  foul  mouth,  the  weakest  possible  infusion  oi  old  hyson  tea  is 
valuable,     (iood  nursing  is  eminently  desirable. 

If  the  fever  runs  a  low  course,  the  patient  being  much  prostrated, 
quinine,  even  in  large  doses,  may  be  given  from  the  beginning. 

Bilious  Remittent  Fever. 

Thkrk  are  three  principal  varieties  of  ;>cm</tVa//fiver,  which,  thougti 
varying  considerably  f»om  each  other,  in  several  particulars,  are  yet 
essentially,  in  their  substance,  but  mie  disease.  These  are  BilUnis 
ReiaUlent  Fever,  Pernicums  IiilervtiUent  or  Congestive  Fever,  and 
lelermittent  Fever  or  Fever  ami  Agve.  According  to  the  custom  of 
most  writers,  I  shall  treat  them  separately,  beginning  with  Bilious 
Remittent  Fever. 

Syniptoms.  —  The  attack  is  generally  sudden  and  well  marked. 
Some  writers  say  it  has  no  premonitory  symptoms ;  others,  that  it 
has.  The  more  general  understanding  is,  that  for  a  day  or  two,  or 
6Ven  longer,  before  the  onset,  there  is  a  sense  of  languor  and  debility, 
ilight  headache,  lack  of  appetite,  furred  tongue,  bitter  taste  in  the 
mouth  in  the  morning,  pains  in  the  joints,  and  general  uneasiness. 

The  formal  onset  is  nearly  always  marked  by  a  distinct  chill,  or  rigor, 
—  sometimes  slight  and  brief;  at  other  times  severe  and  prolonged 
The  chill  may  begin  at  the  feet,  or  about  the  shoulder  blades,  or  in 
I  he  back,  and  thence  run  like  small  streams  of  cold  water  poured  in 
every  direction  through  the  whole  body.  There  is  generally  but  one 
well-marked  chill,  the  returns  of  the  paroxysms  of  fever  being  seldom, 
after  the  first,  preceded  by  the  cold  stage. 

At  certain  periods  of  the  day,  there  is  an  increased  intensity  in  the 
symptoms  of  the  disease,  occasionally  preceded,  though  generally  not, 
by  the  chill.  Between  this  period  of  severity  in  the  feverish  symp- 
toms, and  a  similar  period  which  follows  it,  there  is  generally  decrease 


■T^" 


412 


DISEASES  OF  THE  GENERAL  STSTEM. 


in  the  violence  of  the  symptoms,  during  which  the  fever  moderates, 
but  does  not,  as  in  fever  and  ague,  entirely  go  off;  has  distinct  remis- 
sions, bnt  not  complete  intermissions. 

During  the  hot  stage,  the  pulse  is  up  to  one  hundred  and  twenty,  or 
one  hundred  and  thirty.  There  are  pains  in  the  head,  back,  and  limbs, 
of  a  most  distressing  kind. 

The  tongue  is  generally  covered  with  a  yellowish,  or  a  dirty-wliito 
fur ;  and  in  bad  cases,  in  the  advanced  stage,  is  frequently  parchi-d, 
brown,  or  nearly  black  in  the  centre,  and  red  at  the  edges.  There  is 
no  appetite  for  food,  and  generally  Tiausea  and  vomiting ;  and  usu- 
ally there  is  pain  and  tenderness  in  the  epigastrium.  The  bowels  are 
at  first  costive,  but  afterwards  become  loose,  and  there  are  frequenti 
evacuations  of  dark,  offensive  matter. 

Causes.  —  This  disease  is  produced  by  malarial  exhalations  from 
the  decomposition  of  vegetable  matter.  It  is  most  prevalent  in  hot 
climates,  and  in  the  summer  and  autumn. 

Treatment.  —  If  the  fever  be  in  the  formative  stage,  and  have  not 
fully  developed  itself,  give  an  emetic  (1)  (2),  and  follow  it  with  a  mild 
cathartic  (7)  (13). 

If  the  disease  be  already  developed,  sponge  the  body,  all  over,  sev- 
eral times  a  day,  with  cold  or  tepid  water,  according  to  the  feelinjOfs 
(of  the  patient,  and  give  cooling  drinks  (132)  (133)  (298)  (299).  to 
moderate  the  fever,  give  three  to  ten-drop  doses  of  tincture,  or  fluid 
extract  of  veratrum  viride.  The  compound  powder  of  ipecac  and 
opium  is  a  valuable  preparation  for  the  same  purpose.  Give  cold 
water  as  drink  if  desired  by  the  patient,  or  let  him  eat  ice. 

When  the  headache  is  very  severe,  let  wet  cups  be  applied  upon  tiie 
temples,  or  behind  the  ears ;  and  the  same  remedy  to  the  pit  of  the 
stomach,  when  there  is  great  tenderness,  is  often  desirable  ;  though  a 
muotard  poultice  will  sometimes  do  better. 

During  the  remissions  of  the  fever,  quinine,  and  other  tonics  are  to 
be  given,  as  in  fever  and  ague. 

Congestive  Fever.— Pernicious  Intermittent  Fever. 

This  is  the  pernicious,  or  malignant  form  of  malarious  fever.  It  is 
marked,  either  in  the  earlier  or  later  stage,  by  a  rush  of  blood  towards 
one  or  more  organs,  by  which  tiiey  are  crowded  full  and  congested,  — 
hence  its  title  of  congestive  fever. 

Symptoms.  —  It  may  be  intermittent.,  or  remittent,  —  more  com- 
monly,  it  is  the  former.  It  may  assume  any  of  the  types  of  peri- 
odical fever,  but  it  is  most  frequently  quotidian  or  tertian. 

The  first  attack  does  not  differ  very  materially  from  a  common 
attack  of  simple  intermittent  The  first  paroxysm  is  simple,  exciting 
but  little  attention.  The  second  is  always  severe,  producing  great 
coldness,  and  a  death-like  hue  of  the  face  and  extremities.  The 
advancement  of  the  disease  brings  dry,  husky,  parched,  and  pun- 
gently  hot  skin,  followed,  after  a  time,  by  a  cold,  clammy  8ensation< 


■:/ 


moderates, 
^tinct  remis- 

Id  twenty,  or 
i,  and  limbs, 

dirty-wliito 
I  fly  parched, 
There  is 
,  and  usu- 
bowels  are 
|are  frequents 

lations  from 
alent  in  hot 

id  have  not 
with  a  mild 

all  over,  sev- 
the  feelings 

(299).  to 
ure,  or  fluid 

ipecac  and 
Give  cold 

ied  upon  the 
he  pit  of  the 
le ;  though  a 

tonics  are  to 


it  Fever. 

fever.  It  is 
3od  towards 
•ong-ested,  — 


more  corn- 
pes  of  peri- 

a  common 
)le,  exciting 
acing  great 
ities.  The 
,  and  pun- 
'  sensatioU' 


DISEASES  OF  THE  GENEUAL  SYSTEM. 


413 


The  eyes  are  dull,  watery,  and  sometimes  glassy;  the  countenance 
dull,  sleepy,  distressed ;  the  tongue,  at  first  white,  changes  to  brown 
or  black,  and  is  usually  tremulous  ;  the  breathing  is  hurried  and  diffi- 
cult. Pressure  over  the  liver,  stomach,  or  bowels,  produces  pain. 
The  mind  is  often  disturbed,  and  falls  into  lethargy  and  stupor,  or  is 
delirious. 

Treatment  —  This  should  be  very  much  fike  the  treatment  of  the 
bilious  remittent  fever. 

While  getting  up  from  the  fever,  the  diet  must  be  light  and  nutri- 
tious at  first,  but  may  be  increased  in  quantity  as  the  strength  returns. 
Exercise  out  of  doors  must  not  be  omitted.  If  recovery  be  slow, 
some  mild  tonic,  or  a  little  wine,  or  ale,  or  brandy,  may  be  taken  two 
or  three  times  a  day. 

Fever  and  Ague.— Intermittent  Fever. 

This  is  a  kind  of  fever  in  which  there  is  a  succession  of  attacks 
with  equal  intervals,  and  intermissions  that  are  complete  but  unequal, 
on  account  of  the  uncertain  duration  of  each  fit. 

An  interval  is  the  period  df  time  between  the  beginning  of  one  fit, 
and  the  beginning  of  the  next. 

An  intermission  is  the  period  of  time  between  the  close  of  one  fit, 
and  the  b^inning  of  the  next 

The  different  varieties  of  ague  take  their  designation  from  the 
length  of  the  interval  in  each  case. 

The  interval  of  a  quotidian,  or  daily  ague,  is  twenty-four  hours. 

The  interval  of  a  tertian,  or  third-day  ague,  is  forty-eight  hours. 

The  interval  of  a  quartan,  or  fourth-day  ague,  is  seventy-two  hours. 

Symptoms.  —  The  disease  first  develops  itself  by  an  ague  fit.  This 
has  three  stages,  the  cold,  the  hot,  and  the  sweating.  The  cold 
stage  is  very  marked.  The  patient  has  a  sense  of  a  debility,  yawns, 
stretches,  has  no  appetite,  and  does  not  wish  to  move.  The  face  and 
extremities  become  pale,  the  skin  shrinks,  causing  universal  horripila- 
tion, or  goose-flesh  ;  the  patient  shakes,  and  his  teeth  chatter. 

After  a  time,  these  symptoms  decline,  and  the  hot  stage  comes  on, 
which  is  characterized  by  high  fever,  with  its  various  uncomfortable 
sensations. 

When  this  fever  passes  off",  it  is  followed  by  the  sweating  stage, 
during  which  a  moisture  breaks  out  which  increases,  frequently,  to  a 
profuse  sweat ;  the  body  returns  to  its  natural  temperature,  the  pains 
and  aches  disappear,  and  a  feeling  of  health  comes  back. 

During  the  cold  stage,  the  blood  is  driven  inward  from  the  surface, 
and  particularly  oppresses  the  spleen,  which,  in  cases  of  long  standing, 
becomes  swelled  and  permanently  enlarged.  This  swelling  may  be 
plainly  felt,  and  is  often  quite  perceptible  to  the  eye.  It  is  called 
iigue  cake. 

Ap'ie  fits  begin  at  different  hours  of  the  day,  and  generally  termi- 
nate in  the  evening. 


414 


DISKASES  OF  THE  GENERAL  SYSTEM. 


A  quotidian  usually  begins  in  the  morning;  a  tertian  at  noon;  and 
a  quartan  in  the  afternoon. 

The  cold  stage  is  shortest  in  the  quotidian,  and  longest  in  the 
quartan. 

Thus  the  longest  fit  has  the  shortest  interval,  and  the  shortest  cold 
stage  ;  while  the  shortest  fit  has  the  longest  interval,  and  the  longest 
cold  stage. 

There  are  also  double  tertians  and  double  quartans,  wherein  th<; 
fits  repeat  themselves,  —  sometimes  the  same  day,  at  other  times  on 
alternate  days. 

To  these  varieties,  the  terms  postponing'  and  anticipating-  are  ap- 
plied, according  as  the  intervals  ave  growing  longer  or  shorter.  When 
a  person  is  recovering  from  ague,  the  interval  may  gradually  grow 
longer,  the  attack  being  put  off,  or  postponed.  But  if  the  disease  be 
increasing  in  severity,  the  attack  may  anticipate  its  usual  period,  mak- 
ing the  interval  shorter. 

Tertians  are  more  common  than  either  quotidians  or  quartans. 

Agues  are  more  prevalent  in  spring  and  autumn.  Fall  agues  are 
most  severe  and  dangerous. 

Causes.  —  Exhalations  from  the  soil,  called  malaria,  arising  from 
decomposition  of  vegetable  matter  in  new  countries,  or  from  low  and 
marshy  districts  in  which  the  land  is  alternately  covered  with  water, 
and  again  left  dry  and  exposed  to  the  sun. 

In  districts  where  it  prevails,  high  hills  are  exempt,  and  even  the 
upper  Btories  of  houses  are  more  healthy  than  the  lower. 

Treatment.  —  First  clear  the  bowels  with  the  fluid  extract  of  senna 
(15),  or  the  preparation  (21).  Then,  in  the  cold  stage,  give  hot,  and 
in  soiiie  cases,  stimulating  drinks.  Administer  hot  foot  baths,  and, 
putting  the  patient  in  bed,  apply  bottles  filled  with  hot  w  *  to  the 
feet,  sides,  and  back,  and  in  every  way  try  to  excite  warmth  and 
comfort 

In  the  hot  stage,  give  cooling  drinks,  and  opium  (117)  (118)  in  de- 
cided doses ;  or,  what  is  better,  quinine  (67)  in  two  teaspoonful  doses 
every  half  hour,  at  the  same  time  giving  five-drcp  doses  of  tint  .ure  or 
fluid  extract  of  veratrum  viride  every  hour. 

During  the  sweating  stage,  stop  the  veratrum,  and  rub  the  patient 
with  dry  towels. 

In  the  intermission,  give  quiniae  (62),  in  three-grain  doses,  once  in 
three  or  four  hours,  and  continue  it,  gradually  increasing  the  dose,  a 
fortnight  after  the  cessation  of  the  attacks.  Tho  following  is  a  good 
preparation:  quinine,  one  scruple;  elixir  of  'atriol,  one  dram;  dis- 
solve the  quinine  in  the  elixir,  and  add  +ir'Ctar?  of  black  cohosh,  four- 
teen drams.  Twenty  drops  are  to  be  giv  -»•,  in  a  little  water,  once  an 
hour. 

The  web  of  the  black  spider,  rolled  up  into  five-grain  pills,  and 
taken,  one  pill  at  a  time,  once  in  two  hours  during  the  intermission, 
is  said  to  cure  many  cases. 

It  is  important,  in  fever  and  ague  districts,  to  avoid  the  hot  eun, 
and  the  damp  evening  and  morning  air. 


noon;  and 

Igest  in  the 

hortest  cold 
the  longest 

therein  the 
Icr  times  on 

ting'  are  ap- 
]ter.     When 

lually  grow 
disease  he 

)eriod,  niak- 

artans. 

11  agues  are 

rising  from 
om  low  and 
with  water, 

nd  even  the 

ict  of  senna 
ive  hot,  and 
baths,  and, 
W"  *  to  the 
varmth  and 

(118)  in  de- 
>onful  doses 
f  tine  .ure  or 

the  patient 

ses,  once  in 
the  dose,  a 

g  is  a  good 
dram;  dis- 

ahosh,  four- 

ter,  once  an 

1  pills,  and 
itermission, 

16  hot  sun, 


DISEASES  OF  THE  GENERAL  SYSTEM. 


416 


Yellow  Fever. 

This  disease  belongs  to  warm  climates,  being  most  prevalent  in 
Southern  cities.  It  makes  its  appearance  chiefly  in  the  latter  part  of 
summer,  and  c'isappears  upon  the  approach  of  frosty  weather. 

Symptoms. —  The  complaint  begins,  generally,  with  a  chill,  which 
^  sometimes  severe,  though  commonly  moderate,  of  short  duration, 
and  rarely  repeated. 

Following  this  chill,  there  is  moderate  fever,  and  a  little  heat  of 
surface ;  but  this  rarely  rises  to  any  considerable  height,  and  only 
continues  to  the  second  or  third  day,  when,  in  fatal  cases,  it  gives 
place  to  coldness  of  surface,  etc.     In  many  cases  there  is  sweating. 

The  pulse  is  peculiar,  —  noteasily  described,  —  generally  not  rising 
above  one  I  indred  in  a  minute,  —  a  kind  of  bubble  under  the  finger, 
which  breaKS  and  vanishes  before  it  can  be  fairly  felt. 

The  tongue  is  moist  and  white  in  the  first  and  second  days,  but 
red,  smooth,  shining,  and  dry,  as  the  disease  advances  towards  the 
close,  having  a  dry,  black  streak  in  the  middle. 

The  most  striking  symptoms  are  nausea  and  vomiting.  The  vom- 
iting, in  fatal  cases,  is  generally  very  persistent,  and  towards  the  ter- 
minution,  the  yellowish  or  greenish  matters  thrown  give  place  to  thin 
and  black  fluid,  having  a  sediment  looking  like  coffee-grounds.  This 
is  called  the  black  vomit. 

The  bowels  are  generally  costive,  with  frequent  epigastric  tender- 
ness and  distress.  There  is  generally  severe  headache,  and  a  pecu- 
liar expression  of  conntcnaace,  in  which  the  lips  smile,  but  the  rest 
of  the  face  is  fixed  and  sad,  sometimes  wild.  The  patient  continues 
wakeful,  night  and  day.  There  are  discharges  of  blood,  often,  from 
the  nose,  the  gums,  the  ears,  the  stomach,  the  bowels,  and  the  urinary 
passages. 

Treatment  —  First,  move  the  bowels  with  some  mild  physic  (40) 
(18)  (19)  (41)  (37). 

During  the  chill,  put  the  feet  in  a  mustard  bath  (242),  give  warm 
cordial  drinks,  and  apply  hot  bottles  etc.,  externally. 

Cups  may  be  applied  to  the  back  of  the  neck,  or  over  the  stomach, 
according  to  circumstances. 

During  the  second  stage,  or  stoffe  of  calm,  nothing  is  to  be  done 
but  give  some  light  stimulants,  and  to  promote  sweating  by  warm 
lirinks,  and  tincture  of  veratrum  viride ;  and  also  quinine  (62). 

The  third  and  severest  stage  is  to  be  met  by  stimulants,  as  brandy, 
freely  given,  with  a  continuance  of  the  quinine. 

During  the  fever  stage,  and  for  the  vomiting,  give  creosote,  twenty 
drops  to  six  ounces  of  spirits  of  Mindererus,  and  alcohol  enough  to 
dissolve  the  creosote.  The  dose  is  half  an  ounce  every  two  hours. 
Said  to  be  excellent  for  putting  a  stop  to  the  retching  and  vomiting. 

Cleanliness,  temperance,  and  cheerfulness,  are  essential  in  warding 
off  the  disease  when  one  is  exposed  to  its  cause. 


416 


DISEASES  OF  THE  GENERAL  SYSTEM. 


Rheumatism. 

This  is  an  inflammation  of  a  peculiar  character,  being  caused  by 
acid  or  poisonous  matter  in  the  blood,  and  having  for  its  seat  the 
fibrous  tissue,  or  that  thready  texture  which  enters  largely  into  the 
composition  of  the  cords  and  muscles  of  the  human  body.  The 
synovial,  or  lining  membrane  of  joints,  is  also  peculiarly  subject 
to  rheumatic  inflammation.  Hence  the  terms,  fibrous  rheumatism, 
and  synovial  rheumatism.  There  are  also  acute  and  chronic  rheu- 
matism. 


Acute  Rheumatism 

Is  a  very  painful  affection.  It  is  most  frequently  bro  ight  on  by 
exposure  to  wet  and  cold  after  violent  and  fatiguing  exercise  of  the 
muscles. 

Symptoms. —  Its  principal  characteristics  are,  high  fever,  with  a 
full,  bounding  pulse  ;  furred  tongue  ;  profuse  sweat,  which  has  a  sour 
smell,  and  seems  to  increase  the  weakness  without  relieving  the 
pain ;  scanty  and  high-colored  urine,  with  brick-dust  settlings ;  and 
■welling  of  the  joints,  with  slight  redness,  great  tenderness,  and  severe 
pain,  which  is  particularly  agonizing  when  the  patient  attempts  to 
move. 

This  aflection  often  changes  suddenly  from  one  part  of  the  body  to 
another,  or  from  one  set  of  joints  to  another.  This  sudden  shifting, 
termed  metastasis,  is  peculiarly  dangerous  ;  for  sometimes  the  inflam- 
mation, seeming  to  regard  the  constantly  moving  heart  as  a  large 
central  point,  suddenly  seizes  upon  its  lining  membrane,  and  occasion- 
ally proves  speedily  fatal. 

Treatment.  —  It  is  well  first  to  open  the  bowels  freely  with  the 
compound  powder  of  leptandrin,  or  the  compound  powder  jalap. 
Then  give  tincture  of  black  cohosh  and  tincture  of  veratrum  viride 
(124),  and  push  the  preparation  to  the  extent  of  producing  sweating. 
This,  if  no  evil  effects  seem  to  result  from  it,  that  is,  no  prostration  or 
bad  feelings  in  the  head,  may  be  kept  up  till  the  violence  of  the  dis- 
ease abates. 

Sometimes  opium,  nitrate  of  potash,  etc  (127),  administered  one 
or  more  times,  will  have  a  good  elfect. 

The  tincture  of  black  cohosh  root,  two  parts,  and  the  tincture  of 
colehicum  root,  one  part,  and  given  in  doses  of  forty  drops,  is  a  valu- 
able remedy. 

For  articular  rheumatism,  iodide  of  potassium,  one  dram,  and 
morphia,  one  grain,  dissolved  in  one  ounce  of  water,  and  given  three 
or  four  times  a  day,  in  two  teaspoonful  doses,  are  said  to  have  the 
power  of  shortening  the  disease. 

It  is  a  valuable  treatment,  after  clearing  the  bowels  with  salts  and 
senna,  to  give  equal  parts  of  wine  of  colchicum  and  spirits  of  tur- 


caused  by 
ita  seat  the 
ly  into  the 
ody.  The 
riy  subject 
rheumatism, 
tonic  rheu- 


ight  on  by 
rcise  of  the 


ver,  with  a 
1  has  a  sour 
Sieving  the 
tlings;  and 
and  severe 
attempts  to 

the  body  to 
en  shifting, 
the  inflam- 
•  as  a  large 
id  occasion- 


ly  with  the 
wder  jalap, 
trum  viride 
ig  sweating, 
ostration  or 
i  of  the  dis- 

listered  one 

tincture  of 
18,  is  a  valu- 

dram,  and 
given  three 
to  have  the 

h  salts  and 
irits  of  tur- 


DISEASES  OF  TIIK  Gr,\T:ilAL  SY8TKM. 


417 


pentine  in  doses  of  ten  drops  every  two  or  three  hours  ;  and  after  a 
clay  or  two,  to  give,  in  connection  with  the  above,  at  intervals  of  five 
hours,  tincture  of  chloride  of  iron,  ten  drops,  with  ten  to  twenty  dropa 
of  laudanum. 

Fomentations  of  hops  and  cicuta,  or  stramonium  leaves,  placed 
upon  the  intlarned  and  swollen  joints,  will  have  a  good  effect  in 
relieving  the  pain.  The  recent  leaves  of  stramonium,  pounded,  mixed 
with  a  little  water,  and  laid  upon  the  joints,  is  said  to  act  very 
favorably.     (See  p.  880.) 

Chronic  Rheumatism. 

The  chronic  form  of  rheumatism  may  follow  the  acute  as  its  conse- 
quence, but  is  more  often  an  independent  disease.  It  is  seldom  at- 
tended by  fever,  and  in  this  differs  from  the  acute  rheumatism.  It 
often  lasts  a  long  time,  and  causes  much  suffering. 

Syiiiptuiiis.  —  These  are  various,  but  are  generally  understood,  even 
by  the  common  people,  to  consist  of  pain,  lameness,  stiffness,  etc.,  in 
1  he  joints  and  other  parts.  The  joints  are  often  swollen,  but  not  as 
much  as  in  the  acute  disease.  It  is  peculiar  to  this  form  of  the  com- 
plaint, that  when  the  patient  remains  at  rest  for  a  time,  he  will  have 
|)ain  and  stiffness  in  the  affected  part  on  beginning  to  move,  but  as 
lie  grows  warm,  both  will  disappear. 

Treatment.  —  This  complaint  is  often  palliated,  and  sometimes 
cured,  by  passing  a  current  of  electro-magnetism  through  the  affected 
part 

The  tincture  or  the  fluid  extract  of  black  cohosh,  taken  in  full 
doses,  is  one  of  the  best  remedies.  It  may  be  taken  alone,  or  mixed 
with  the  tincture  of  poke-berries,  and  a  tincture  of  prickly-ash  bark, 
if  convenient. 

Opium  and  nitre  (127)  form  a  valuable  remedy.  Colchicura  ia 
much  used,  and  has  a  deservedly  high  reputation  (292)  (301). 

Liniments  often  have  a  good  effect  (190)  (195)  (196)  (198).  It  is 
well  to  wear  a  piece  of  oiled  silk  over  the  affected  part.  It  keeps  up 
a  gentle  perspiration  from  the  rheumatic  surface,  and  materially 
hastens  a  cure. 

To  bathe  the  affected  jpint  at  bed-time  with  hot  sweet  oil,  and  then 
envelop  it  in  cotton  batting,  to  be  Kept  on  through  the  night,  will 
often  give  much  relief. 

The  bowels  must  be  kept  regular,  and  all  exposure  to  wet  feet  or 
clothes,  and  to  currents  of  cool  air  when  sweating,  must  be  carefully 
shunned. 

Gout. 

Gout  is  rheumatism's  cousin ;  the  parentage  of  both  belong  to  the 
brotherhood  of  the  acids. 

A  very  acid  state  of  the  blood,  or  a  state  favorable  to  the  forma- 
tion of  acid,  is  supposed  to  be  the  cause  of  the  inflammation  peculiar 

53 


O;  ] 


41« 


DISKASKS  OF  THK  GKNllUAL  8YSTKM. 


to  both  these  disorders.  In  rheumatism,  an  acid  which  exists  in  sour 
milk,  and  in  cider,  called  lactic  acid,  is  thought  to  be  the  disturbing 
element.  In  gout,  lithic  or  uric  acid  ia  known  to  be  uncommonly 
abundant,  and  to  form  a  principal  ingredient  of  those  concretions, 
found  in  gouty  joints,  and  familiarly  called  chalk-atones. 

The  larger  joints  are  most  often  affected  by  rheumatism ;  while 
gout  prefers  the  smaller  ones.  In  rheumatism,  the  pain  is  excruciat' 
ing ;  in  gout,  it  is  intolerable.  There  is  truth  in  the  humorous 
Frenchman's  description  of  the  pains  of  these  two  complaints,  wiiich 
is,  in  substance,  as  follows :  Place  your  joint  in  a  vice ;  turn  the 
screw  till  you  can  bear  it  no  longer ;  that  gives  you  an  idea  of  rheu- 
matism ;  now  give  the  instrument  one  more  turn,  and  you  have 
gout 

Symptoms. —  A  fit  of  the  gout,  as  it  is  called,  generally  makes  its 
attack  in  the  night.  Its  unsuspecting  victim  is  ftrst  awakened,  per- 
haps an  hour  or  two  after  midnight,  by  an  intensely  burning,  wreiicli- 
ing  pain  in  the  ball  of  the  great  toe,  or  some  other  small  joint.  This 
pain,  with  its  accompanying  symptoms  of  fever,  continues  with  little 
abatement  for  twenty-four  hours.  There  is  then  a  distinct  remission, 
when  the  sufferer  may  get  some  sleep.  He  has  a  similar  experience 
during  several  succeeding  days  and  nights,  when  the  disease,  which 
has  been  growing  milder,  leaves  him. 

After  a  considerable  interval,  there  is  likely  to  be  another  similar 
visitation.  The  length  of  this  interval  is  inversely  as  the  number  of 
attacks,  —  that  is,  it  diminishes  in  length  as  the  attacks  increase  in 
number;  in  yet  plainer  and  more  homely  terms,  the  attacks  come 
"thicker  and  faster;"  the  space  between  them  gradually  shrinking 
from  three  or  four  years  to  one  or  two  months. 

Recovery  from  the  first  attack  may  be  complete,  —  the  skin  peeling 
off  from  the  red  and  swollen  joint,  and  leaving  it  strong  and  supple 
as  ever.  But,  after  several  repetitions  of  the  inflammation,  the  joint 
becomes  stiff,  its  motions  being  obstructed  by  the  deposit  of  lithic 
acid  concretions,  or  chalk-stones.  The  limbs  are 
sometimes  actually  frosted  over  with  crystals  of 
urate  of  soda  (Fig.  143).  This  form  of  urate  of 
soda  crystals  differs  very  materially  from  Fig.  122. 
When  these  crystals  appear  upon  the  surface,  and 
deposits  are  made  in  the  joints,  uric  acid  is  not 
secreted  as  usual  by  the  kidneys,  but  accumulates 
in  the  blood. 

But  gout  is  a  disease  by  no  means  entirely  local 
in  its  character.  It  vitiates  the  blood,  affects  the  system  generally, 
9,nd  is  often  betrayed  by  general  symptoms  long  before  the  local  mis- 
chief is  indicated  by  one  of  the  attacks.  Irritability  of  temper,  un- 
pleasant sensations  in  the  stomach  and  head,  and  various  uncomfort- 
able feelings  of  body  and  mind,  have  been  considered  as  premonitory 
of  this  disorder.  Many  other  organs  also,  beside  joints,  are  subject  to 
the  gouty  inflammation.  The  stomach,  heart,  lungs,  head,  and  even 
the  eyes,  are  known  to  have  been  thus  affected. 


Fio.  143. 


ists  in  sour 

diaturbing 

icommoiily 

loncretions, 

ism ;  while 

excruciut' 

humorous 

lints,  wliich 

;   turn  the 

ea  of  rlioD- 

you  have 


f  makes  its 
ikened,  per- 
iig,  wrencli- 
oint.  This 
a  with  Httle 
remission, 
r  experience 
lease,  wliich 

thcr  similar 
!  number  of 
increase  in 
;tack9  come 
ly  shrinking 

skin  peeling 

and  supple 

on,  the  joint 

jsit  of  lithic 

Via.  143. 


m  generally, 
he  local  mis- 
'  temper,  un- 
s  uncomfort- 
premonitory 
ire  subject  to 
lad,  and  even 


DISEASES  OF  THE  GENEKAL  SYSTEM. 


419 


Causes. —  Luxury  and  indolence,  —  particularly  the  former,  —  are 
regarded  as  the  principal  causes  of  gout 

Trentmeiif.  —  Colchicum  is  the  remedy  for  gout.  It  removes  the 
disease  by  exciting  the  kidneys  to  action,  so  that  the  poison  is  con- 
veyed away  in  the  urine.  Perhaps  it  acta  in  some  other  unexplained 
way,  as  an  antidote  to  the  disease.  One  teaspooiiful  of  the  wine  of 
colchicum  may  be  taken  two  or  three  times  a  day,  until  relief  is  ex- 
perienced. It  should  then  be  continued,  in  ten-drop  doses,  for  a  f(!W 
days  longer,  to  prevent  a  relapse.  The  colchicum  may  be  taken  in 
the  form  of  prescription  (301). 

CofP'e,  drank  freely  every  day,  is  said  to  be  a  sovereign  remedy 
for  gout.  It  is  also  declared  to  be  excellent  for  gravel,  —  a  fact 
which  1  forgot  to  mention  when  treating  of  the  affections  of  the 
kidneys,  etc. 

The  bowels  must  be  kept  in  order,  but  not  actually  jvutged  (34) 
(40).     1'he  diet  must  be  simple  and  unstimulating. 

Let  the  inflamed  joint  be  bathed  often  in  a  saturated  solution  of 
bicarbonate  of  soda  in  soft,  warm  water.  Cold  applications  should 
not  be  made,  as  there  is  danger  of  provoking  a  sudden  change  of  the 
inilammation  to  some  internal  organ. 

Scrofula.— King's  Evil. 

This  disease  was  once  thought  to  be  peculiar  to  swnne,  and  hence 
derived  its  name  from  scrofu,  a  sow.     It  shows  itself  in  various  forms, 

—  as  hip  disease,  white  swelling,  rickets,  salt-rheum,  etc.  Persons 
affected  by  it  are  subject  to  swelling  of  the  glands,  particularly  those 
of  the  neck. 

Symptoms.  —  In  the  beginning  of  the  disease,  small,  hard,  movable 
kernels  appear  about  the  neck,  just  under  the  skin.  These  are  lym- 
phatic glands,  and  the  swelling  generally  takes  place  long  before  there 
is  any  soreness,  or  perceptible  redness.  They  may  be  felt  under  the 
skin ;  and,  in  the  course  of  six  months  or  a  year,  may  grow  to  the 
size  of  a  filbert,  or  even  a  hen's  egg.  Sometimes  they  are  much 
larger  even  than  this,  and  very  hard.  They  may  appear  in  many 
other  parts  beside  the  neck. 

After  a  time,  though  very  slowly,  they  come  to  a  head,  and  break, 

—  discharging  a  watery  fluid,  or  a  mixture  like  whey  and  curd.  They 
are  seldom  very  sore.  When  they  heal,  they  are  apt  to  leave  a  puck- 
ered condition  of  the  skin,  and  ugly  scars. 

The  scrofulous  humor  may  sometimes  aflfect  the  eyes,  when  the 
lids  will  become  red  and  thick,  and  discharge  mucus  and  water;  — 
the  under  lid  sometimes  turning  out,  and  presenting  a  sliocking 
spectacle. 

The  scrofulous  condition  is  generally  supposed  to  be  indicated  by 
a  white,  delicate  skin,  thick  lips,  light  hair,  and  a  delicate  constitu- 
tion ;  but  these  signs  are  not  worthy  of  much  confidence. 

The  disease  often  attacks  the  cellular  tissue,  causing  numerous 


>M 


420 


DISEASES  OF  THE  GENERAL  SYSTEM. 


suppurations  and  abscesses.  It  also  affects  the  bones,  producing 
caries,  necrosis,  and  other  affections.  It  shows  itself  in  certain  in- 
flammations of  tlie  eyes,  in  the  formation  of  running  uorus  in  the 
ears,  and  in  various  other  ways. 

Causes.  —  It  is  contended  by  some,  that  scrofula  is  in  all  cases 
inherited ;  that  we  receive  it  from  our  progenitors,  as  we  do  their 
other  constitutional  peculiarities  ;  that  the  disease  is  everywhere,  and 
in  all  time,  one  and  the  same,  which  shows  it  to  come  from  within, 
and  not  from  without ;  that  were  it  dependent  on  external  causes  for 
its  existence,  it  would  be  greatly  modified  by  temperature,  climate, 
and  the  peculiarities  of  the  races  affected  by  it. 

They  assert  that  though  the  causes  which  are  usually  assigned 
for  scrofula,  such  as  living  in  cold,  damp,  and  impure  air,  and  the 
lack  of  sufficient  food,  connected  with  filthy  habits,  often  have  a 
powerful  effect  in  developing  scrofula  already  existing  in  the  con- 
stitution, and  of  aggravating  it  when  already  developed;  it  never 
produces  it. 

How  far  these  statements  are  to  be  received,  I  will  mt  undertake 
to  jndge.  It  is  certain  that  the  disease  is  often  inluirited  ;  and  if  we 
admit  that  the  other  causes  named  have  some  share  in  its  production, 
it  is  possible  we  may  not  go  entirely  astray.  Yet  my  own  strong 
suspicion  that  scrofula  arises  from  the  animal  poison  of  syphilis,  fil- 
tered through  the  blood  of  many  generations,  inclines  me  to  the  adop- 
tion of  the  above  views. 

Treatment. —  In  olden  times  of  superstition,  this  disease  was  be- 
lieved to  be  cured  by  the  patient  coming  into  the  presence  of  the 
king,  and  being  touched  by  his  royal  hand.  The  ceremony  was 
called  the  "sacred  touch."  It  was  from  this  that  the  disease  took 
its  Tiame  of  "king's  evil."  This  superstition  reached  its  height  in 
th(  reign  of  Charles  II.  After  the  Restoration,  the  numbers  who 
flocked  to  Whitehall  and  Windsor  to  receive  the  "touch,"  are  said  to 
have  been  immense,  —  no  less  than  ninety-two  thousand  in  twelve 
years ;  and  the  writers  of  that  day  declare  that  none  failed  to  receive 
benefit. 

In  modern  times,  believing  that  the  ceremony  of  the  touch  was 
bi  st  adapted  to  the  period  when  kings  were  thought  to  have  sacred 
persons,  we  rely  for  the  cure  of  this  disease,  upon  rational  medicine 
and  hygiene. 

The  medical  treatment  of  it  is  constitutional  and  local. 

Iodine  is  the  great  remedy  for  scrofula.  Dissolve  one  scruple  of 
iodine  and  two  scruples  of  iodide  of  potassium  in  seven  teaspoonfuls 
of  water.  Of  this,  give  ten  drops  three  times  a  day,  in  a  little 
water,  gradually  increasing  the  dose  to  once  and  a  half  or  twice 
that  amount.  The  iodide  of  potassium,  as  in  prescription  (101),  is  a 
good  remedy. 

Whbre  there  is  considerable  debility,  the  iodide  of  iron,  in  doses 
of  twenty-five  or  thirty  drops,  in  water,  three  times  a  day,  is  a  good 
preparation. 


IrfA 


:^i^ft\f'W  *,«'•-; 


DISEASES  OF  THE  GENERAL  SYSTEM. 


421 


producing 
certain  in- 
uorea  in  the 


in  all  cases 
we  do  their 
ywhere,  and 
from  within, 
al  causes  for 
ture,  climate, 

ly  assigned 
air,  and  the 
)ften   have  a 
in  the  con- 
ed ;  it  never 

ot  undertake 
d  ;  and  if  we 
rs  production, 

own  strong 
f  syphilis,  fil- 

to  the  adop- 


lease  was  be- 
esence  of  the 
eremony  was 
disease  took 
its  height  in 
numbers  who 
I,"  are  said  to 
nd  in  twelve 
iled  to  receive 

he  touch  was 
3  have  sacred 
onal  medicino 


me  scruple  of 
I  teaspoonfuls 
ly,  in  a  little 
half  or  twice 
ion  (101),  is  a 

iron,  in  doses 
day,  if  a  good 


The  compound  syrup  of  yellow  dock  root,  and  the  compound 
syrup  of  stillingia,  taken  sometimes  alone,  and  at  other  times,  with 
two  to  five  grains  of  iodide  of  potassium  in  each  dose,  are  both  ex- 
cellent medicines  for  scrofula. 

The  bowels  must  be  kept  open  by  laxative  food,  or  in  the  failure 
jf  this,  by  some  gentle  physic  (12). 

Medicinal  springs,  particularly  those  containing  iodine,  are  ex- 
sellent. 

Before  the  tumors  become  very  sore,  let  them  be  bathed  several 
times  a  day  with  a  solution  of  muriate  of  lime,  or  annnunia,  or  soda, 
two  drams  to  the  ounce  of  water.  When  they  are  innained,  apply 
poultices  of  ground  8lip|)ery  elm  and  powdered  bayberry,  e(iual  parts. 
Powdered  poke-r(X)t,  or  blue-flag  may  be  substituted  for  the  bayberry. 
If  these  things  are  not  at  hand,  use  white  bread  and  milk,  or  flax-seed 
[Kiultices. 

When  the  tumors  have  ojwned,  and  ulcers  have  formed,  the  ulcers 
must  be  washed  out  with  soap  suds,  and  dressed  with  salve  made  of 
beeswax  and  sweet  oil ;  or,  when  the  ulcers  are  indolent,  with  the 
red  iodide  of  mercury  ointment.  Let  the  dressing  be  changed  two 
or  three  times  a  day. 

Great  attention  should  be  paid  to  the  improvement  of  the  general 
health.  The  diet  must  be  ample  and  nourishing, — consisting  of  fresh 
meat,  poultry,  broths,  soups,  milk,  and  wholesome  vegetables  in  such 
variety  as  the  season  allows. 

The  skin  must  be  washed  daily  with  cool  water  and  spirit,  or  water 
and  saleratus ;  and  rubbed  to  redness  with  a  coarse  towel,  or  flesh 
brush.  Either  flannel  or  silk  should  be  worn  next  the  skin,  summer 
and  winter. 

Exercise  must  be  regular,  and  cheerfully  performed,  in  the  -:»pen  air. 
If  the  residence  be  in  a  damp  and  unhealthy  air,  it  should  be  rhanged 
at  once,  if  possible.  In  any  case,  a  change  of  residence,  from  time  to 
time,  when  travelling  is  not  possible,  is  much  to  be  desired. 

Scurvy.  —  Scorbutus. 

Owing  to  a  better  knowledge  of  this  disease,  and  of  its  proper 
treatment,  it  is  much  less  common  than  in  former  years.  It  shi'^Hy 
aftects  seamen  who  make  long  voyages ;  but  is  not  entirely  unknown 
on  land. 

Symptoms.  —  Languor,  loss  of  strength,  and  great  depression  of 
mind,  are  among  the  first  signs  of  scurvy.  To  one  about  being  at- 
tacked, work  and  play  are  alike  burdensome.  There  is  no  heart  even 
to  move.  The  face,  and  the  whole  skin,  look  pale  and  bloated,  and 
the  breath  has  a  fetid  smell.  The  gums  are  swelled,  .soft,  red,  and 
spongy;  and  they  bleed  upon  the  slightest  touch,  —  sometimes  the 
blood  oozes  from  them  spontaneously.  The  teeth  get  loose,  and 
often  fall  out.  The  skin  becomes  covered  with  bluish  or  purple 
spots,  —  looking  precisely  like  bruises.  These  spots  spread  and  run 
into  each  other,  forming  large  patches  of  discoloration. 


422 


DI8KASKS  OF  TUE  GENERAL  8YSTKM. 


These  spots  appear  to  be  formed  by  the  bursting  of  the  small  capii- 
luries  of  flie  veins  and  arteries,  which  have  grown  t<K)  weak  and  rot- 
ten to  hold  their  contents,  and  the  infdtration  of  dissolved  bKM)d  into 
the  cellular  substance  under  the  skin. 

Ulc«?rous  sores  break  out  in  various  parts  of  the  body,  which  smell 
ba<lly,  and  discharge  a  thin  matter.     These  ulcers  are  covered  with  a 
crust.     Various  parts  of  the  body,  the  bones  included,  are  twinged 
with  pains.     The  pulse  is  weak  and  soft.     All  the  secretions,  includ' 
iwf:^  the  urine,  have  an  oflensiv«!  smell,  —  as  though  the  whole  bodyl 
were  approaching  putridity.     In  truth,  the  whole  man  seems  to  be! 
disint<;grating,  decaying ;  the  flesh  becomes  soft,  and  dwindles ;  audi 
th«!  bones  break  easily,  —  being  afllicted  with  a  decay  approaching  to 
rott«"nnes8. 

In  bad  cases,  l)lood  is  discharged  frotn  the  I  'adder,  bowels,  womb, 
nose,  and  moutli ;  and  the  smallest  excrtit)n  is  followed  by  fainting, 
and  in  many  cases,  by  sudden  death. 

Crtuses. —  The  disease  is  owing  to  the  use  of  food  and  drink  begin- 
ning to  be  decomposed,  and  to  living  long  at  sea  without  vegetables 
containing  certain  acids.  Its  attacks  are  likewise  encouraged  by 
whatever  weakens  and  depresses  the  nervous  system,  —  as  long  expos- 
ure to  a  moist,  damp  air,  particularly  when  this  is  connected  with 
confinement  on  board  a  ship,  unclean  linens,  occasional  loss  of  the 
usual  rest,  and  great  fatigue,  as  in  storms.  The  force  of  these  causes 
is  increased  by  the  loneliness,  the  sadness,  and  the  despondency  of 
the  sailor's  life. 


Treatment. —  Sailors  are  very  much  protected  from  the  disease 
now,  by  frequent  returns  to  land,  during  long  voyages,  to  procure 
fresh  meats,  vegetables,  and  water.  This  practice  is  very  generally 
adopted,  particularly  by  our  whale  ships,  which  make  long  voyages ; 
and  the  result  is,  very  little  scurvy,  and  general  health  among  the 
men. 

One  of  the  best  medicines  for  the  disease  is  quinine ;  it  may  be 
given  in  from  one  to  two-grain  doses  twice  or  three  times  a  day. 
Gentian  and  quassia  are  also  suitable  remedies ;  so  is  the  muriatic 
tincture  of  iron  (73). 

But  the  best  of  all  remedies  are  fresh  and  succulent  vegetables,  and 
also  fruits.  Spinage,  lettuce,  dandelion,  sorrel,  cresses,  and  the  like, 
are  among  the  very  best  things  when  they  can  be  had.  Lemon  juice 
produces  the  happiest  effects.  Potatoes  are  among  the  very  besl 
remedies,  —  particularly  if  scraped  and  ate  raw.  They  are  also  valu*, 
able  when  cooked.  Spruce  beer  is  a  good  antidote ;  and  may  be 
made  at  sea  from  the  essence.  Many  kinds  of  beer  may  be  brewed 
at  sea,  which  aie  valuable. 

When  the  bowels  are  costive,  cream  of  tartar,  dissolved  in  water, 
and  drank  freely,  will  be  found  the  best  remedy.  If  there  be  loose- 
ness of  the  bowels,  morphine,  laudanum,  a  tea  made  of  logwood,  or 
geranium,  or  the  tincture  of  catechu,  will  be  suitable. 

For  the  spongy  gums,  a  solution  of  alum  applied  to  them  will  be 


I 


(P=- 


iniall  cupil- 
k  and  rot- 
blood  into 

liich  smell 
red  with  a 
re  twinged 
oils,  iiicliid'' 
vliolo  bodyl 
etna  to  be  I 
ndles ;  and' 
roaching  to 

v^cIh,  womb, 
by  fainting, 


Irink  begin- 

:  vegetables 

)u raged   by 

long  expog- 

nect(!d  with 

loss  of  the 

these  causes 

londency  of 


the  disease 
,  to  procure 
ry  generally 
ig  voyages ; 

among  the 

;  it  may  be 
imes  a  day. 
the  muriatic 

[etables,  and 
nd  the  like, 
-icmon  juice 
le  very  besl 
re  also  valu-^ 
ind  may  be 
y  be  brewed 

ed  in  water, 
re  be  loose- 
logwood,  or 

lem  will  be 


DISEASES  OF  THE  GENERAL  SYSTEM. 


423 


proper,  or  a  mixture  of  ccjual  parts  of  tincture  of  myrrh,  catechu,  and 
Peruvian  bark  ;  and  ulcers  may  be  washed  with  the  same. 

Vinegar,  which  is  an  excellent  prevention  in  this  disease,  may  bo 
made  at  sea  from  molasses  and  water  exposed  to  the  sun.  Two 
ounces  of  nitre  dissolved  in  a  quart  of  vinegar,  and  given  in  table- 
spoonful  doses,  three  times  a  day,  is  said  to  be  an  excellent  remedy. 

Every  ship,  on  going  to  sea,  should  be  supplied  with  dried  fruit,  as 
raisins,  currants,  whortleberries,  prunes,  etc. ;  and  should  have  peas, 
beans,  rice,  flour,  sugar,  and  molasses.  Beside  these,  ships  should  have 
essence  of  spruce  and  lemon,  and  dried  balm,  sage,  pennyroyal,  and 
other  hcbs. 

Seami  n,  whtin  down  with  this  disease,  should  be  moved  with  care, 
as  the  spark  of  life  may  be  easily  extinguished. 

Purple  Disease. — Purpura  Hemorrhagica. 

This  has  been  sometimes  ranked  as  an  affection  of  ihc  skin ;  but  it 
18  not  such  ;  it  is  rather  a  disease  of  the  general  system. 

Symptoins.  —  This  complaint  is  known  by  the  appearance  upon  the 
skin  of  two  kinds  of  spots;  the  one  kind  are  small,  round,  bright-red 
points,  even  with  the  surface,  and  changing  in  a  day  or  two  to  a  pur- 
ple or  livid  color,  which  are  yellowish  brown  when  about  to  disap- 
pear. This  variety  of  the  purples  is  quite  simple,  attflcking,  generally, 
young  persons,  aiul  in  warm  weather.  It  is  sometimes  tedious  in  its 
course,  but  never  dangerous.  It  requires  little  treatment ;  —  pure  air, 
wholesome  diet,  with  quinia  and  the  mineral  acids,  make  up  the  chief 
part  of  it.  It  may  be  known  by  the  spots  not  disappearing  when 
pressed  upon  by  the  finger. 

The  other  and  more  dangerous  variety  of  the  disease  is  attended, 
generally,  by  faintncss,  wandering  pains,  great  debility,  and  the  ap- 
pearance upon  the  legs,  arms,  and  body,  of  dark-red  spots,  and  irreg- 
ular, livid  patches,  looking  just  like  the  marks  of  recent  bruises. 
These  marks  are  caused  by  the  effusion  of  blood  in  patches  under  the 
skin  ;  and  in  this  respect,  they  are  just  like  bruises,  only  they  are  pro- 
duced by  different  causes. 

In  the  rapid  progress  of  the  disease,  dark  venous  blood  frequently 
oozes  from  the  tongue,  mucous  membrane  of  the  mouth,  nose,  breath- 
ing tubes,  ears,  vagina,  womb,  stomach,  etc  The  other  symptoms 
vary  in  different  cases  very  much,  but  generally  indicate  great  dis- 
turbance of  the  system. 

It  often  runs  a  very  rapid  course,  but  sometimes  remains  for 
months. 

Trfiatment. —  The  bowels  are  to  be  kept  regular  by  gentle  physio 
(26)  (21)  (12)  (15). 

Iron  is  a  valuable  remedy  (73). 

Astringents  generally  have  a  good  eflfect  (156)  (159)  ^279)  (305). 
The  best  astringent  in  this  complaint,  is  gallic  acid,  taken  in  five- 
grain  doses,  every  three  oi  four  houn. 


•,* 


<9 


111.1  iJM.llL  i  _U 


424 


DISEASES  OF  THE  GENERAL  ST8TE1L 


The  Bponge  bath,  twice  a  day,  with  tepid  or  cool  water,  and  fol- 
lowed  with  gentle  rubbing  with  a  coarBe  towel,  will  do  much  to 
ircBtore  and  equalize  the  circulation  in  the  skin. 

During  the  active  stage  of  the  disease,  the  diet  should  be  very 
light, — simple  toast-water,  rice  and  arrow-root  gruel,  and  either  alum 
or  wine  whey. 

While  getting  well,  the  patient  may  have  a  more  nounshmg  diet, 
consisting  of  tender  fresh  meat,  broths,  etc. ;  and  must  take  geatla 
fexercise  in  the  open  air. 


..■;i'2'i(iiijiN.ii'-\S.iff'-.  - 


TTOf^jppp^i^PR; 


r,  and  fol- 
much  to 

d  be  very 
ithcr  aluii) 

Hhing  diet, 
ake  gentla 


+ 


SURGICAL   DISEASES. 


Inflammation. 


Every  part,  of  the  body,  which  has  voshcIh  and  nerves,  is  liable  to 
inflammation.  Where  there  are  no  nerves,  it  cannot  exist  Many 
diHeaACs  are  caused  by  it.  Mechanical  injurion,  such  as  cuts,  bruises, 
and  fractures,  produce  it.  And  many  other  disorders,  not  caused  by 
or  causing  it  in  the  beginning,  become  entangled  with  it  in  their  pro- 
gress. It  is  very  important,  therefore,  to  understand  the  nature  and 
management  of  inflammation.  It  is  not  always  to  be  looked  upon 
as  a  disease ;  it  is  frecjuentiY  a  simple  process  of  repair,  wherel)y 
nature  restores  injured  parts  to  health. 

The  Sij^iis  of  Inflaniiiiation  are  redness,  pain,  heal,  and  swelling, 
though  in  some  cases,  these  do  not  all  appear. 

Acute  Illfliiliimatioil. —  When  the  redness,  the  pain,  the  heat,  and 
the  swelling,  are  clearly  marked,  and  the  inflammation  is  so  rapid, 
that  it  either  subsides  in  a  few  days,  or  quickly  brings  on  supjmration, 
or  ulceration,  or  mortification,  it  is  said  to  be  acute. 

Chronic  Inflnininutioil.  —  When  it  is  less  painful,  and  slower  in  its 
progress,  beginning  very  gradually,  and  lingering  a  long  time,  it  is 
then  chronic. 

Coiiiiiioii,  or  Simple,  or  Ilenltliy  Inflaiiiniiition  is  that  which  is  not 
mixed  up  with  any  disease,  but  is  established  by  nature  fot  some 
salutary  purpose. 

riilieaitliy  Inflaniiiiation  is  that  which  has  been  caused  by  some 
other  disease,  and  is  under  its  control. 

Specific  Inflamniation  is  that  which  seems  to  vary  from  all  ordinary 
eases,  being  dependent  on  a  particular  state  of  the  system,  on  an 
animal  poison,  or  a  principle  of  contagion  or  infection,  and  a  power 
of  propagation  from  one  person  to  another. 

Some  of  these  produce  such  permanent  effects,  that  those  having 
them  are  not  liable  to  a  second  attack. 

Inflammation  is  Primary,  or,  as  the  doctors  say,  idiopathic,  when  it 
is  the  original  disease. 


Inflammation  is  Secondary  or  Sympathetic  when  it  is  the  result  o( 
some  other  diaorder,  which  goes  before,  and  produces  it. 

It  has  been  explained  elsewhere  that  the  different  parts  of  the  body 
are  connected  by  little  threads  or  nervous  strings  which  ran  from  one 
Ij  the  other.  If  one  part  of  the  body  become  injured  or  disordered, 
it  uses  these  nervous  threads,  as  telegraphic  wires,  to  tell  other  parts 
of  its  misfortune ;  and  it  sometimes  happens,  that  when  the  Intelli- 
gence conveyed  is  of  a  sad  and  alarming  character,  the  part  receiving 
the  news  is  so  excited  and  distressed  as  to  become  inflamed.  Nothing 
can  be  more  proper  than  to  call  this  sympathetic  inflammation. 

When  the  inflammation  is  violent,  and  is  seated  upon  some  impor- 
tant part,  the  sympathetic  action  is  so  great  as  to  disturb  the  whole 
constitution ;  and  this  general  disturbance  is  sympathetic  or  symptom' 
atic  irylammaiory  fever. 

Tlie  Symptoms  are  quick  and  strong  pulse,  dryness  and  heat  of 
skin,  parched  mouth,  great  thirst,  scanty  and  high-colored  urine,  cos- 
tiveness,  disordered  nervous  system,  loss  of  appetite,  anxiety,  restless- 
ness, sleeplessness,  headache,  wandering  and  ron'"4sion  of  mind,  and 
sometimes  delirium.  This  fever  John  Hunter  called  a  universal  sym- 
pathy of  the  body  with  the  disturbed  condition  of  a  part  of  it. 

It  is  only  by  inflammation  that  a  wound  is  healed,  or  a  broken 
bone  repaired. 

Upon  the  surface  of  a  wound  nature  pours  out  a  fluid  called 
plastic  lyvipL  This  is  composed  oi  fibrine,  —  the  material  of  which 
flesh  is  made,  —  united  with  a  little  of  the  watery  part  of  the  blood, 
chiefly  albumen.  The  watery  part  disappears  soon  after  it  is  poured 
out,  and  the  fibrine  hardens  into  a  kind  of  membrane.  Through  this, 
nature  sends  small  nerves,  arteries,  and  veins,  which  she  uses  as 
threads  to  sew  up  the  wound.  Fibrine  being  the  chief  material  with 
which  nature  constructs  our  bodies,  she  of  course  uses  it  to  repair 
them  when  wounded, — just  as  a  carpenter,  who  constructs  a  floor 
with  planks,  uses  planks  to  mend  it  when  it  is  broken  through. 

In  the  case  of  highly  inflamed  and  swelled  tonsils,  nature  some- 
times becomes  alarmed,  and,  for  orice  making  a  mistake,  she  rushes 
in  with  her  material  for  repair,  and  fills  up  all  the  interspaces  with 
fibrine,  —  thus  hardening  the  glands,  and  making  their  cure  impossi- 
ble without  cutting  them  off.  But  in  most  cases,  nature  is  right,  and 
cures  the  injury  by  inflammation. 

Bnfiy  Coat  of  tlie  Blood.  —  The  effects  of  inflammation  extend  to 
the  blood.  This  fluid,  when  drawn  from  the  veins  of  a  person  suffer- 
ing from  an  inflammation  active  enough  to  disturb  the  constitution, 
"orms  a  clot  in  the  basin  more  slowly  than  usual,  but  the  clot  is 
larder ;  and  a  layer  of  fibrine  is  left  upon  the  surface  of  a  yellowish 
buff  color,  looking  like  sivse  or  glue,  and  called  th^  buffy  coat.  The 
clot  is  also  scoopv.d  out  in  the  centre,  and  the  blood  is  said  to  be 
cupped. 

Coin  Discs.  —  It  is  another  peculiarity  of  inflamed  blood,  that  i' 
a  drop  of  it  be  examined  under  a  powerful  loicroscope,  its  globules, 


L 


ihe  result  of 

lof  the  body 

m  from  one 

disordered, 

|1  other  parts 

the  intelli- 

irt  receiving 

y.    Nothing 

Uion. 

fc5ome  impor- 
the  whole 
or  symptoni' 


ind  heat  of 
d  urine,  cos- 
ety,  restless- 
)f  mind,  and 
liversal  sym- 
of  it. 
or  a  broken 

fluid  called 
rial  of  which 
>f  the  blood, 
r  it  is  poured 
rhrough  this, 

she  uses  as 
naterial  with 
I  it  to  repair 
ructs  a  floor 
•ough. 

lature  some- 
?,  she  rushes 
Tspacep  with 
ure  impossi- 
is  right,  and 


>n  extend  to 
)erson  suffer- 
constitution, 
b  the  clot  is 
f  a  yellowish 
y  coat.  The 
s  said  to  be 

iood,  that  i^ 
it«  globules, 


SURGICAL  DIfeKASES. 


427 


or  discs,  which  are  very  numerous,  will  be  found  standing  on  their 
edges,  and  leaning  against  each  other,  like  a  row  of  copper  or  silver 
coins.     (Fig.  144.) 

Inflammation  may  end  in  one  of  four  different  ways. 

I.  By  Resolution.  —  Suppose  a  large  splint  of  wood  be  stuck  into 
the  hand  of  a  healthy  man.  It  causes  redness,  heat,  swelling,  and 
pain ;  and  these,  cotnbined,  are  inflammation.  The  splint  is  ])ulled 
out,  and  the  hand  well  done  up  with  a  water  dressing,  and  properly 
cared  for.  The  redness  fades,  the  heat  declines,  the  swelling  sub- 
sides, and  the  pain  disappears ;  the  inflammation  is  ended,  and  the 
hand  is  well.  Coming  to  a  fortunate  end  in  this  way,  inflammatio 
•a  said  to  be  resolved,  or  terminated  by  resolution. 


Fia.  144. 


Via.  146. 


n.  By  Suppuration.  —  It  does  not  always  end  so  happily.  The 
splint  may  be  broken  off"  below  the  skin,  and  not  pulled  out ;  and 
proper  means  may  not  be  used  to  subdue  the  inflammation.  Instead 
of  abating,  it  may  increase  ;  and  the  centre  of  the  injured  part  may 
begin  to  ri  3  up  to  a  point,  and  grow  white  on  the  top.  This  shows 
that  there  is  matter  formed  underneath,  which  is  lifting  up  the  scarf- 
skin,  and  seeking  to  come  through.  Fig.  145  is  a  microscopic  view 
of  pus  corpuscles. 

The  pain  is  now  very  throbbing  and  pulsating,  —  keeping  time 
with  the  beats  of  the  heart.  When  the  scarf-skin  can  hold  out  no 
longer,  it  breaks,  and  yellow,  cream-like  fluid  runs  out,  which  we 
call  pus.  The  redness,  pain,  etc.,  now  subside.  This  process  we  call 
suppuration. 

At  this  time,  if  the.  ^vound  have  been  a  severe  one,  attended  by 
sympathetic  fever,  and  the-  discharge  of  pus  be  now  large,  there  may 
be  a  change  i;.  the  fever,  marked  by  frequent  shiverings  and  chilli- 
ness, followed  by  flushes  of  heat,  which  ends  in  sweating.  We  call 
this  hectic  fever 

HI.  By  Ulceration,  or  the  formation  of  open,  running  sores. 

IV.  By  mortification.  —  If  the  wounded  part  have  been  so  much 
injured  as  gradually  to  destroy  its  vitality,  it  dies.  The  vivid  red  of 
the  inflammation  changes  to  a  purplish,  or  livid  or  black  hue.  The 
strained  condition  of  the  skin  ceases.  —  a  bloo^ly  fluid  lifts  up  the 


cuticle,  —  the  pain  and  feeling  are  all  gone,  —  the  part  is  dead  and 
putrid,  and  gives  out  a  peculiarly  offensive  smell.  This  process  is 
called  morlificatiun. 

The  mortified  and  dead  part  is  called  a  slough  ;  and  it  is  separated 
from  the  living  parts  by  a  peculiar  vital  process  which  has  the  name 
of  ulceration. 

Treatment  of  Inflammation.  —  Though  inflammation  sometimes 
eada  kindly  by  resolution,  and  though  it  is  often  a  salutary  proc;ess, 
yet  it  is  frequently  very  destructive,  —  ending  in  suppuration,  ulcera- 
tion, and  mortification,  —  thickening,  hardening,  softening,  and  en- 
larging parts  affected  by  it ;  and  doing  these  things  in  textures  of 
great  delicacy,  and  of  vital  importance  in  the  economy  of  life.  It 
calls,  therefore,  for  judicious,  and,  often,  for  very  active  treatment. 

There  are  two  principal  things  to  be  done,  —  to  remove  the  cause, 
if  it  be  still  active,  and  to  take  the  blood  away  from  the  inflamed 
part. 

If  a  bullet  be  lodged  in  the  flesh,  or  a  thorn,  or  a  splint  of  wood, 
or  a  piece  of  glass,  it  is  the  exciting  cause  of  the  inflammation  which 
follow  ,  and  little  can  be  done  to  advantage,  till  the  offending  sub- 
stance is  extracted.  If  inflammation  be  excited  in  the  bladder  by 
the  irritating  presence  of  urine,  which  cannot  be  passed,  this  must 
be  drawn  off  with  the  catheter,  before  relief  can  be  had.  If  the 
stomach  be  inflamed  by  improper  food,  or  too  much  of  it,  the  diet 
must  cease  to  follow  appetite,  and  take  reason  for  its  master.  If 
ladies  have  excited  inflammation  in  the  bowels,  or  any  of  the  internal 
organs,  by  a  dragging  weight  of  skirts,  they  must  either  put  off  the 
burden,  or  hang  it  upon  the  shoulders  with  straps. 

The  blood  is  removed  from  the  inflamed  part  in  two  ways  — 

Cupping  and  Leeching.  —  It  is  done  directly  by  cupping  and  leech- 
ing. These  methods  take  the  blood  out  of  the  small  vessels,  which 
are  so  full  and  crowded  as  to  produce  pain.  Cold  water,  ice,  et(!., 
applied  to  the  part,  cause  these  little  vessels  to  contract,  and  squef/e 
the  blood  out  of  themselves.  These  are  very  useful  applications ; 
and  they  are  to  be  pursued  as  long  as  there  is  any  hope  of  break- 
ing up  the  inflammation,  or  causing  it  to  end  by  resolrtion.  lint 
when  this  is  no  longer  to  be  expected,  and  it  is  found  that  it  will  go 
on  to  suppuration,  then  apply  warm  fomentations  and  poultices. 
These  will  mollify  and  soften  the  parts,  and  cause  the  sup))urating, 
or,  in  common  language  the  rotting  process,  to  go  on  more  rapidly, 
and  with  less  pain. 

Counter-Irritation.  —  The  other  method  of  removing  the  blood 
from  the  inflamed  part  is  by  what  is  called  counter-irritation. 

People  are  apt  to  think  it  very  absurd  that  inflammation  should  be 
induced  in  one  place  to  relieve  or  cure  it  in  another.  But  it  is  not 
absurd.  It  relieves  or  cures  on  the  principle  of  sympathy,  which  1 
have  already  explained.  We  put  croton  oil,  or  tartar  emetic,  or 
Spanish  flies,  or  cayenne  pepper,  or  mustard,  upon  the  surface  of  the 
bowels  when  the  intern? ,1  parts  are  dangerously  inflamed,  and  what 


■a^^ 


[dead  and 
jrocess  ia 

I  separated 
the  name 


ometimea 

y  process, 

n,  ulcera- 

,  and  en- 

xturea  of 

f  life.     It 

ment. 

the  cause, 

!  inflamed 

of  wood, 
ion  which 
iding  sub- 
)ladder  by 
this  must 
i.  If  the 
t,  the  diet 
lastei-.  If 
le  internal 
Jut  off"  the 

rs  — 

and  leech« 
sels,  which 
;r,  ice,  etc., 
id  squeeze 
plicatioiH ; 

of  break- 
^'on.  Hilt 
it  will  go 

poultices, 
ppurating, 
•e  rapidly, 

the  blood 
I. 

should  bc' 
it  it  is  not 
',  which  1 
imetic,  or 
ict  of  the' 
and  what 


SURGICAL  DISEASES. 


429 


is  the  result  ?  Why,  the  terrible  smarting  and  pain  alarms  nature, 
and  she  rushes  up  to  the  surface  with  a  large  amount  of  the  blood 
around  the  inflamed  })arts,  and  there,  for  hours,  perhaps  for  days, 
struggles  to  beat  down  the  new  mischief  at  the  surface ;  and,  in  the 
mean  time,  the  internal  parts,  relieved  by  the  removal  to  the  surface 
of  so  large  a  quantity  of  hot  blood,  make  a  long  stride  towards  re- 
covery. 

A  popular  orator  is  speaking  to  a  multitude  in  a  hall  which  ii 
thronged  to  excess,  and  a  few  feeble  persons  faint,  and  are  likely  to 
be  suffocated  and  trodden  upon  in  the  dense  mass.  A  person  at  the 
door,  seeing  what  has  happened,  cries  "y/Ve."  The  crowd  rush  out ; 
the  fainting  persons  get  breath,  and  are  saved.  So,  when  the  thou- 
sand streams  of  blood  rush  through  their  channels  upon  an  inflamed 
and  fainting  internal  organ,  crowding  and  oppressing  it,  we  set  the 
skin  on  fire  with  some  inflammatory  substance ;  the  blood  rushes  to 
the  new  point  of  excitement,  and  the  oppressed  and  fainting  organ 
recovers. 

Cupping  and  leeching,  which  are  often  necessary,  are  n  .  to  be 
resorted  to  in  very  debilitated  constitutions.  In  some  peisons,  leech- 
ing produces  erysipelas. 

Costiveness  is  always  produced  by  the  symptomatic  fever  which 
often  results  from  inflammation.  This  should  be  removed  by  saline 
purgatives,  such  as  rochelle,  epsom  salts,  glauber's  salts,  salts  of  tartar, 
tartrate  of  potassa,  and  the  tartrate  of  soda  (9)  (7)  (12)  (14)  (18)  (20) 
(25)  (27)  (41).  Sometimes  more  active  purgatives  are  required,  and 
then  the  compound  extract  of  colocynth,  etc.  (29),  will  be  excellent, 
or,  five  grains  of  blue  pill,  at  night,  followed  by  (299),  may  be  used. 

As  a  drink,  cream  of  tartar  (298)  will  be  found  cooling  and  re- 
freshing. In  all  inflammations,  the  diet  must  be  light  and  unstimu- 
lating. 

Suppuration  and  Abscess. 

An  abscess  is  the  collection  of  pus  or  matter  in  the  substance  of 
some  pa.t  of.  the  body.  When  the  matter  is  poured  out  from  some 
part,  the  process  is  said  to  be  suppuration;  when  it  collects  in  a 
tissue,  it  is  an  abscess.  When  the  matter  collecting  in  some  organ, 
comes  towards  the  surface,  and  a  place  in  the  centre  rises  above  the 
surrounding  skin,  and  turns  white,  the  abscess  is  said  to  point.  Some 
abscesses  point  and  break  in  a  week ;  others  of  a  more  chronic  char- 
acter, will  linger  on  for  months. 

Fluctuation.  —  Before  an  abscess  points,  a.  fluctuation  may  generally 
be  felt  in  the  swelling,  which  is  one  of  the  surest  signs  that  it  con- 
taina  pus.  Sometimes  this  fluctu"tion  may  be  felt  even  when  the 
matter  lies  very  deep  in  the  flesh.  And  when  it  is  so  deep  that  it 
cannot  be  felt,  if  a  sudden  cessation  of  the  symptomatic  fever  should 
occur,  and  shiverings  or  rigors  should  come  on,  attended  by  coldness 
in  the  aflected  part,  we  may  reasonably  suspect  that  pus  is  formed. 
It  is  not  easy,  at  times,  to  say  whether  matter  is  really  present ;  and 


:k 


480 


SURGICAL  DISKASES. 


great  care  should  be  used  not  to  plunge  in  a  lancet  where  nouc 

exists. 

Treatiiienf,  —  When  the  abscess  is  completely  formed,  and  there  is 
no  longer  any  doubt  of  the  presence  of  matter,  it  should  be  opened 
at  once.  To  let  out  the  confined  pus  alleviates  the  pain,  and  lessens 
the  inflammation.  If  the  matter  lie  close  to  a  bone,  the  opening 
should  be  made  without  delay.  The  opening  should  be  large  enough 
to  let  the  matter  out  freely.  It  is  a  rule  to  keep  the  incision  o|)Oii 
till  the  cavity  of  the  abscess  is  so  far  filled  up  that  another  collection 
of  pus  is  not  likely  to  occur. 

If  the  matter  do  not  readily  get  to  the  surface  through  the  opening 
it  may  burrow  itself  in  the  fleshj  in  a  long  narrow  channel  called  a 
sinus.  To  relieve  this,  the  opening  must  be  extended  in  such  a  way 
as  to  give  vent  to  the  new  collection. 

An  abscess  is  sometimes  indisposed  to  heal  at  the  bottom,  and  pus 
continues  to  be  formed  a  long  time,  and  is  discharged  through  an 
opening  smaller  than  the  sack  which  contains  it.  Thh  is  a.  fistula ; 
and  the  opening  to  it  should  be  enlarged  so  as  to  let  out  the  matter 
more  freely.  A  little  soft  lint  may  then  be  gently  pressed  into  the 
wound  to  prevent  its  healing  before  the  cavity  below. 

An  abscess  from  acute  inflammation  requires  to  be  poulticed  for  a 
time  after  it  has  been  opened.  When  the  swelling  and  inflammation 
are  gone,  the  poultices  are  to  be  laid  aside,  and  a  bandage  put  on. 
When  the  inflammation  is  gone,  let  the  diet  be  improved;  and  if  the 
discharge  of  matter  be  large,  give  wine  and  tonics. 


Mortification. 

The  complete  death  of  a  part  of  the  body,  and  its  change  into  a 
black,  stinking,  cold,  and  insensible  mass,  with  which  the  other  parts 
of  the  system  have  discontinued  all  organic  connection,  is  what  we 
call  mortification.  That  form  of  it  which  is  most  common,  is  said  to 
be  humid,  on  account  of  the  moisture  of  the  dead  parts. 

Gailg:rene.  —  Before  the  mortified  part  is  completely  dead,  and, 
consequently,  wliile  its  recovery  is  supposed  to  be  possible,  the  con- 
dition of  the  part  is  called  gangrene. 

Sphacelus  is  the  name  given  to  it  after  its  entire  death. 

SloUjK;hin^  is  the  process  of  separating  the  dead  matter,  and  the 
substance  separated  is  a  slough. 

The  causes  of  mortification  are  quite  numerous.  The  most  com- 
mon are,  stoppage  of  the  circulation  by  inflammation,  by  mechanical 
causes  which  obstruct  the  passage  of  the  blood,  by  chemical  agents 
and  poisons,  and  by  local  or  general  debility. 

In  a  bad  constitution,  which  bears  disease  poorly,  mortification  is 
very  dangerous. 

Treatment. —  In  treating  mortification,  three  things  are  to  be  aimed 
at, — to  stop  its  progress,  to  promote  the  separation  of  the  dead  from 


% 


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there  is 
le  opened 
id  lessens 

opening 
',c  enough 
<ion  open 
collection 

opening, 
called  a 
ich  a  way 

I,  and  pus 
rough  an 
a  fistula  ; 
le  matter 
into  the 

iced  for  a 
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put  on. 
Liid  if  the 


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what  we 

is  said  to 


ead,  and, 
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ost  com- 
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cation  is 


36  aimed 
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8UBGICAL  DISEASES. 


431 


the  living  parts,  and  to  heal  the  ulcer  which  is  left  after  the  separa- 
tion. 

To  stop  the  progr(!S8  of  mortification,  we  must  remove  its  cause. 
If  it  be  inflammation,  treat  that  according  to  the  principles  laid  down , 
though  leeching,  purgatives,  etc.,  should  be  used  sparingly,  as  mortifi- 
cation reduces  the  constitution  so  rapidly  that  it  does  not  bear  reduc- 
ing as  well  as  usual,  and  sometimes  not  at  all.  As  soon  as  the  in- 
flammation has  subsided,  particularly  if  the  system  be  weakened, 
tonic  bitters  and  a  nourishing  diet  must  be  had.  When  there  is 
fever,  with  great  excitement  of  the  nervous  system,  delirium,  picking 
of  the  bed-clothes,  etc.,  the  patient  should  have  anodynes  (121)  and 
antispasmodics  (87)  (91)  (90),  with  blisters  upon  the  back  of  the 
neck,  drafts  upon  the  feet,  and  such  other  local  remedies  as  the  case 
may  require. 

It  is  oi  little  use  to  put  anything  upon  the  mortified  part,  except 
with  a  view  of  lessening  the  stench.  For  this  purpose,  lay  upon  the 
part  lint  soaked  in  a  solution  of  chloride  of  lime  or  soda,  or  a  solution 
of  pyroligneous  acid,  or  of  creosote. 

Very  little  can  be  done  to  hasten  the  separation  of  the  dead  part 
from  the  living;  but  while  it  is  taking  place,  a  common  flax-seed 
poultice,  mixed  with  a  little  powdered  charcoal,  may  be  kept  on  it. 

The  ulcer  left  after  the  separation  is  to  be  treated  like  otlier 
ulcers. 

Ulceration  and  Ulcers. 

When  the  small  particles  composing  the  body  have  been  used 
awhile,  they  wear  out,  and  become  useless.  Over  the  whole  body 
are  distributed  a  multitude  of  small  vessels,  called  absorbents,  whose 
business  it  is  to  pick  up  these  worn  and  loosened  particles,  and  carry 
them  away. 

There  is  another  class  of  small  vessels,  having  just  the  opposite 
duty,  —  namely,  to  bring  new  particles  of  matter,  and  put  in  the 
places  of  those  taken  away.  These  are  arteries.  They  are  the  natu- 
ral artisans,  who  construct  our  bodies.  The  absorbents  are  the  de- 
molishers  who  pull  them  down.  Under  these  two  forces,  our  existence 
is,  for  a  time,  a  drawn  game  between  life  and  death.  The  absorb- 
ents, like  myriads  of  hungry  insects,  eat  us  up,  —  the  constructing 
arteries,  like  faithful  builders,  reconstruct  us.  The  work  of  the  ab- 
sorbents, is  called  absorption ;  that  of  the  constructing  arteries  nulri- 
Hon. 

When  nutrition  partially  ceases,  and  absorption  continues  una- 
bated, we  grow  thin,  or  lose  flesh.  This  happens  in  consumption. 
If  nutrition  should  stop  altogether,  absorption  going  on  as  usual,  our 
bodies  would  be  quickly  destroyed.  We  should  be  wholly  devoured 
by  these  little  absorbent  vessels.  This  would  \»'  ulceration  applied  to 
the  whole  body.  But  it  does  not  appear  in  so  general  a  form.  It 
confines  itself  to  particular  parts. 

When  nutrition  entirely  ceases  in  any  portion  of  the  body,  the 
absorbents  devour  all  the  skin,  flesh,  and  vessels  of  the  part, — leaving 


H^ 


i 


■ 


432 


SURGICAL  DISEASES. 


an  open  cavity.     The  process  of  taking  away  the  flesh,  etc.,  is  ulcera- 
tion, —  the  cavity  left  is  an  ulcer  or  sore. 

Natural  Surgery.  —  Ulceration  sometimes  acta  the  part  of  a  natural 
surgeon.  When  a  part  dies  from  mortification,  it  is  necessary  to 
have  it  removed ;  so  nature  sets  up,  directly  around  it,  an  acute  in- 
flammation, in  which  all  nutrition  stops,  and  absorption  goes  on 
rapidly.  In  this  way,  a  complete  dike  is  in  a  short  time  made  around 
the  dead  mass,  and  it  is  as  handsomely  amputated,  or  cut  oft",  as  any 
surgeon  could  do  it. 

When  the  ulceration  is  going  on,  and  the  blood-vessels  are  being 
cut  off"  by  it,  the  blood  coagulates  or  curdles  in  them  for  a  short  dis- 
tance back  from  the  breach,  which  prevents  bleeding.  This  is  as 
good  as  tying  the  arteries. 

Some  textures  ulcerate  more  easily  than  others,  —  the  akin  and 
mucous  membranes  most  easily  of  all. 

Ulcers  are  divided  into  healthy,  unhealthy,  and  specific. 

A  Healthy  ulcer  is  a  simple  sore,  not  showing  any  bad  symptoms, 
'"ut  rather  a  kindly  disposition  to  heal.  It  is  generally  small  in  size, 
of  a  florid-red  color,  and  has  upon  its  surface,  little  elevations,  pointed 
like  cones,  called  granulations,  which  are  not  so  apt  as  in  the  case  of 
unhealthy  ulcers,  to  rise  above  the  level  of  the  surrounding  skin. 

Uuhealthy  Ulcers  comprise  those  called  irritable,  indolent,  and  phor 
gedenic,  etc. 

Indolent  Ulcers  are  numerous.  The  edges  of  the  skin  around 
them  are  generally  thick,  prominent,  and  rounded.  The  granulations 
are  pale,  smooth,  large,  and  flabby,  with  a  peculiar  gloss  upon  them. 
These  ulcers  form  most  often  on  the  leg ;  and  the  nearer  they  are  to 
the  ankle,  the  harder  they  are  to  cure. 

Phagedenic  Ulcers  are  those  which  look  as  though  they  literally  eat 
away  the  parts.  Their  surface  has  a  livid  appearance.  The  matter 
formed  is  small  in  quantity,  and  is  frequently  tinged  with  blood. 

Specific  Ulcers  embrace  scrofulous,  cancerous,  venereal,  scorbutic,  and 
others.  They  are  called  specific  because  they  are  produced  by  par- 
ticular diseases,  and  states  of  the  system. 

Treatment  —  The  first  thing  to  be  done  is  to  remove  the  exciting 
cause.  A  venereal,  or  a  scrofulous,  or  a  scorbutic  ulcer,  cannot  be 
cured,  unless  we  first  lessen  the  force  of  the  disease  in  the  general 
system.  If  the  cor.anuance  of  a  sore  depends  on  bad  digestion,  we 
cannot  expect  to  cure  it,  till  we  put  the  stomach  right. 

Healthy  ulcers  want  no  treatment,  except  some  simple  dressing, 
such  as  marshmallow  or  spermaceti  ointment.  It  is  well,  in  some 
cases,  to  touch  the  granulations  near  the  surface,  with  lunar  caustic. 

Ulcers  upon  the  legs  and  ankles  do  not  heal  well  if  the  patient 
walks  about  much,  or  even  allows  the  legs  to  hang  down  a  great 
deal  , 


u.,  la  ulcera- 

)f  a  natural 
ecesaary  to 
n  acute  in- 
m  goes  on 
lade  around 
t  off",  as  any 

3  are  being 
a  short  dis- 
This  ia  as 

e  akin  and 


symptoms, 
nail  in  size, 
ons,  pointed 

the  case  of 
g  skin. 

nt,  and  phor 


ikin  around 
granulations 
upon  them. 
•  they  are  to 

literally  eat 
The  matter 
blood. 

:orbjtic,  and 
ced  by  par- 

the  exciting 
,  cannot  be 
the  general 
igestion,  we 

•le  dressing, 
?11,  in  some 
ar  caustic, 
the  patient 
wii  a  great 


SURGICAL  DISEASES. 


433 


Fio.  146. 


Indolent  ulcers  are  to  be  touched   by  lunar  caustic  stick,  or  by 
diluted  nitric  acid.     The  diluted  ointment  of  the  nitrate  of  mercury 
is  also  often  used  with  benefit.      So  is  the  com- 
pound tincture  of  benzoin ;  the  basilicon  ointment, 
I  etc.     Or,  apply  a  bread  and  milk  poultice  to  the 
ulcer,  and    keep  the   patient  twenty-four  hours  in 
bed.      Then  apply  the  lunar  caustic  stick  to  the 
whole  sore,  and  to  the  sk'n  around  it.     Afterward* 
cover  the  ulcer  with  sticking  plaster,  and  a  bandage. 
The  following  is  the  best  plan.     Lay  upon  the 
sore  a  number  of  piec^es  of  lint,  soaked  in  the  ni- 
tric acid  lotion  (314),  and  cover  them  with  a  bread 
and  milk  poultice.     Change  these  applications  twice 
a  day,  and  continue  them  till  the  discharge  looks 
healthy,  and  the  granulations  begin  to  appear. 

If  there  is  inflammation  about  the  sore,  give  some 
of  the  preparations  of  salts  to  purge  the  bowels,  and 
confine  the  patient  to  bed.  When  the  parts  begin 
to  look  healthy,  lay  some  pieces  of  lint  upon  the 
sore,  wet  with  nitric  acid  lotion  (214),  or  zinc  lotion 
(215) ;  and  then  apply  strips  of  adhesive  plaster, 
one  and  one-half  inches  wide,  two-thirds  round  the 
limb,  and  extending  an  inch  below  the  ulcer,  and  an 
inch  above  it,  —  at  the  same  time,  drawing  the 
edges  of  the  sore  together  with  a  gentle  force,  and 
retaining  them  there  with  the  plaster.  Put  a  compress  of  soft  linen 
over  the  plaster,  and  apply  a  bandage  over  the  whole,  making  it  tighter 
below,  and  a  little  looser  above,  and  extending  to  the  knee.    (Fig  146). 


Boils. — Ferunculus. 

Underjceath  the  skin  is  a  layer  of  tissue  composed  chiefly  of  cells. 
From  this  tissue  there  are  small  elevations,  in  the  shape  of  cones, 
wliich  rise  up  into  the  substance  of  the  true  skin.  Like  those  papillae 
of  the  skin  which  become  inflamed  and  produce  corns,  these  eleva- 
tions are  subject  to  an  inflammation,  which  causes  boils. 

At  first,  a  tender  knot  or  hardness  is  felt  just  under  the  skin,  which 
soon  begins  to  look  red.  A  painful  tumor  now  begins  to  show  itself, 
(tf  a  dusky  red  or  purple  color,  which  acquires  the  size  of  a  pea,  a 
liiizcl-iuit,  or  a  walnut.  Sometime  between  the  fourth  and  eighth 
(lay,  it  becomes  pointed  and  white  at  the  top,  when  the  scarf-skin 
gives  way,  and  lets  out  a  little  pus  mixed  with  blood,  and  exposes  to 
view  a  mass  of  dead  matter,  called  a  core,  which  is  too  large  for  the 
opening,  and  is  not  ready  to  come  away,  if  it  were  not.  This  core  is 
a  mass  of  mortified  or  dead  flesh ;  and  nature  is  cutting  a  space 
around  it,  that  it  may  be  thrown  off!  In  two  or  three  more  days,  it 
comes  away,  leaving  a  cup-like  cavity,  which  gradually  fills  up,  and 
the  boil  is  over. 

Some  costitutions  yield  boils  in  successive  crops.     When  this  hap- 

55 


. ) 


434 


rrr 


SURGICAL  DISEASES. 


pent)  they  are  a  terrible  affliction.     There  are  not  m^ny  Jobs  who  can 
bear  them  with  patience. 

Treatment  —  A  boil  will  generally  run  its  course,  A  five-grain 
blue  pill,  taken  at  bed-time,  when  the  boil  is  first  showing  itself,  is 
about  the  only  thing  I  know  that  will  blast  it.  And  yet,  my  unwil- 
lingness to  encourage  a  general  .ise  of  mercurials,  makes  me  hesitate 
to  recommend  it.  One  pill,  not  tc  be  repeated,  can  do  no  harm,  how- 
ever, and  may  safely  be  taken. 

Boils  may  sometimes  be  stopped  by  touching  them  with  lunar 
caustic.  Water-dressiiior,  if  used  oarly,  and  persevered  in,  will  some- 
times prevent  their  growing  larger  than  a  pea.  After  the  boil  has 
opened,  apply  poultices  for  a  day  or  two,  then  some  simple,  stimu- 
lating ointment,  as  basilicon  salve,  or  Turner's  cerate,  or  nitric  acid 
lotion  (314).  If  boils  continue  to  come  out  iu  successive  crops,  give 
alterative  medicines,  or  sulphurous  mineral  waters,  or  liquor  potasses, 
or  bicarbonate  of  soda. 


Carbuncle. — Anthraa;. 

This  is  like  a  boil,  only  much  larger,  and  more  painful.  Instead 
of  one  of  the  little  cellular  elevations  being  inflamed,  as  in  the  case 
of  the  boil,  the  carbuncle  begins  with  the  inflammation  of  several. 
Its  surface  is  more  flat  than  that  of  a  boil ;  its  inflammation  more 
violent ;  and  the  constitutional  symptoms  excited  more  severe.  It 
has  the  breadth,  sometimes,  of  the  top  of  a  quart  bowl.  Like  the 
boil,  it  appears  most  often  upon  the  neck,  the  shoulders,  the  back,  the 
buttocks,  the  thighs,  etc.  It  goes  through  the  same  process  as  a  boil, 
and  ends  in  the  same  way,  only  discharging  a  vastly  larger  core. 

Carbuncles  most  often  appear  in  persons  above  middle  age,  and 
indicate  an  impaired  and  broken  constitution.  They  occasion  great 
suffering,  and  sometimes  prove  fatal.  Upon  the  head  or  neck,  they 
are  more  dangerous  than  in  other  situations. 

Treatmeiit.  —  Apply,  constantly,  during  the  formation  of  the  carbun- 
cle, either  fomentations  and  poultices,  or  cold  water  dressing.  I  pre- 
fer the  latter.  To  stop  both  the  local  and  the  constitutional  disorder, 
make  tvvo  incisions  in  the  form  of  a  cross,  cutting  entirely  through 
the  dead  mass.  Then  apply  a  fermenting  poultice,  or  one  of  oat- 
meal, for  two  or  three  days,  —  after  which,  use  the  basilicon  salve,  or 
apply  daily  a  weak  solution  of  lunar  caustic,  or  the  nitric  acid  lotion 
(314).  During  recovery,  tonics  are  useful,  such  as  quinine,  tincture 
of  Peruvian  bark,  and  sulphuric  acid ;  and  morphine  to  procure  rest, 
at  every  stage  when  it  is  required. 


I  ■/ 


Malignant  Pustule. 

This  is  one  of  the  five  diseases  which  man  may  take  from  animals. 
The  other  four  are  the  cow-pox,  hydrophobia,  glanders,  and  pestilential 
carbuncle.     This  last  is  what  the  French  call  charbon,  —  pronounced 


1 


aba  who  can 

A  five-grain 

ing  itaeir,  i^ 

t,  rny  unwil- 

inc  hesitate 

harm,  how- 

with  lunar 
n,  will  some- 
the  boil  has 
mple,  stimu- 
nitric  acid 
crops,  give 
[uor  potaasee, 


ful.  Instead 
I  in  the  case 
in  of  several, 
rnation  more 
e  severe.  It 
vl.  Like  the 
the  back,  the 
cess  as  a  boil, 
ger  core, 
idle  age,  and 
)ccasion  great 
or  neck, they 

af  the  carbun- 
issing.  I  pre- 
onal  disorder, 
tirely  through 
•r  one  of  oat- 
licon  salve,  or 
ic  acid  lotion 
nine,  tincture 
J  procure  rest, 


from  animals, 
nd  pestilential 
—  pronounced 


shftrbo.  My  own  mother  and  an  elder  brother  came  near  losing  their 
liv  •■(  by  it,  —  having  taken  it  by  handling  the  flesh  and  tallow  of  a 
dead  COW. 

Malignant  pustule  begins  with  a  water-pimple,  not  bigger  than  a 
millet  seed.  Underneath  it  is  a  hard  point,  surrounded  witii  redness, 
iiK'!  a  flea-bite.  This  hardness  is  soon  attacked  by  moctitication, 
wliich  spreads  on  all  sides,  and  kills  evcrytliing  as  it  goes.  Next,  in 
fu'ul  cases,  come  great  restlessness,  faintings,  sunken  countenance, 
dt ,  skin,  dry  brown  tongue,  despondency,  delirium,  and  death.  It  is 
BiiDposed  generally  not  to  arise  from  constitixtional  causes,  but  to  be 
pi  duced  by  a  sptjcific  poison  applied  to  the  skin,  or  by  eating  the 
ill  h  of  cattle  which  die  of  gangrenous  diseases.  The  disorder  is 
probably  the  same  with  the  pestilential  carbuncle. 

Treatment.  —  Deep  incisions,  and  the  application  of  the  most  pow- 
erful caustics,  as  the  caustic  potash,  etc.,  and  tincture  of  peruvian 
bark,  quinine,  aromatic  sulphuric  acid,  wine,  ether,  and  opium. 
Probably  the  best  treatment  is  to  surround  the  pustule  with  a  thick 
\hyct  of  ointment;  then  to  fasten  some  lint  to  the  end  of  a  stick,  wet 
it  with  nitric  acid,  and  press  it  upon  the  pustule.  Now  apply  cloths, 
wet  with  cold  water,  and  when  the  slough  comes  off,  dress  with 
simple  ointment,  or  touch  occasionally  with  weak  solution  of  nitrate 
of  silver  (211). 

Chemical  Injuries. 

These  are  of  two  kinds,  produced  by  causes  of  an  exactly  opposite 
nature.     The  first  are 

Burns  and  Scalds.  ^ 

A  bum  is  the  effect  of  concentrated  heat  acting  upon  living  tissues. 
Tlie  effects  are  inflammation,  and  sometimes  complete  disorganization 
and  destruction  of  the  parts. 

A  scald  is  an  injury  produced  by  applying  hot  water  or  other  fluid, 
to  the  skin  or  mucous  membrane.  The  natural  temperature  of  the 
human  body  is  ninety-eight  degrees ;  that  of  boiling  water,  two  hun- 
dred and  twelve  degrees.  Bringing  the  skin  in  contact  with  a  fluid 
heated  so  far  above  it,  produces  redness  and  pain ;  and  when  nothing 
is  done  instantly  to  ward  oft'  the  injury,  the  scarf-skin  is  raised  fro;n 
the  true  skin  in  the  form  of  a  blister,  filled  with  water. 

The  degree  of  danger  from  a  burn  or  scald,  depends  upon  the  e.r- 
tent  of  the  injured  surface,  and  also  upon  the  depth  of  the  injury.  An 
extensive  scald  or  burn  may  prove  fatal  in  a  few  hours,  —  the  patient 
never  rallying  from  the  first  prostration.  These  injuries  are  mor*t 
dangerous  when  upon  the  head,  neck,  chest,  and  belly.  Old  persons, 
and  those  who  are  feeble,  and  have  shattered  constitutions,  will  sink 
under  burna  and  scalds,  from  which  robust  persona  will  suffer  but 
little.  .  .    .  - 

Treatment  —  For  slight  burns  and  scalds,  make  cold  applicationa 


Put  the  injured  part  in  very  cold  wntrr,  or  lay  upon  it  pieces  of  linoii, 
or  lint,  wet  with  vinegar  and  water,  or  rose  water  and  sugar  of  lead 
(238),  or  diluted  solution  of  acetate  (f  ammonia.  When  these  aro 
not  to  be  quickly  had,  lay  on  scraped  potatoes.  The  object  is  to 
reduce  the  inllammation,  and  to  prevent  blistering.  They  must, 
therefore  be  put  on  very  soon.  U  the  scald  be  extensive,  and  on  the 
bodt/,  —  producing  shivering,  faintness,  paleness,  and  coldness  of  the 
ekin,  and  a  small  pulse,  —  cold  applications  are  not  proper.  In  such 
case  we  may  use  warm  fomentations,  or,  in  the  case  of  a  child,  the 
warm  bath.  A  liniment  of  spirits  of  tur|)entine,  linseed  oil,  etc. 
(194),  makes  an  excellent  application. 

Raw  cotton,  spread  out  thin,  and  laid  upon  a  burn,  is  a  good  dress- 
ing, and  one  which  is  much  used.  So  is  flour  sprinkled  upon  the 
injured  surface  with  a  dredger.  For  loosening  the  flour  when  it  is 
to  be  taken  off",  poultices  are  useful. 

Keep  the  air  from  the  wound  as  much  as  possible.  With  this 
view,  do  not  remove  the  dressing  often,  and  when  a  cold  lotion  is 
used,  merely  pour  it  upon  the  rags,  letting  them  remain  undisturbed. 


Effects  of  Gold.— FroBt-Bite. 

Cold  is  a  relative  term.  The  same  temperature  may  be  called  hot 
or  cold,  according  as  it  is  compared  with  a  hotter  or  colder  tempera- 
lure.  If  we  warm  one  hand  by  a  fire,  while  we  lay  the  other  upoa 
ice,  and  then  plunge  them  both  into  cold  water,  the  water  will  feel 
cold  to  the  one  which  has  been  by  the  fire,  and  warm  to  the  one  taken 
from  the  ice. 

The  warmth  of  the  body  being  ninety-eight  degrees,  any  tempera- 
ture below  this  may  be  said,  in  a  certain  sense,  to  be  cold.  Yet  a 
temperature  much  lower  than  this,  namely,  from  sixty  to  seventy,  is 
the  most  agreeable  and  invigorating,  because  it  takes  away  the  heat 
just  about  as  fast  as  it  is  produced  in  a  healthy  body. 

The  first  efiect  of  cold  applied  to  the  body  is  to  weaken  the  circu- 
lation in  the  small  blood-vessels  of  the  skin.  When  applied  with 
some  intensity,  the  heart  and  arteries  in  general  are  weakened ;  the 
blood  is  delayed  in  the  vessels  near  the  surface,  and  not  being 
c-Ii  inged  to  a  red  color  in  the  lungs  as  fast  as  it  should  be,  the  fin- 
gers, ears,  etc.,  become  blue  or  livid ;  and,  if  the  cold  be  continued 
sufliciently  long,  the  circulation  stops  in  these  parts ;  heat  ceases  to 
be  evolved,  and  mortification  or  death  is  the  consequence.  Parts 
killed  in  this  way  are  saitl  to  he  frost-bitten. 

A  free  circulation  of  red  blood  is  essential  to  the  continuance  of 
sensibility.  Hence,  when  the  circulation  is  seriously  impeded  by 
cold,  the  body  becomes  numb,  —  it  loses  its  feeling ;  the  muscles  act 
feebly  ;  a  languor  and  torpor  follows  ;  drowsiness  comes  on,  followed 
by  sleep,  from  which  there  is  no  waking.  Drowsiness,  during  expos- 
ure to  extreme  cold,  indicates  great  danger. 

Trentment.  —  It  is  a  great  principle  in  restoring  frost-bitten  parts, 
and  persons  benumbed  with  cold,  to  communicate  heat  in  the  most 


•  » 


eces  of  linen, 
lugar  of  lead 

len  these  arc 

object  is  to 

They  must, 

,  and  on  the 

dness  of  the 

Iper.     In  such 

if  a  child,  the 

iseed  oil,  etc, 

a  good  dress- 
ed upon  the 
ur  when  it  is 

With  this 
cold  lotion  is 
undisturbed. 


y  be  called  hot 
i)lder  tempera- 
the  other  upon 
tvater  will  feel 
)  the  one  taken 

1,  any  tempera- 
3  cold.  let  a 
y  to  seventy,  is 
away  the  heat 

ikcn  the  circii- 
1  applied  with 
weakened  ;  the 
and  not  being 
lid  be,  the  fin- 
i  be  continued 
heat  ceases  to 
quence.     Parts 

continuance  of 
y  impeded  by 
he  muscles  act 
es  on,  followed 
,  during  expos- 


>st-bitten  parts, 
eat  in  the  most 


SURGICAL  DISEASES. 


437 


gradual  manner.  Mr.  Hunter  says  the  degree  of  external  heat  should 
be  ill  pro|)ortion  to  the  quantity  of  life.  When  life  is  weakened  and 
nearly  destroyed  by  frost,  therefore,  the  warmth  imparted  must  be 
small,  and  ris(!  no  faster  than  life  returns. 

To  restore  a  frozen  limb  or  part,  rub  it  with  snow,  or  place  it  in 
cold  water  for  some  time.  When  feeling  begins  to  return,  still  keep  it 
in  cold  water,  and  let  heat  be  added  in  a  very  grp-'  al  manner,  by 
poring  in,  now  and  then,  a  very  small  quantity  of  wi.i  n  water. 

If  a  person  be  reduced  by  cold  to  insensibility,  and  apparenlly 
frozen  to  death,  take  his  clothes  od',  and  cover  him  all  over  with  snow, 
except  the  mouth  and  nostrils.  If  snow  is  not  to  be  had,  put  him  in 
water  as  cold  as  ice,  and  let  him  lie  for  some  miimtes.  Then  rub 
liini  with  cloths  wet  with  cold  water.  When  the  body  is  thus  thawed 
by  degrees,  and  the  muscles  begin  to  relax,  dry  the  body,  and  placing 
it  in  a  cold  bed,  rub  with  the  warm  hands,  only  under  the  clothes. 
Continue  this  for  hours.  If  signs  of  life  appear,  give  a  small  injec- 
tion of  camphor  and  water,  and  put  a  drop  of  spirits  of  camphor  on 
the  tongue.  After  a  time,  rub  with  spirit  and  water,  and  finally  with 
spirit,  and  give  tea,  or  coflfee.  or  brandy  and  water. 

Mechanical  Injuries. 

Wounds  are  divided  into  several  kinds. 

Incised  Wounds  are  very  common.  Being  made  with  sharp  instru- 
ments, they  are  cuts,  and  have  no  laceration  or  tearing  about  them. 

Stabs,  or  Punctured  Wounds,  form  another  class.  They  are  made 
with  pointed  weapons,  as  bayonets,  lances,  swords,  and  daggers. 
They  are  more  dangerous  than  the  former,  because  they  penetrate 
to  a  greater  depth,  —  injuring  blood-vessels,  nerves,  bowels,  and  other 
organs. 

Contused  and  Lacerated  Wonnds  form  still  another  class.  They 
embrace  gun-shot  wounds,  and  all  those  produced  by  blunt  instru- 
ments.    They  tear,  and  bruise,  and  mash  the  flesh. 

Poisoned  Wounds  form  yet  another  class.  They  are  such  as  are 
united  with  the  introduction  of  some  venomous  poison  into  the  in- 
cised, or  punctured,  or  contused  part.  Stings  and  bites  of  venotnous 
insects  and  snakes  are  of  this  class,  —  also  the  wounds  made  by  poi- 
soned arrows. 

Simple  Wounds  are  such  as  are  inflicted  on  a  healthy  subject  with 
a  clean  sharp  instrument. 

Complicated  Wounds  are  those  inflicted  when  the  state  of  the 
whole  system,  or  of  the  wounded  part,  is  such  as  to  make  it  neces- 
sary for  the  surgeon  to  deviate  from  the  treatment  needed  for  a 
simple  wound,  —  as,  for  example,  when  there  is  bleeding,  or  nervous 
symptoms,  or  great  pain,  or  locked-jaw,  or  much  contusion,  or  ery- 
sipelas. 


V  > 


43b 


SURGICAL  DISEASES. 


RymputlH'fic  Fever. --All  large  wounds  are  followed  by  Bymptom- 
atic  fevrr,  which  coiih'h  on  frorn  Hixtpcn  to  thirty-wix  hoiirn  ufter  the 
accident.  Thia  is  gcnfrully  of  the  influminatory  kind,  and  in  indi- 
cated by  greater  warmth  of  the  Hkin,  n  more  frequent  and  stronger 
piil.se,  anxiety,  tfiirwt,  and  lows  of  digestive  power.  Where  timeh 
blood  is  lost,  and  the  constitution  is  feeble,  the  pulse  io  more  quick 
than  Htrong,  and  the  fever  of  a  lower  and  more  typhoid  type.  In 
this  caHC,  wood  must  not  be  drawn. 

Lacerated  wounds  are  more  dangerous  than  incised  ones,  because 
the  parts  are  stretched  and  otherwise  injured,  besides  being  separated. 

A  very  small  wound  upon  the  brain,  the  spinal  marrow,  the  bowels, 
or  the  heart,  will  often  prove  fatal,  because  the  functions  of  these 
parts  are  intimately  connected  with  life. 

Wounds  of  young  persons  heal  much  more  rapidly  and  kindly  than 
tho.se  of  old  persons. 


Fio.  147. 


Incised  Wounds. 

When  the  flesh  is  divided  with  a  cutting  instrument,  the  cut  edges 
separate,  and  the  wound  has  a  gaping  appearance.  This  drawnig 
apart  happens  in  consequence  of  the  elasticity  of  the  skin.  It  often 
happens  that  vessels  of  considerable;  si/e  are  cut,  so  that  bleeding  is 
the  principal  thing  to  receive  attention. 

Treatment  of  Heniorrh»|(e. — Bleeding  is  stopped  by  the  tourniquet, 
by  the  fiffoture,  by  compression,  by  the  application  of  cold  water  and 
ice,  and  by  astringents  and  styptics. 

The  Tourniquet.  —  This  instrument  consists  of  a  band  nnd  buckle, 
a  pad,  and  two  brass  frames,  the  upper  of  which  is  furniBhed  with 
two  small  rollers,  and  the  lower 
with  four,  over  all  of  which  the 
band  plays.  When  the  handle  is 
turned  to  the  right  or  left,  the 
band  is  tightened  or  relaxed  to 
just  the  extent  required.  (Fig. 
147.)  The  band  is  buckled  round 
the  limb  in  such  a  manner  that 
the  pad  is  placed  exactly  over  the 
artery.  When  an  artery  is  cut,  it 
is  known  by  the  blood  being  very 
red,  and  spirting  ovl  in  jets  ;  and 
in  this  case,  the  instrument  must 
be  placed  upon  the  limb  above 
the  wound,  or  between  it  and  the 
heart 

Tlie  Lipiture. — When  an  artery 
is  divided,  the  surgeon  lays  hold 
of  the  end  of  it  with  his  forceps,  and  ties  a  thread  tight  around  it 
This  is  called  a  ligature.     By  it,  the  bleeding  ia  instantly  stopped; 


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IMAGE  EVALUATION 
TEST  TARGET  (MT-S) 


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mmmmi^m 


SURGICAL  DISEASES. 


43i> 


and  long  before  the  thread  becomes  loose,  the  opposite  sides  of  the 
vessel  have  grown  together,  and  all  danger  of  a  renewal  of  the 
bleeding  is  over. 

Application  of  Water  and  Ice. —  This  is  done  by  saturating  with 
cold  water  several  folds  of  linen  rags,  or  lint  pads,  and  applying  them 
to  the  wound,  remoistening,  and  reapplying  them  as  fast  as  they  be- 
come hot,  till  the  pain  and  inflammation  subside. 

Compression.  —  When  the  blood  does  not  come  from  any  large 
vessel,  but  from  several  small  ones,  compression  is  sufficient.  It  con- 
sists in  placing  the  opposite  sides  of  the  woup  '  together,  if  )x>ssible, 
and  then  laying  compresses  over,  and  applyi  a  bandage  with  mod- 
erate tightness. 

Astringents  and  Styptics. —  These  are  spirits,  tinctures  of  myrrh, 
Peruvian  bark,  diluted  mineral  acids,  solutions  of  tannin,  alum,  sul- 
phate of  copper,  decoctions  of  white  oak  bark,  etc.  These  have  the 
power  to  stop  lileeding  from  small  vessels.  Monsel's  salt,  a  remedy 
just  coming  into  use,  is  said  to  have  more  power  than  all  the  above. 
It  is  a  preparation  of  iron  and  nitric  acid,  and  has  been  used  with 
great  success  in  stopping  violent  bleeding  at  the  military  hospital  of 
Bordeaux.  It  is  not  a  caustic  or  an  irritant ;  but  it  acts  very  power- 
fully upon  albumen  and  blood,  —  producing  with  the  latter  a  large 
clot,  absolutely  insoluble^  which  continues  to  enlarge  for  several  hours 
after  the  application,  and  becomes  quite  hard  and  firm,  so  that  no 
blood  can  get  through. 

Beside  these  means,  the  application  of  the  lunar  caustic  stick, 
potash,  and  the  hot  iron,  are  used,  particularly  the  first,  quite  often. 

Union  by  the  First  Intention. 

When  the  bleeding  is  stopped,  all  foreign  substances  removed,  and 
the  wound  properly  cleansed,  the  next  thing  is  to  bring  the  opposite 
sides  of  the  cut  evenly  together,  and  to  keep  them  steadily  in  this 
position  till  they  hav^  healed.  If  this  method  succeeds,  the  healing 
takes  place  without  the  formation  of  any  pus.  This  is  called  healing 
by  the  first  intention,  or  adliesion.  The  cut  surfaces  grow  together. 
For  keeping  the  surfaces  together,  straps  of  adhesive  plaster  are  used, 
putting  them  at  ri^ht  angles  across  the  cut,  and  leaving  spaces  be- 
tween them.     Over  the  straps  should  be  cold  water  dressings. 

Sutu^'ef  —  Incised  wounds  are  sometimes, — though  seldom  now,— 
sewed  U^  'her,  by  what  is  called  the  interrupted  suture.  After  the 
bleeding  is  stopped,  a  curved  needle  is  threaded,  and,  the  lips  of  the 
wound  being  brought  together,  is  introduced  through  the  right  lip, 
and  then,  being  directed  across  the  wound,  is  pushed  through  the  leift 
lip,  from  within  outward.  It  is  now  cut  off,  and  tied  in  a  bow. 
Ihese  stitches  should  be  at  least  an  inch  from  each  other.  The 
adhesive  plaster  is  generally  better  than  the  suture. 

The  first  plasters  and  dressings  should  remain  on  the  parts  at  least 


1;-? 


!  ! ;■ 


three  or  four  days,  unless  very  great  pain,  bleeding,  or  some  other  bad 
symptom,  should  call  for  their  removal. 


i-4 


Useful  Rules  for  Examining  and  Dressing  Wounds. 

Never  give  the  patient  more  pain  from  the  mode  of  handling  and 
dressing  the  wound  thai;i  is  necessary  for  his  present  good,  or  future 
safety.  Never  distress  him  by  probing,  squeezing,  etc.,  to  find  things 
that  will  be  of  no  use  when  learned. 

Make  all  (laminations  as  soon  after  the  accident  as  possible  ;  for, 
before  inflammation  and  swelling  take  place,  the  probe  or  finger  in- 
flicts much  less  pain. 

In  changing  the  dressing  of  a  wound,  let  all  the  fresh  ones  be  ready 
before  the  removing  of  the  old.  The  sponge,  warm  water,  adhesive 
plaster,  lint,  ointment,  lotions,  bandages,  etc.,  should  all  be  at  hand, 
and  not  have  to  be  looked  after  when  the  wound  is  exposed. 

Put  the  patient  in  the  most  easy  position,  that  he  may  not  be  need- 
lessly fatigued  during  the  dressing. 

If  the  bandage,  plaster,  and  other  dressings,  have  become  hard,  and 
glued  together,  and  to  the  skin,  by  blood  or  matter,  soften  them  with 
warm  water,  which  is  to  be  pressed  out  of  a  sponge,  —  a  basin  being 
held  below  the  part  to  catch  the  water  as  it  falls  from  the  dressing. 

The  strips  of  adhesive  plaster  are  to  be  removed  by  pulling  gently 
at  one  end,  and  then  the  other,  —  each  to  be  drawn  towards  the 
wound,  so  as  not  to  pull  its  lips  apart. 

In  large  wounds,  take  oft*  one,  or  at  most,  two  strips  of  plaster  at 
a  time.  Cleanse,  wipe  dry,  and  again  support  this  part  of  the  wound 
with  new  strips  of  plaster,  before  any  more  are  taken  off.  This  will 
prevent  the  wound  being  torn  open  by  the  weight  of  its  parts. 

If  the  wound  be  large  and  deep,  its  sides  should  be  supported  by 
an  as'iistant  while  changing  the  dressings. 

If  there  are  several  wounds,  dress  but  one  at  a  time,  that  there  may 
be  no  needless  exposure  to  the  air. 

Pay  the  utmost  attention  to  cleanliness. 

The  frequency  of  the  dressing  must  depend  en  the  amount  and 
quality  of  the  discharge,  the  situation  of  the  inji7i; ,  the  climate  and 
season  of  the  year,  the  effect  produced  by  the  dressing,  and  by  the 
feelings  of  the  patient     (See  p.  878.) 


I"- 


1^ 


I: 


The  Way  in  which  Wounds  Unite.       •     < 

When  the  two  surfaces  of  a  wound  are  brought  together,  they  be- 
come impervious  to  the  blood,  but  not  to  coagulable  lymph,  or  fibrine. 
This,  —  the  material  of  which  all  flesh  is  mad,,  —  flows  out  upon  the 
two  surfaces,  and  becomes  a  bond  of  union  between  them. 

Into  this  layer  of  fibrine,  the  small  blood-vessels,  —  arteries  and 
veins,  —  which  have  been  cut  asunder,  push  themssives  with  open 
mouths,  and,  meeting  in  the  centre,  they  inosculate,  or  grow  togetheif 
and  the  blood  resumes  its  circulation  through  them. 


le  other  bad 


Wounds. 

andling  and 
xl,  or  future 
>  find  things 

ossible ;  for, 
or  finger  lu- 
es be  ready 
ter,  adhesive 
be  at  hand, 

Fid. 

not  be  need- 
le hard,  and 
them  with 

basin  being 

dressing, 
illing  gently 
towards  the 

of  plaster  at 
if  the  wound 
f.     This  will 
arts, 
iupported  by 

it  there  may 


1  mount  and 
climate  and 
and  by  the 


ler,  they  be- 
h,  or  fibrine. 
at  upon  the 
I. 

irteries  and 

with  open 

)W  together, 


SURGICAL  DISEASES. 


441 


By  this  method,  incised  wounds  of  moderate  size  are  often  healed 
in  forty-eight  hours.  This  method  of  healing  by  the  first  intention 
is  always  to  be  brought  about,  if  possible. 

Punctured  Wounds. 

These  are  produced  by  swords,  daggers,  etc. 

Great  swelling  and  inflammation,  large  abscesses,  erysipelas,  the 
wounding  of  large  arteries,  and  the  consequent  extravasation  of  blood, 
symptomatic  fever,  and  lock-jaw,  are  the  frequent  results  of  punc- 
tured wounds.  They  are,  therefore,  more  dangerous  and  hard  to  cure 
than  cuts. 

Treatment. —  For  the  first  twenty-four  hours,  use  superficial  dress- 
ings of  lint,  wet  with  a  solution  of  sugar  of  lead  dissolved  in  cold 
water,  or  with*  cold  water  simply,  and  a  loose  bandage.  If,  after  this, 
pain  and  swellirtg  should  increase,  leeches  may  be  applied  to  the 
neighborhood  of  the  wound,  and  fomentations,  or  poultices,  be  put  in 
place  of  the  cold  water,  —  placing  a  small  linen  rag,  spread  with  sper- 
maceti cerate,  over  the  wound.  When  the  pain  and  inflammation 
are  great,  saline  purgatives  (7)  (18)  (25)  (27),  and  opiates  are  often 
called  for. 

Contused  and  Lacerated  Wounds. 

These  are  produced  by  cudgels,  stones,  bullets,  or  whatever  else  of 
a  blunt  nature,  tears  asunder  the  muscular  fibres,  leaving  jagged  and 
uneven  surfaces.  They  are  rarely  healed  without  suppuration,  and 
are  frequently  followed  by  violent  inflammation.  They  suppurate 
and  slough,  but  they  do  not  bleed  much, — not  even,  sometimes,  when 
large  arteries  are  torn  asunder.  Whole  limbs  are  occasionally  torn 
away  without  hemorrhage.  In  warm  climates,  lock-jaw  is  a  frequent 
consequence  of  them. 

Treatment.  —  Draw  the  edges  of  the  wound  loosely  together,  and 
retain  them  with  a  few  strips  of  adhesive  plaster.  Sometimes  a 
suture,  here  and  there,  will  be  proper.  If  a  great  deal  of  inflamma- 
tion ensues,  take  away  the  adhesive  plaster  and  the  stitches,  and 
apply  a  poultice,  or  water  dressing;  and  if  there  be  much  fever,  rest- 
lessness, or  delirium,  saline  purgatives  (18)  (25),  opium  (118),  and 
/ery  low  diet,  will  be  needed. 

The  wound  having  thrown  off  its  sloughs,  suppurated,  become 
clean,  and  formed  granulations,  the  poultices  are  to  be  taken  ofl",  and 
simple  dressings  substituted.  These  should  be  adapted  to  the  condi- 
tions of  the  sore,  according  to  the  directions  for  treating  ulcers. 

When  the  wound  is  so  severe  that  extensive  mortification  will  be 
sure  to  follow,  the  limb  must  be  immediately  taken  off,  to  save  the 
life  of  the  patient 


■Ml 


442 


SURGICAL  DISEASES. 


.J.l 


Granulation  and  Scarification. 


Suppurating  wounda  heal  in  the  flame  way  with  ulcers.  The 
■chasm  is  filled  up  by  the  appearance  of  little  soft  elevations  of  new 
substance,  which  originate  at  all  points,  and  meet  at  the  centre,  draw- 
ing the  sides  nearer  together,  and  raising  the  bottom  towards  the 
surface.  This  is  called  granulaHon,  because  these  elevations  look  like 
grains  ;  and  the  result  is  a  new  tissue,  of  a  peculiar  character,  which 
constitutes  the  cicatrix,  or  scar. 

Reproduction  of  Lost  Parts.   ' 

Among  some  of  the  lower  animals,  whole  limbs  which  have  been 
destroyed,  are  easily  reproduced.  It  ia.not  so  with  man  ;  though  cer- 
tain parts,  when  only  partially  destroyed,  are  sometimes  regenerated. 
Thus,  portions  of  skin,  of  considerable  extent,  are  often  reproduced ; 
and  so  are  the  whole  of  some  long  bones,  when  destroyed  by  necrosis. 
The  same  is  true,  to  some  extent,  of  ligaments.  But  portions  of 
brain,  and  spinal  marrow,  and  muscle,  and  mucous  membrane,  when 
once  removed,  are  never  regenerated. 

Gunshot  Wounds. 

At  a  time  when  fire-arms  are  so  much  carried  about  the  person, 
and  so  often  used  for  purposes  of  duelling,  and  murder,  it  is  proper 
that  every  person  should  know  something  of  the  modes  of  treating 
gunshot  wounds. 

Treatment.  —  It  is  often  proper  to  make  a  gunshot  wound  larger  at 
the  orifice.  When  this  is  done,  it  is  generally  on  the  side  where  the 
bullet  has  passed  out,  if  it  has  gone  entirely  through.  A  bullet  is 
always  to  be  removed,  if  it  can  be  felt 

The  dressings  are  at  first  to  be  superficial,  light,  and  unirritating. 
The  common  tepid  water  dressing,  covered  with  a  piece  of  oiled  silk, 
is  one  of  the  best.  Some  use  pledgets  of  simple  ointment,  poultices, 
and  fomentations.  These  latter  are  generally  employed  during  sup- 
puration ;  but  during  the  first  two  or  three  days,  cold  evaporating 
washes,  and  cold  water,  are  best,  when  the  wounded  part  is  inflamed 
and  hot,  and  the  circulation  is  vigorous. 

Poisoned  Wounds. 

To  the  bites  of  various  creatures  man  is  exposed  in  most  climates, 
and  all  seasons  of  the  year.     These  may  be  divided  into  three  classes. 

Bitss  of  Mosquitoes  and  Spiders,  and  Stings  of  Bees  and  Wasps. — 

For  these,  the'best  applications  are  a  solution  of  common  salt,  or 
water  of  ammonia,  or  sugar  of  lead  (239),  or  laudanum,  or  tincture 
of  iodine.  If  none  of  these  are  at  h;iiid,  nt  the  moment,  cover  the 
part  with  wet  earth.     Tinr'"re  of  arnica  (r^40)  is  a  good  application. 


Jli! 


I  ulcers.      Tlie 

itions  of  new 

centre,  draw- 

towards  the 

Itions  look  like 

iracter,  which 


ch  have  been 
;  though  cer- 
3  regenerated, 
reproduced ; 
;d  by  necrosis, 
it  portions  of 
mbrane,  when 


ut  the  person, 
ier,  it  is  proper 
les  of  treating 

ound  larger  at 
side  where  the 
u     A  bullet  is 

d  unirritating. 
:e  of  oiled  silk, 
nent,  poultices, 
:d  during  sup- 
Id  evaporating 
irt  is  inflamed 


most  climates, 
9  three  classes. 

and  Wasps. — 

mmon  salt,  or 
im,  or  tincture 
lent,  cover  the 
d  application. 


SURGICAL  DISEASES. 


44b 


Bites  of  Veiiomuus  Snakes. —  Either  instantly  cut  out  a  piece  from 
the  bitten  part,  or  apply  a  dry  cup,  to  prevent  the  absorption  of  the 
poi  on.  Suction  with  the  mouth  will  sometimes  answer  the  same 
purpose.  After  doing  one  of  these  things,  touch  the  part  with  caustic 
potash.  Internally,  give  Fowler's  Holution,  twenty  drops,  in  a  little 
water,  every  two  hours.  Also  purgative  injections,  —  stopping  the 
arsenic  when  purging  is  well  established. 

For  the  bite  of  the  rattle.-snake,  the  only  known  remedy  is  alcoholic 
drink,  taken  in  large  quantities,  and  immediately,  (iin  and  whiskey 
are  believed  to  be  the  best.  Fill  the  system  full.  When  the  poison 
hiis  begun  to  take  effect,  enormous  quantities  will  be  borne,  before  in- 
toxication can  be  induced.  Keep  the  whole  person  saturated  until 
the  symptoms  decline. 

Fractures. 

The  existence  of  a  fracture  is  to  be  known  by  the  symptoms. 
These  are,  pain,  swelling,  deformity  from  the  limb  bending  to  one 
side,  sometimes  shortening  of  the  limb,  or  loss  of  power  to  use  it,  and 
a  crepitus  or  grating  sound  or  sensation  from  the  rubbing  of  the  ends 
of  the  broken  bone  together.  There  are  several  kinds  of  fractures. 
They  are 

The  Transverse  Fracture,  which  is  directly  across  the  bone. 

The  Oblique  Fracture;  which  runs  from  side  to  side,  in  an  oblique 
•direction. 

Tlie  Longitudinal  Fracture,  which  mns  lengthwise  of  the  bone. 

'  A  Simple  Fracture  is  one  in  which  the  bone  is  broken  simply,  with- 
out any  wound  of  the  flesh  with  it. 

A  Compound  Fracture  consists  of  a  simple  fracture,  and  of  an  ex- 
ternal wound  in  addition,  caused  by  pushing  the  end  of  the  broken 
bone  through  the  flesh. 

A  Complicated  Fracture  is  one  in  which,  beside  the  breaking  of  the 
bone,  there  is  the  dislocation  of  a  joint,  the  wounding  of  an  artery, 
I'.ie  extensive  tearing  of  the  soft  parts,  or  the  wounding  of  the  bowels 
or  some  other  internal  organ. 

A  Comminuted  Fnicture  is  one  in  which  the  bone  is  broken  into 
several  pieces. 

Treatment  of  Fractures. —  When  a  bone  is  broken,  the  first  thing 
to  be  done  is  to  get  the  injured  person  to  his  home,  or  to  the  nearest 
house.  To  do  this  in  a  rough  or  careless  way,  might  add  much  to 
his  suflerings. 

If  it  be  an  arm  which  is  oroken,  let  it  be  placed  in  a  broad  sling, 
«xtending  from  the  elbow  to  the  fingers.  In  this  condition  the  pa- 
tient, if  in  tolerable  health,  and  the  distance  is  not  great,  will  find  it 
«a8ier  to  wallc  home,  tnan  to  bear  the  jolting  of  a  carriage. 


!;i 


■■<\- 


us 


444 


SURGICAL  DISEASES. 


Fro.  14S. 


If  the  log  or  <he  thigh  be  brokerj,  then  a  hurdle  of  sonic  sort  (Fig. 
148),  must  be  obtaiiu-il  a.s  mkjh  iis  possible,  and,  being  covered  with 
straw,  or  blankets,  or  gar- 
ments, the  patient  uhunid 
be  gently  lifted  uixin  it  by 
just  persons  enough  to  nise 
him  easily  from  the  ground. 
This  should  now  be  carried 
by  four  persons,  two  at  each  end,  moving  with  great  gentli-ncss,  and 
keeping  exact  step  witii  each  other.  If  these  persons  take  hold  of 
the  ends  of  two  poles,  laid  under  the  hurdle,  they  will  find  they  can 
carry  it  much  more  easily.  If  no  hurdle  be  at  hand,  let  four  poles,  two 
long  ones,  and  two  short  ones,  be  laid  across  each  other  at  right  angles, 
and  fastened  together  with  nails  or  strings.  Then  lay  upon  those  an 
old  door,  or  some  loose  boards  ;  and  the  injured  person  may  be  easily 
carried  u|X)n  this  temporary  structure.  A  blanket  fastened  upon  four 
poles,  in  the  manner  of  a  cot-bed,  will  answer  a  good  pur|X)se. 

Having  placed  the  patient  upon  the  hand  carriage,  bring  the  sound 
limb  and  the  broken  one  snug  tx)gether,  and  tie  them  to  each  other 
with  two  or  three  pocket  handkerchiefs  ;  this  will  support  the  broken 
limb,  and  prevent  its  being  shaken  about  and  injured  by  motion.  In 
doing  this,  the  limb  should  be  laid  as  near  as  jwssible  in  the  natural 
position,  so  that  the  bones  may  not  get  out  of  place,  and  their  ends 
get  pushed  through  the  flesh. 

Tlie  Reduction,  or  Setting  of  tlie  Fracture,  is  the  first  thing  to  be 
done.  By  this  is  meant  the  bringing  of  the  ends  of  the  broken  bone 
together,  and  adjusting  them  to  each  other  in  their  natural  position. 
This  is  done  by  what  surgeons  call  exteriMon,  counter-extension^  and 
coaptation. 

Extension  means  taking  hold  of  the  limb  below  the  fracture  and 
pulling  Jrum  the  body. 

Counter-Extension  is  pulling  above  the  fracture  towards  the  body. 
These  op|>osite  puUings  are  done  at  the  same  time  to  overcome  the 
force  of  the  muscles,  which  contract,  and  draw  the  ends  of  the  bone 
by  each  other  and  shorten  the  limb. 

Sometimes  no  extension  or  counter-extension  is  necessary,  the  ends 
of  the  broken  bone  not  being  pulled  out  of  their  place.  Wher.  the 
pulling  is  necessary,  it  should  be  gentle  and  steady.     (See  p.  877.) 

Coiiptatiou  means  adjusting  the  ends  of  the  bone  to  each  other. 

The  next  thing  is  to  provide  for  keeping  the  ends  of  the  broken 
bone  steadily  in  contact,  so  that  nature  may  have  a  fair  chance  to 
unite  them. 

To  secure  this  object,  mechanical  contrivances  are  used,  which  are 
simple,  and  may  always  be  had  without  difficulty. 

They  consist  of  linen  bandages,  about  the  breadth  of  four  fingers, 
and  "from  four  to  ten  yards  long ;  and  pads.,  made  of  old  woollen  cloth 
or  blankets  lightly  quilted  together,  or  pillow-cases  filled  with  tow,  or 
crhaft",  or  cut  straw,  or  even  leaves  ;  and  of  splints,  made  of  clapboards, 


n- 


sort  (Fig. 
lered  with 


JK'ss,  and 

e  hold  of 

they  can 

polfs,  two 

ht  angles, 

those  an 

be  easily 

upon  four 

)se. 

the  sound 
2ach  other 
I  lie  broken 
otion.  In 
he  natural 
their  ends 


ling  to  be 
oken  bone 
il  position. 
'.nsion,  and 


icture  and 

the  body. 
3 room e  the 
'  the  bone 

Y,  the  ends 
Whei:  the 
[).  877.) 

other. 

he  broken 

chance  to 

which  are 

ur  fingers, 
ollen  cloth 
th  tow,  or 
tapboards, 


8UKOICAL    DISEASES. 


445 


or  thick  BJiinglcs,  four  fingers  wide,  and  in  length  con-esponding  with 
thiit  of  tlie  broken  limb  ;  or  wheiit  straw  hiid  side  by  side,  and  quilted 
into  ii  piece  of  cioth  to  prevent  them  moving  about.  A  very  useful 
f«pliMt  may  bo  made  from  the  fresh  bark  of  trees. 

The  pads  are  to  l)o  placed  tinder  the  splints,  to  prevent  injuries  to 
the  skin  ;  and  the  bandages  to  bo  bound  ovir  the  whole.   (Seo  p.  878. ) 

Yor  some  hours  after  a  liml>  is  broken,  the  parts  continue  to  swell  ;• 
and  if  bound  up  immedialeli/  with  the  pads,  splints,  etc.,  much  need- 
less pain  will  be  occasioned.  It  is  best,  therefore,  not  to  put  these  on 
under  two  or  three  days,  l)nt  merely  to  lay  the  limb  in  a  natural 
-nossition,  and  perhaps  lightly  bind  one  spl'iit  to  it.  Broken  ribs  and 
iollar  bones  are  exceptions,  and  should  bo  bound  up  immediately. 

A  broken  arm  lies  easiest  half  bent,  upon  a  pillow ;  the  thigh  or 
leg,  upon  the  outside,  M'ith  the  knee  bent. 

When  the  apparatus  is  onco  adjusted,  the  loss  it  is  meddled  with 
the  better. 

In  fractures  of  the  shoulder  or  arm,  a  sling  is  a  contrivance  of  great 
importance.  This,  if  well  made  and  adjusted,  keeps  the  broken  bone 
in  its  place,  and  at  the  same  time,  allows  tho  patient  to  take  some 
exercise  by  walking  about.  _ 


FlO.  149. 


Beside  the  above  contrivances,  there  is  the  double  inclined  plane 
^Fig.  149)  for  giving  the  leg  the  advantage  of  a  bent  position.   There 


Fia.  150. 


dXQtA&o  fracture-boxes  (Fig.  150),  on^  fracture-cradles, — tho  latter  to 
keep  the  bed-clothea  lifted  away  from  the  painful  limb.     Fracture^ 


/ 


f;; 


446 


SURGICAL  DISEASKS. 


beds  are  now  brought  to  great  perfection,  and  one  tihould,  if  possible, 
be  procured  when  the  patient  is  likely  to  be  confined  a  long  time 
with  a  compound  fracture.  The  fracture-box,  represented  by  Fig. 
150,  may  be  made  from  thin  boards,  by  any  carpenter.  It  has  a 
hinge  at  the  knee  to  enable  it  to  fulfil  the  double  purpose  of  a  double- 
inclined  plane  and  a  fracture-box.  ^ 

The  Way  in  which  Broken  Bones  Unite. 

The  union  of  broken  bones  is  much  slower  than  that  of  severed 
flesh.  The  ends  of  the  bone  being  kept  steadily  together,  tliey  soon 
become  surrounded  by  a  swelling  of  the  soft  parts,  which  change  to 
a  sort  of  osseous  substanc",  making  a  kind  of  bony  hoop,  to  act  as  a 
splint  or  support, —  nature  not  being  willing  to  trust  the  surgeon  to 
keep  the  fragments  axactly  in  their  place.  This  is  called  a  provis- 
ional callus,  because  it  only  has  a  temporary  use. 

This  First  Htage  lasts  about  ten  days.  At  the  end  of  this  time,  a 
spongy  substance  appears  between  the  ends  of  the  bone.  This  sub- 
stance is  not  bone,  but  in  tiie  swelling  around  the  fracture  specks  of 
bone  begin  to  be  deposited;  the  fibrine  hei„  poured  out  becoming 
first  cartilage,  and  then  receiving  into  itself  phosphate  of  lime,  it  be- 
comes bone.  A  similar  work  is  going  on  within,  in  the  part  called 
the  medullary  membrane. 

Tills  8ec(md  Stage  lasts  from  the  tenth  to  the  twenty-fifth  day. 

Then  Beg^lns  the  Third  Stuge,  which  goes  to  the  end  of  the  sixth 
or  eighth  week.  During  this  period,  the  external  swelling,  and  the 
internal  medullary  membrane,  become  completely  ossified  and  firm ; 
though  the  ends  of  the  bone  are  not  yet  grown  together. 

The  Fourth  Stagie  goes  to  the  end  of  the  fifth  or  sixth  month. 
During  this  time,  the  external  swelling,  or  provisional  callus,  becomes 
covered  with  a  periosteum,  and  the  ends  of  the  bones  themselves  are 
fastened  together  by  a  bony  union. 

The  Fifth  Stage  extends  from  the  fifth  or  sixth  to  the  twelfth 
month.  During  this  time,  the  ends  of  the  bone  become  grown  to- 
gether so  strongly  that  the  bony  ring,  or  provisional  callus,  is  no 
longer  wanted,  and  it  becomes  absorbed,  and  disappears,  —  in  other 
words,  having  no  further  use  for  it,  nature  takes  off  her  splint.  The 
place  where  the  fracture  was,  is  now  as  strong  as  any  other  part. 

Union  in  Compound  Fractures. 

The  union  of  compound  fractures  takes  place  in  a  different  way 
from  that  of  the  simple  fracture,  just  described.  In  this  case  there  is 
supjjuration,  and  the  bones  remain  disunited  several  weeks,  and  there 
is  no  provisional  callus  formed.  But  after  some  weeks,  the  ends  of 
the  bone  soften  and  granulate ;  and  when  the  production  of  pus  de- 
clines, these  granulations  are  gradually  changed  into  bone. 


|if  po88il)Ie, 

long  time 

2d  by  Fig. 

It  ha»  a 

^f  a  double- 


of  severed 

r,  they  soon 

change  to 

to  act  as  a 

surgeon  to 

ed  a  provis- 

this  time,  a 
This  sub- 
e  specks  of 
t  becoming 
lime,  it  be- 
3  part  called 

th  day. 

of  the  sixth 
iig,  and  the 
jd  and  firm ; 

lixth  month. 
Ivs,  becomes 
imselves  are 


the  twelfth 
I  grown  to- 
;allus,  is  no 
,  —  in  other 
splint.  The 
er  part. 


ifferent  way 
lase  there  is 
s,  and  there 
the  ends  of 
of  pus  de- 


=3e=» 


SURGICAL  DISEASES. 


44/ 


Time  Required  for  Uniting  Different  Bones. 

Fractures  of  the  arms  unite  sooner  than  those  of  the  legs. 

The  ribs  and  collar  bone  unite  with  tolerable  firmness  in  about  a 
month ;  those  of  the  arm  in  six  weeks ;  of  the  thigh  and  leg  in  eight 
weeks.     I  only  mean  the  firmness  derived  from  the  provisional  callus. 

A  broken  bone  will  unite  much  sooner  in  a  healthy  person  than  in 
an  unhealthy  one ;  much  sooner  in  a  young  than  in  an  old  person. 

As  a  general  rule,  the  apparatus  should  be  kept  on  thirty  days  in 
the  case  of  children ;  forty  days  in  that  of  adults ;  and  much  longer 
in  that  of  aged  persons. 

False  Joint. 

The  union  of  a  broken  bone  is  sometimes  prevented  by  a  frequent 
moving  of  the  limb.  The  ends  of  the  bone  having  failed  to  grow  to- 
tjcther,  will  sometimes  become  rounded  and  smoothed,  uniting  only 
by  a  kind  of  ligament,  and  acquire  the  habit  of  sliding  upon  each 
other,  and  thus  form  what  is  called  a.  false  or  artificial  joint,  —  tin- 
limb  being  permanently  capable  of  bending,  to  some  extent,  at  tin- 
olace  of  the  fracture. 

Fractures  of  the  Skull. 

Thksk  are  always  dangerous  in  their  nature,  and  the  aid  to  be 
derived  from  surgery  much  less  than  in  other  fractures.  If  a  fracture 
of  the  skull  produce  deep  sleep,  and  snoring,  and  the  patient  doen 
not  show  any  symptoms  of  pain  when  pinched,  etc.,  we  are  to  infer 
that  a  piece  of  bone  is  pressed  down  upon  or  into  the  h:i^^ 

In  this  case,  if  the  position  of  the  blow  be  known,  a  cut  is  to  be 
made  through  the  skin,  two  or  three  inches  long,  down  to  the  bone. 
If  arteries  bleed,  they  must  be  taken  hold  of  with  a  pair  of  forceps, 
and  tied  with  a  silk  thread,  the  ends  of  which  are  to  be  cut  off.  The 
bone  being  well  exposed  by  one  or  two  incisions,  the  piece  which  is 
pressed  down  upon  the  brain  is  to  be  raised  with  a  chisel,  or  some 
similar  instrument,  to  a  level  with  the  other  bones.  The  surface 
must  then  be  cleaned  with  a  sponge,  the  hair  around  shaved  off,  the 
skin  brought  together,  and  the  cut  edges  reunited  by  sticking  plaster. 

When  the  inflammation  appears,  twenty-four  hours  after,  it  is  to  be 
kept  down  by  doses  of  from  five  to  ten  drops  of  tincture  of  veratrum 
Tiiide,  given  every  one  or  two  hours. 

Fractures  of  the  Bones  of  the  Nose. 

Injuries  of  this  kind  may  generally  be  rectified  by  passing  a  strong 
probe  up  the  nostril,  and  pressing  out  the  bones  to  their  natural  place, 
at  the  same  time  using  the  fingers  on  the  outside  to  prevent  their 
being  pressed  out  too  far.  Inflammation  must  be  kept  down  bj 
cloths  wdt  in  cold  water  and  laid  on,  and  by  light  diet. 


448 


SURGICAL  DISEASES. 


i'^ 


r.. 


Fia.  m. 


'  Fracture  of  the  Lower  Jaw. 

This  usually  takes  place  near  the  chin.  It  may  occur  aUo  near  the 
angles  of  the  jaw.  It  may  be  simple  or  compound,  and  is  known  by 
the  pain,  the  swelling,  the  inability  to  move  the  jaw,  the  inth'iitation 
felt  by  the  finger,  the  irregularity  of  the  teeth,  and  the  grating  Hensa- 
tion  ^'It  while  moving  the  jaw  with  the  hand  placed  on  the  back 
fragment. 

Treatineiit. — Let  one  or  both  thumbs  be  introduced  into  the  mouth. 
With  these,  keep  the  back  part  of  the  jaw  stationary,  iuid  pull  for- 
ward the  fora  part  with  the  fingers  on  the 
outside.  In  this  wav  the  fracture  can 
sooa:  be  put  rififht.  iMiis  done,  shut  the 
mouth  Hrmly,  and  place  a  thici:  compress 
of  lint  o/Ci-  the  broken  part;  over  this  put 
a  piece  ol  pasteboard,  wetted  so  as  to 
bend  easily  to  tti«-'  parts,  SU^'l  over  this  a 
strong  banduge  oi"  muflin,  Iwc  and  a  half 
inches  wide,  with  a  small  ba^  t^fit  and 
hold  the  chin  ;  all  which  ia  represented  in 
Hg.  151. 

For  a  fortnight  the  patient  must  feed  on  gruel,  broth,  arrow-roof, 
and  milk,  that  the  jaw  may  not  be  displaced  by  chewing. 


Fracture  of  the  Collar  Bone,  or  Clavicle. 

Twrs  accident  generally  occurs  about  the  middle  of  the  bone,  and 
ia  geiio rally  caused  by  falls  on  the  arm  and  shoulder. 


Fio. 163. 


Kia.  168. 


'%. 


Syiiiptoiiis.  —  Pain  and  tenderness  at  the  place  of  the  injury,  and 
inability  to  lift  the  arm  ;  a  small  bunch  or  prominence  at  th«-point  of 


I 


^-■■' 


[ilrto  near  the 
is  known  by 
iii(l<Mitat.ion 
rating  HiMiHa- 
on  the  back 

lo  the  moutM. 
uid  pull  for* 

151. 


h,  arrow-roof, 

r 
I* 

ricle. 

the  bone,  and 


le  injury,  and 
t  th»-point  of 


r^ 


SURGICAL  PISKASES. 


44« 


thfi  fracture ;  the  diHtance  from  the  point  of  the  nhoiihler  to  the  breast- 
hone  shorter  than  on  the  other  f«i<h' ;  and  the  dropping  downwards, 
forwaidH,  and  ii, wards  of  the  Hhoulder.  To  make  th*5  cane  aure,  com- 
pare  the  two  bones,  and  see  whether  they  agree. 

Trcntmrnt. —  Place  the  knee  between  the  shoulder-blades,  and 
grasping  the  round  ends  of  the  shoulders  with  the  t\  hands,  dr  w 
them  gently  back  till  the  ends  of  the  bone  come  to  their  proper  place; 
or,  place  the  elbow  of  the  patient  close  to  the  body,  and  a  little  for- 
ward, and  then  push  it  upward. 

To  retain  the  shoulders  in  this  upward  and  backward  position  for 
HOinu  weeks,  pass  a  flannel  bandage,  four  inches  wide,  around  the 
front  of  one  shoulder,  under  the  arm-pit,  across  the  back,  over  the 
op|X)site  shoulder,  under  the  other  arm-pit,  and  again  across  the  back, 
in  the  form  of  the  figure  oo.  To  prevent  the  bandage  from  cutting 
the  akin,  put  pads  under  the  arms.     (Figs.  152  and  153.) 


Fracture  of  the  Shouldei-Blade. 

When  this  accident  happens,  the  body  of  the  bone  is  generally 
broken  across  by  some  great  direct  violence.  In  a  few  instances,  the 
end  next  to  the  collar-bone  is  broken. 

Nymptoms.  —  Great  pain  in  moving  the  shoulder,  and  the  grating" 
sensHtion  which  may  be  felt  by  placing  on  i  hand  on  the  upper  end 
•»f  the  bone,  and  moving  the  lower  portion  with  the  other. 

Treiitnient.  —  A  bandage  must  be  passed  round  the  chest,  and  a 
few  'rns  be  made  around  the  upper  arm,  so  as  to  fasten  it  to  the 
."idc,  and  prevent  all  motion.  Purging,  low  diet,  and  the  tincture  of 
vcratrum  viride  will  be  requiitd  to  keep  down  inflammation. 

Fracture  of  the  Acromion,  or  the  end  of  the  scapula  which  unites 
with  the  collar-bone,  may  be  known  by  the  flattening  of  the  shoulder, 
—  the  broken  part  being  drawn  down  by  the  action  oi  the  deltoid 

muscle. 

Treatment.  —  It  must  be  supported  by  the  same  bandages  as  are 
used  for  a  fracture  of  the  collar-bone ;  and  the  elbow  must  be  well 
raised,  so  that  the  head  of  the  upper-arm  bone  may  be  lifted  against 
<hc  upper  portion  of  the  scapula,  and  act  as  a  prop  to  keep  it  in  place. 
No  pad  should  be  put  in  the  arm-pit,  for  this  would  push  the  broken- 
nart  too  much  outwfird. 

Fracture  of  the  Upper-Arm  Sone. 

The  bone  of  the  upper-arm  is  most  frequently  broken  near  the 
centre,  though  it  may  be  fractured  near  the  ends.  It  may  be  known 
by  taking  hold  of  the  arm  abov3  and  below  the  suspected  fractuve, 
and  attempting  to  move  the  ends  of  the  upper  p.nd  lower  fragments 
U]X)n  each  other.  If  there  be  a  fracture,  the  grating  of  the  br  >ken 
ends  .against  each  other  will  either  Le  heard  or  felt     The  r'-r,  will 

57 


I  i    ' 


if':|' 


|fi# 


mp-" 


4/50 


SURGICAL  DISEASES. 


Fia.lfii. 


also  be  bent  and  helpless :  and  if  the  ends  of  the  bone  be  slipped  by 
each  other,  it  will  be  shortened. 

Treatment.  —  Let  a  powerful  man  take  hold  of  the  arm  and  pull 
gently  and  gradually;  but  with  considerable  force,  till  the  arm  is 
brought  to  its  natural  length,  —  another  man  taking  hold  of  the  body 
of  the  patient,  and  pulling  in  an  opposite  direction.  In  the  mean 
time,  the  surgeon  is  to  adjust  the  ends  of  the  bone  to  each  other, 
and  apply  a  bandage,  but  not  very  tightly,  from  the  elbow  to  the 
shoulder,  and  over  this,  four  splints,  with  pads  under  them ;  one  in 
front,  reaching  from  the  shoulder  to  the  bend  of 
the  elbow,  with  a  few  turns  of  the  bandage  over 
it ;  another  behind,  reaching  from  the  shoulder 
to  the  point  of  the  elbow,  with  a  few  turns  of  the 
bandage  around  it,  also ;  another  on  the  inside, 
extending  from  the  arm-pit  to  the  inner  projection 
of  the  bene  at  the  elbow,  also  secured  by  a  few 
turns  of  the  bandage ;  and  the  fourth  one  on  the 
outside,  reaching  from  the  shoulder  to  the  outside 
knob  at  the  elbow.  The  whole  is  now  to  be  se- 
cured either  by  a  bandage  or  tape.  (Fig.  154.) 
The  arm  is  to  be  confined  to  the  side,  and  the  hand  and  fore-arm 
placed  in  a  sling.  In  from  seven  to  ten  days,  the  dressing  should  be 
taken  off  to  see  if  all  is  right. 

Fracture  of  the  Elbow. 

This  may  be  known  by  the  pa+'ent  being  able  to  bend  the  arm,  but 
not  straighten  it,  and  by  the  grating  which  may  be  heard  or  felt  when 
the  arm  is  moved  back  and  forth  by  the  operator,  and  also  by  the 
severe  pain  felt  in  the  fractured  part 

Treatment.  —  First  apply  leeches  and  evaporating  lotions  to  reduce 
the  inflammation.  When  this  is  effected,  straighten  the  limb,  and  ap- 
ply a  bandage  snugly  from  the  fingers  to  the  elbow.  The  broken 
end  of  the  bone  must  now  be  brought  to  its  place,  and  the  bandage 
continued  over  it,  and  for  a  few  inches  above  it.  Secure  it  here,  and 
bring  it  back,  —  carrying  it  above  and  below  the  elbow  for  several 
times  ;  and  thin  extend  it  up  to  the  shoulder.  A  splint  must  now  be 
applied  to  the  inner  side  of  the  arm  to  prevent  its  being  bent,  —  ex- 
tending from  the  hand  nearly  to  the  shoulder,  and  another,  of  similar 
•hape,  to  the  outside.  The  joint  should  be  kept  quiet  for  four  or  five 
weeks,  —  during  which  time,  the  splints  may  be  taken  off  three  or 
four  times,  to  see  if  there  is  any  chafing  of  the  skin,  or  any  disturb- 
ance of  the  bones. 


Fractures  Between  the  Elbow  and  Wrist. 

The  part  of  the  arm  between  the  elbov/  and  wrist,  called  the  forO' 
arm,  has  two  bones,  —  one  extending  from  the  elbow  on  the  inside  to 
U^  wrist  at  the  root  of  the  little  finger,  called  the  ulna,  and  the  other. 


SURGICAL  DISEASES. 


451 


slipped  by 

rm  and  pull 
the  arm  is 
of  the  body 

11  the  mean 
each  other, 

jlbow  to  the 


Fie.lM 


Xji 


and  fore-arm 
ng  should  be 


d  the  arm,  but 
d  or  felt  when 
d  also  by  the 

ions  to  reduce 
limb,  and  ap- 
The  broken 
1  the  bandage 
e  it  here,  and 
>w  for  several 
;  must  now  be 
ig  bent,  —  ex- 
lier,  of  similar 
or  four  or  five 
1  off  three  or 
r  any  disturb- 


ITrist. 

died  the  fore- 
1  the  !  aside  to 
and  the  other, 


on  the  side  next  the  thumb,  a  shorter  and  a  f  mailer  bone,  and  called 
the  radius. 

When  both  these  bones  are  broken  at  the  same  time,  the  fracture 
may  be  easily  discovered  ;  when  only  one,  the  sound  bone  keeps  the 
other  in  place,  and  the  Injury  is  not  so  easily  made  out. 

Treatment.  —  Relax  the  muscles  by  bending  the  elbow,  and  then, 
by  extension  and  counter-extension,  put  the  ends  of  the  bones  in 
proper  place,  and  then  place  two  splints  thickly  padded  in  the  centre, 
one  upon  the  front  of  the  hand  and  fore-arm,  and  the  other  upon  the 
back  of  the  hand  and  fore-arm,  —  the  palm  of  the  hand  being  turned, 
not  towards  the  chest,  but  downwards.  They  are  to  be  covered  with 
a  bandage  from  the  fingers  to  the  elbow.  The  whole  arm  and  hand 
should  be  placed  in  a  sling,  and  remain  in  this  position  four  or  five 
weeks. 

Fractures  of  the  Wrist,  Hands,  and  Fingers. 

The  setting  of  fractured  bones  in  these  parts  is  to  be  done  by  ex- 
tension and  counter-extension,  as  in  the  case  of  other  bones. 

If  the  wrist  be  broken,  a  splint  should  be  applied  in  front  and  one 
behind,  and  a  bandage  bound  tightly  from  the  hand  half  way  to  the 
elbow. 

In  fracture  of  the  bones  of  the  hand,  a  pad  or  compress  must  be 
put  upon  the  palm  of  the  hand,  and  a  splint  placed  over  this,  with 
a  bandage  extending  from  the  wrist  to  near  the  ends  of  the  fin- 
gers. 

If  one  finger  only  be  broken,  apply  narrow  paste-board  splints  on 
four  sides,  and  cover  them  with  a  narrow  bandage ;  and  then  bandage 
the  whole  hand. 

In  all  these  fractures,  place  the  hand  in  a  sling.  About  three  weeks 
will  be  required  for  the  bones  to  unite  properly,  and  several  weeks  for 
the  parts  to  acquire  their  natural  usefuln.3S. 

Fracture  of  the  Ribs. 

This  accident  occurs  either  by  blows,  or  by  being  crushed  between 
two  opposing  forces.  One,  two,  or  more  ribs  may  be  broken  at  a 
time,  according  to  circumstances. 

Symptoms.  —  A  fixed,  piercing  pain,  made  worse  by  breathing, 
coughing,  or  any  other  motion,  and  also  a  grating  sensation  during 
the  taking  of  a  long  breath,  the  hand  being  laid  upon  the  injured  part 
at  the  time. 

Treatment. —  The  ribs  are  to  be  held  steadily  in  their  place  by  pres- 
sure. To  effect  this,  request  the  patient  to  draw  in  a  long  breath, 
and  hold  it.  While  the  ribs  are  swelled  out  ia  this  way,  and  the 
broken  ends  are  thus  brought  to  their  proper  place,  pass  a  woollen 
bandage,  five"  or  six  inches  wide,  several  times  tightly  around  the 
chest,  from  the  arm-pits  to  the  pit  of  the  stomach.     This  will  confine 


.'..t 


tlie  muscles  of  the  chest,  and  the  breathing  will  have  to  be  done  with 
the  muscles  of  the  belly,  and  the  ribs  will  thus  be  kept  still,  and 
have  a  chance  to  grow  together. 

If  the  pleura  be  wounded,  and  inflammation  follow  from  this  or 
other  cause,  the  patient  must  be  confined  in  bed,  kept  on  a  low  diet, 
and  his  pulse  be  kept  down  by  tincture  of  veratrum  viride.  The 
bowels  should  be  emptied  by  recipes  18,  or  20,  or  27,  or  41,  both  to 
subdue  inflammation,  and  to  give  the  diaphragm  a  chance  to  drop 
down  freely. 

Fracture  of  the  Breast-Bone. 

Symptoms.  —  The  injured  part  is  frequently  either  sunk  down  or 
rais«;d  up ;  there  is  difficult  breathing,  cough,  spitting  of  blood,  pain, 
inability  to  lie  on  the  back,  and  a  grating  noise  caused  by  breathing. 

Treatment. — The  same  as  that  for  broken  ribs.  Should  the  broken 
part  be  pressed  down  upon  the  lung,  so  as  to  cause  serious  difficulty 
of  breathing,  an  incision  may  be  made,  and  the  broken  piece  raised 
up  with  a  chisel,  or  stiff  case  knife,  or  some  similar  instrument. 

Fracture  of  the  Haunch  Bones,  or  Pelvis. 

These  fractures  are  dangerous,  —  being  often  connected  with  some 
other  injury,  as  tearing  of  the  bladder,  lower  bowel,  or  great  veins  or 
arteries.  Fortunately,  however,  they  are  only  caused  by  some  great 
violence,  and  do  not  often  occur. 

Treatment. —  Place  the  patient  in  the  easiest  possible  position,  and 
keep  him  entirely  at  rest.  Generally  a  catheter  should  be  kept  in  the 
bladder,  that  the  water  may  pass  off  easily ;  and  the  whole  hips 
should  be  bound  round  tightly  with  a  flannel  or  calico  bandage,  and 
made  as  firm  and  fixed  as  possible,  to  keep  the  broken  bones  together. 
The  most  perfect  rest  must  be  ordered  for  six  weeks  or  two  months. 

If  tlie  extreme  lower  end  of  the  sacrum,  the  os  coccygis  (Figs.  8 — 3) 
be  broken,  the  separated  portion  must  be  put  in  its  place  by  introduc- 
ing the  finger  into  the  rectum  ;  and  the  bowels  must  be  kept  loose  by 
g(MitIc  physic,  that  the  broken  bone  may  not  be  pushed  from  its  place 
by  the  pressure  against  it  of  hard  stools. 

Fracture  of  the  Thigh-Bone. 

The  points  where  this  bone  are  broken  are  at  its  upper  portion  or 
neck,  and  near  its  middle.  The  break  at  this  latter  place  may  be 
straight  across,  or  oblique,  —  partially  lengthwise.  When  oblique,  the 
point  of  the  bone  may  stick  into  one  of  the  large  muscles,  and  be 
made  fast  by  it.  ''  . 

Symptoms.  —  The  fracture  in  the  middle  of  the  bone,  if  it  be  trans- 
verse, may  be  known  by  some  swelling  or  irregularity-discovered  by 
running  the  hand  along  the  thigh,  and  grasping  it  here  and  there; 


)e  done  with 
|ept  still,  and 

from  this  or 
)n  a  low  diet, 

I  viride.  The 
)r  41,  both  to 

[ance  to  drop 


unk  down  or 
f  blood,  pain, 
>y  breathing. 

lid  the  broken 
ious  difficulty 
:n  piece  raised 
rument. 

elyis. 

:ted  with  some 

great  veins  or 

by  some  great 

3  position,  and 
be  kept  in  the 
lie  whole  hips 
)  bandage,  and 
jones  together, 
two  months. 
!s  (Figs.  8  —  3) 
36  by  introduc- 
!  kept  loose  by 
from  its  place 


per  portion  or 
place  may  be 
en  oblique,  the 
.uscles,  and  be 


I  if  it  be  trans, 
■discovered  by 
ire  and  there; 


SURGICAL  DISEASES. 


453 


and  if  it  be  oblique,  the  ends  of  the  bone  will  be  drawn  by  each 
other,  and  the  limb  will  be  shortened. 

Treatment.  —  Place  the  patient  on  his  back,  and  let  two  strong  men 
use  extension,  —  one  taking  hold  near  the  hip,  and  the  other  grasping 
the  limb  at  the  knee  and  pulling  steadily  and  strongly  till  the  limb  is 
of  the  proper  length,  and  the  ends  of  the  bone  are  in  their  place.  The 
man  who  takes  hold  of  the  upper  end  of  the  limb  may  hold  it  more 
[irmly  and  with  less  fatigue  by  passing  a  folded  sheet  around  the  groin. 

The  extending  force  being  still  continued,  the  operator  is  now  to 
apply  the  splints,  which  are  to  be  four  in  number,  —  one  in  front, 
reaching  from  the  knee-pan  to  the  groin;  one  behind;  one  on  the 
in.side,  from  the  upper  part  of  the  thigh  to  the  inside  of  the  knee ; 
and  a  fourth  one,  about  four  inches  wide,  reaching  from  the  arm-pit 
to  a  distance  of  two  or  three  inches  beyond  the,  sole  of  the  foot. 
Cotton  must  be  placed  under  these  splints  to  prevent  their  injuring 
the  skin,  and  they  must  be  of  a  width  to  nearly,  but  not  quite,  touch 
each  other.  These  being  properly  adjusted,  and  the  extension  still 
continued  if  the  fracture  is  oblique,  the  bandage  is  now  to  be  firmly 
applied  from  the  foot  to  the  upper  part  of  the  thigh,  and  then  passed 
a  few  times  around  the  body.  This  fracture  is  sometimes  treated 
without  eplints,  as  represented  in  Fig.  155. 


Fio.  166. 


Fio  156 


Six  or  seven  weeks  will  be  required  <"  +he  bones  to  grow  together, 
during  which  time  the  patient  will  neeu  to  lie  upon  his  back.  But 
the  dressing  may  now  and  then  be  taken  off  and  put  on  again. 


§^' 


%. 


454 


SURGICAL  DISEASES. 


SotnetimcH  only  a  single  long  splint  is  used  ;  sometimes  no  splint; 
in  still  other  cases,  four  splints, — the  outside  one  being  short,  and  the 
limb  resting  on  n  double  inclined  plain. 

Fracture  at  the  Xeck  of  the  Bone.  —  When  the  bone  is  broken  at 
the  neck,  close  to  the  hip  joint,  the  injury  is  known  by  the  knee  and 
foot  turning  outtoard,  and  by  the  limb  being  an  inch  or  two  shorter 
than  the  other  (Fig.  156).  This  is  an  accident  to  which  old  persons 
are  particularly  liable.  When  the  bone  is  broken  here,  it  seldom 
grows  together  again.  The  union  which  is  formed  is  generally  by  a 
ligament. 

Treatment. —  This  requires  a  very  long  splint,  reaching  from  the 
armpit  to  beyond  the  sole  of  the  foot,  and  bound  firmly  with  a  band- 
age, as  in  fracture  in  the  middle  of  the  thii^h.  The  limb  should  be 
kept  extended,  and  the  injured  one  must  be  boimd  to  the  other  by  a 
bandage,  keeping  both  legs  straight  and  immovable.  A  broad  leather 
strap,  bound  firmly  round  the  hips  and  thighs,  will  be  serviceable. 

Two  or  three  months  will  be  required  for  *'z^  injury  to  become 
repaired,  so  that  the  limb  maiy  be  used.  The  patient  must  get  up 
cautiously,  and  be  careful  not  to  use  the  limb  much  so  long  as  pain 
is  produced.      (See  p.  877.) 

Fracture  of  the  Enee-Pan. 

The  knee-pan  (patella)  may  be  broken  up  and  down,  or  across;  — 
the  latt-er  fracture  is  the  more  common.  It  is  a  troublesome  fracture, 
antl  is  very  apt  to  leave  a  stiff  knee. 

Symptoms.  —  When  the  bone  is  broken  across,  the  patient  cannot 
stand  upon  the  limb ;  the  leg  may  be  flexed  or  crooked,  but  cannot 
be  straightened ;  the  upper  part  of  the  knee-pan  is  drawn  up  away 
from  the  lower  portion,  leaving  a  wide  gap,  into  which  the  fingers 
may  be  laid,  —  at  the  top  and  bottom  of  which  the  rough  edges  of 
the  movable  bones  may  be  felt 

Treatment.  —  First,  reduce  the  inflammation  by  tincture  of  arnica, 
leeches,  etc.  Then  straighten  the  limb,  and  put  a  well-padded  splint 
behind,  to  keep  the  knee  motionless;  place  the  patient's  body  in  a 
half-sitting  posture,  and  raise  the  foot  considerably  above  a  level. 
Put  a  bandage  over  the  splint,  beginning  half  way  up  the  thigh,  and 
extending  down  to  the  knee-pan,  and  being  made  very  tignt  just 
above  the  broken  bone,  so  that  it  cannot  easily  slip  under  it.  The 
broken  bones  must  now  be  brought  together,  and  the  bandage  be 
passed  below  and  again  above  the  knee  several  times  in  the  form  of 
a  figure  8,  to  keep  the  bones  from  parting. 

The  bandage,  generally,  may  not  be  removed  for  a  fortnight.  After 
this  period,  if  everything  has  gone  on  well,  the  limb  may  be  carefully 
bent  a  little  every  day,  to  avoid  a  stiff  knee. 


I 


ks  no  splint; 
Urt,  and  the 

lis  broken  at 
le  knee  and 

I  two  shorter 
old  persons 
it  seldom 

[nerally  by  a 

g  from  the 
ith  a  band- 
fa  should  be 
le  other  by  a 
)road  leather 
viceablc. 

to  become 
nust  get  up 
long  as  pain 


r 


)me  fracture, 

a.tient  cannot 
1,  but  cannot 
wn  up  away 
h  the  fingers 
igh  edges  of 

ire  of  arnica, 
padded  splint 
t's  body  in  a 
bove  a  level. 
\\e  thigh,  and 
ry  tight  just 
ider  it  The 
bandage  be 
1  the  form  of 

:night.  After 
f  be  carefully 


SURGICAL  DISEASES. 


4fio 


Fio.  167. 


L 


Fracture  of  the  Leg. 

The  leg  is  that  part  of  the  limb  between  the  knee  and  ankle.  It 
has  two  bones ;  the  smaller  on  the  out'»ide,  called  the  fibula ;  the 
largtT  on  the  inner  and  front  side,  called  the  tibia^  or  shin  bono. 

One  or  both  of  these  may  be  broken  at  the  same  time.  If  both 
are  broken,  it  is  impossible  to  walk  upon  the  limb  ;  there  is  a  change 
in  its  shape  ;  it  may  be  bent ;  and  the  grating  of  the  broken  ends  of 
bone  may  be  felt  or  heard. 

Treatment.  —  First,  adjust  the  bones  by  means  of  extension  and 
counter-extension,  as  in  other  fractures.     Then  apply  two  splints,  one 

on  the  outside  from  the  knee  to  the  sole 
of  the  foot ;  the  other  upon  the  inside. 
Over  these  a  bandage  is  to  be  firmly  ap- 
plied, reaching  from  the  toes  to  the  knee. 
The  leg  may  rest  upon  the  side  or  the 
back,  as  the  comfort  of  the  patient  may 
require.  Upon  the  side  is  generally  the 
easiest  position,  with  the  knee  a  little 
bent  (Fig.  157). 

The  dressing  rnay  be  removed  in  six  or 
seven  days,  to  see  that  the  bones  are  in  their  proper  place.  Five  or 
six  weeks  will  be  required  for  recovery  ;  and  at  the  end  of  this  time, 
the  dressing  may  be  laid  aside.  But  the  patient  must  use  his  leg 
very  gradually. 

One  of  the  simplest  methods  of  treating  a  fractured  leg  is  to  place 
it  in  a  fracture-box.  A  pillow  is  to  be  placed  in  this,  and  the  leg,  the 
bones  being  put  in  place,  is  to  be  placed  in  the  box,  and  the  foot  to 
be  secured  to  the  foot-board  by  a  bandage,  and  the  sides  of  the  Imjx, 
movable  upon  hinges,  are  to  be  brought  close  enough  to  the  limb  to 
keep  the  bones  in  place,  —  compresses,  etc.,  being  placed  around  the 
limb  as  required.  Bran  may  be  placed  in  the  box  in  place  of  a 
pillow. 

Fractures  of  the  Bones  of  the  Foot. 

These  are  to  be  treated  in  the  same  manner  with  fractures  of  the 
hand.  They  are  often  attended  with  much  other  mischief,  as  lacera- 
tion of  the  flesh,  ligaments,  etc  Hence,  cutting  off  the  foot,  or  a 
part  of  it,  is  often  necessary.  Paste-board  splints  are  frequently  used 
in  these  fractures.  If  matter  forms,  it  must  be  let  out  by  opening  the 
parts. 

Oompound  Fractures. 

"When,  in  connection  with  a  broken  bon^,  there  is  a  wound  of  ♦ne 
flesh,  which  leads  to,  and  communicates  with  the  space  between  the 
broken  endt)  of  the  bone,  the  whole  injury  is  called  a  compound  frac' 


M 


456 


SURGICAL  DISEASES. 


1^' . 


ture.  The  wound  in  the  flesh  may  be  caused  by  the  same  force 
which  breaks  the  bone,  as  a  bullet  from  a  gun,  or  a  cart-wheel,  or 
some  machinery  in  which  the  limb  is  entangled.  Quite  often  tlic 
flesh  wound  is  caused  by  one  of  the  ends  of  the  bone  being  forced 
through  the  flesh  and  skin. 

But,  however  caused,  a  compound  fracture  is  of  a  much  more 
serious  nature  than  a  tfiini)le  one  ;  and  it  is  partieulMiy  dangerouy 
when  a  joint  is  involved.  It  is  more  serious  abovj  the  knee  and 
elbow  than  below,  and  more  to  be  dreaded  in  the  lower  limbt'  "lan 
in  the  upper. 

Treatment.  —  An  attempt  should  generally  be  made  to  preserve 
the  limb ;  it  should  not  be  cut  olF,  unless  the  compound  fracture  is  of 
the  worst  kind.  But  if  there  be  no  hope  of  saving  the  limb,  the 
amputation  should  be  performed  at  once,  while  the  constitution  is 
tranquil,  and  before  it  has  been  shocked  and  injured  by  the  sympa- 
thetic fever,  suppuration,  abscesses,  and  hectic,  which  are  almost  sure 
to  follow  such  grave  injuries. 

But,  suppose  it  be  determined  not  to  cut  the  limb  off",  —  as  it  gen- 
erally should  be,  —  the  first  thing  is,  after  the  bone  is  set,  to  close  the 
wound  against  all  entrance  of  air,  and  to  cause  it  to  heal  by  the  first 
intention,  that  is,  without  suppuration.  To  do  this,  one  method  is  to 
cover  the  wound  with  lint  dipped  in  blood  ;  but  the  more  usual  mode 
is,  to  bring  the  sides  of  the  wound  together,  and  secure  them  very 
carefullj'  by  strips  of  adhesive  plaster,  in  the  same  way  as  in  ooinmon 
cuts.  The  bandage  should  be  kept  wet  with  cold  water,  by  squeez- 
ing a  sponge  over  it,  or  by  sprinkling  cold  water  upon  it  as  fast  as  it 
becomes  dry. 

It  will  be  necessary,  in  this  case,  to  keep  the  bed-clothes  away  from 
the  limb  while  it  is  thus  wet,  which  may  be  done  by  cutting  a  barrel 
hoop  in  two,  and  nailing  it  to  two  pieces  of  lath.  There  should  be 
air  circulating  under  the  sheet,  that  the  heat  of  the  inflammation  may 
not  keep  the  limb  in  a  steam-bath. 

Should  the  wound  heal  by  the  first  intention,  the  danger  will  soon 
be  over,  and  the  treatment  may  be  the  same  as  for  simple  fracture. 
But  this,  unfortunately,  does  not  often  occur. 

It  more  often  happens,  that  after  three  or  four  days,  the  patient 
grows  restless,  has  very  short  and  disturbed  sleep,  is  hot  and  thirsty, 
has  headache  and  shivering  fits,  is  more  ill  towards  evening,  wanders 
in  his  mind,  or  becomes  delirious,  and  perhaps  dies  in  ten  days  or  a 
fortnight  from  these  constitutional  disturbances.  If  the  symptoms 
are  a  little  less  severe,  the  wound  will  at  first  discharge  a  small  quan- 
tity of  dirty,  bloody  matter,  which,  if  everything  goes  well,  will,  by 
degrees,  change  to  healthy  matter,  without  smell,  of  a  straw  color, 
and  about  as  thick  as  cream. 

The  fever,  and  other  bad  symptoms,  will  now  subside ;  the  sleep 
and  appetite  come  back,  and  a  new  process  begins,  that  of  healing  by 
granulaiion,  or  the  formation  of  new  flesh  to  fill  up  the  gap  made  by 
the  wound. 

For  old  persons,  or  those  whose  health  has  been  broken,  this  stag^ 


samo   force 

rt-wheol,  or 

fe  often  the 

being  forci^d 

ranch  men; 
y  daiigerou." 
le  knte  and 
r  limbi'  "laii 


to  preserve 
racture  is  of 
le  limb,  the 
nstitution  ia 
y  the  sympa- 
almost  sure 

—  as  it  gen- 
,  to  close  the 
I  by  the  first 
method  is  to 
r  usual  mode 
e  them  very 
s  in  corntnon 
;r,  by  squeez- 
as  fast  as  it 

js  away  front 
tting  a  barrel 
re  bh  )uld  be 
imation  may 

gor  will  soon 
iple  fracture. 

,  the  patient 
and  thirsty, 
ing,  wanders 
en  days  or  a 
le  symptoms 
.  small  quan- 
well,  will,  by 
straw  color, 

le ;  the  sleep 
if  healing  by 
gap  made  by 

m,  this  stag* 


SURGICAL  DISEASK8. 


457 


is  full  of  danger,  and  ia  apt  to  result  in  death,  if  the  lower  limb  be 
the  injured  part. 

If  the  constitution  proves  unable  to  bear  up  against  this  stage  of 
the  injury,  alternate  heat  and  sweating  set  in,  the  face  is  (lushed  with 
a  pink  color,  the  pulse  becomes  weak  and  (|uick,  the  body  wastes,  the 
appetite  disappears,  the  tongue  becomes  dry  and  brown,  restlessness, 
wandering,  and  delirium,  follow  in  quick  succession,  and  all  are 
•peedily  terminated  by  death.  With  the  seating  in  of  these  symp- 
toms, the  wound  stops  discharging,  or  throws  out  only  a  thin,  watery 
and  stinking  matter.  Quite  often  the  skin  and  other  parts  mortify, 
and  if  there  be  strength  enough  to  throw  oil'  the  dead  parts,  the 
broken  ends  of  the  bone  stick  out,  looking  dead  and  white. 

When  the  constitutional  symptoms  begin,  apply  poultices,  to  set 
up,  if  possible,  the  formation  of  good  matter ;  for  if  this  can  be 
brought  about,  the  symptoms  may  be  regarded  as  favorable.  The 
poultice  must  be  continued  till  the  wound  is  tilled  with  new  flesh 
nearly  to  the  surface. 

In  the  First  Stai^e,  the  medical  treatment  must  have  reference  to 
checking  the  inflammatory  condition.  This  may  be  done  by  full 
doses  of  tincture  of  veratrum  viride.  Should  the  symptoms  take  a 
typhoid  type,  and  the  powers  of  life  seem  to  sink,  then  quinine,  and 
iron,  and  bitters  will  be  needed. 

In  the  Second  Stiig;e,  whatever  inflammation  there  is  depends  on 
exhaustion,  and  everything  fitted  to  prop  and  fortify  the  constitution, 
as  brandy,  wine,  broth,  and  easily  digested,  nourishing  food,  must  be 
freely  given. 

Dislocations.— Luxations. 

The  surfaces  where  two  bones  meet  and  glide  upon  each  other  for 
the  purposes  of  a  joint,  are  called  articular  surfaces,  and  the  union  is 
said  to  be  an  articulation.  These  surfaces  are  covered  bv  a  smooth 
cartilage,  to  render  their  play  upon  each  other  easy. 

The  joints  are  held  together  by  cartilaginous  straps  and  ligaments, 
which  serve  as  puUies ;  by  the  aid  of  these,  the  joints  turn  back  and 
forth,  as  a  door  opens  and  shuts  upon  its  hinges. 

When  by  some  external  violence,  or  th  3  weakening  of  these  liga- 
ments, these  surfaces  are  suddenly  separated,  or  forced  apart,  there  is 
said  to  be  dislocation  or  luxation. 

Joints  are  divided  into  two  kind^,  the  ball  and  socket  (orbicular) 
which  has  a  rotatory  motion,  as  the  shoulder,  hip,  thumb,  —  and  the 
angular,  or  pump-handle  (ginglymoid),  as  the  elbow  and  knee. 

The  ball  and  socket  joints  have  a  greater  diversity  of  motion,  and 
are  more  exposed  to  dislocation.  They  are  likewise  more  easily  put 
in  their  place. 

In  a  Primary  Dislocation,  the  bone  is  thrown  at  once  into  the  place 
where  the  surgeon  finds  it. 

The  Secondary  Dislocation  is  one  in  which  the  muscles  pull  the 


Wm 

pjir 


head  of  the  bone  etill  further  from  iti)  natural  place  than  it  was 
thrown  by  the  first  nhock  of  violence. 

A  Dislocation  is  Simple  when  there  ia  no  wound  penetrating  the 
nynovial  membrane. 

It  is  Compoand  when  attended  by  such  a  wound. 

A  Dislocatiou  is  Complete  when  the  articular  surfaces  are  entirely 
separated. 

It  is  Incomplete  when  the  separation  is  only  partial. 

Recent  Dislocations  are  rectified  with  comparative  ease. 

01(1  Dislocations  are  hard  to  be  repaired,  and  sometimes  cannot  be 
reduced  at  all. 

The  Symptoms  of  Dislocation  are,  inability  to  use  the  joint;  the 
head  of  the  bone  being  felt  in  an  unnatural  place ;  the  limb  shortened, 
lengthened,  or  distorted  ;  a  change  in  the  shape  of  the  joint,  etc. 

Simple  dislocations  are  generally  trivial.  Compound  dislocations 
often  render  amputation  necessary,  and  are  always  perilous. 

Aged  persons  are  less  liable  to  dislocations  than  the  young. 

When  a  dislocation  and  a  fracture  occur  at  the  same  time,  the  dis- 
location is  to  receive  attention  first. 

A  dislocation  is  to  be  reduced  by  a  gradual  and  continuous  extend- 
ing force.  The  reduction  is  known  by  the  Jimb  recovering  its  natural 
length,  shape  and  direction,  and  by  its  being  able  to  perform  certain 
motions  which  are  not  possible  while  in  a  dislocated  state.  The  pain 
is  immediately  reduced  upon  reduction  taking  place.  In  shoulder 
and  hip  dislocations,  the  head  of  the  bone  makes  a  loud  noise  when 
it  slips  into  its  place. 


Dislocation  of  the  Lower  Jaw. 

Gaping  very  wide  is  the  usual  cause  of  this.  It  has  been  known 
to  result  from  a  mere  yawn.     One  or  both  sides  may  be  disjointed. 

Symptoms.  —  If  but  one  side  is  dislocated,  the  chin  is  twisted  to  one 
side,  and  immovable,  and  the  jaws  are  partially  open ;  if.  both  sides., 
ths  mouth  is  wide  open,  the  chin  projects,  there  is  a  hollow  in  froiit 
of  each  ear,  great  pain,  inability  to  speak,  and  dribbling  of  spittJe 
from  the  mouth. 

Treatment  —  To  efTect  a  reduction,  cover  the  thumbs  with  a  towel 
or  a  piece  of  wash-leather  to  prevent  their  being  injured  by  a  sudden 
snapping  together  of  the  jaws,  and  then,  standing  in  front  of  the 
patient,  introduce  them  into  the  mouth,  press  them  upon  the  crown 
.  of  the  back  lower  teeth,  at  the  same  time  lifting  the  rhin  with  the 
fingers. 

After  the  jaw  is  set,  it  should  be  kept  bandaged  for  a  few  days,  — 
the  bandage  being  merely  passed  once  or  twice  over  the  top  of  the 
bead,  and  under  the  chin.  No  solid  food  requiring  chewing  should 
*?«  taken  for  a  short  time. 


uAl. 


mi 


than  it  was 
mctratiiig  the 

3  are  entirely 


mea  cannot  be 

the  joint ;  the 

iinb  shortened, 

joint,  etc. 

lid  dislocations 

ilous. 

young. 

e  time,  the  dis- 

Uintiotis  extend- 
:ring  its  natural 
perform  certain 
tate.  The  pain 
p.  In  shoulder 
oud  noise  when 


r. 

las  been  known 
be  disjointed. 

8  twisted  to  one 
1 ;  if.  both  sides. 
I  hollow  in  front 
)bling  of  spittJe 


lbs  with  a  towel 
red  by  a  sudden 
in  front  of  the 
upon  the  crown 
le  r;hin  with  the 

)r  a  few  days,  — 

r  the  top  of  the 

chewing  should 


8UKGICAL  DISKASKS. 


459 


Dislooation  of  the  Collar-Bone. 

This  may  take  pliicd  by  the  end  attuc'ucd  to  the  bmist-bone  slip- 
ping over  or  viuler  that  bone,  or  by  ihe  other  end  slipping  above  oi 
below  the  bone  to  whi'li  it  's  attached.  When  ti»e  first  nanu'd  end 
of  the  bone  slips  over  \\w  I^i-eu-st-bone,  it  is  said  to  be  a  forward  d\a- 
Vocation  ;  when  it  slips  vruler  the  breast-bone,  it  is  bai-kvmrd.  In  this 
Jjitter  form  of  dislocation,  the  end  of  the  colhir-bone  sometimes  presses 
uiioii  the  gullet,  and  prevents  swallowing. 

S,VMipt«)iils. —  In  thtt  forvmrd  dislocation  of  the  inner  end  of  the 
bone,  a  bunch  may  be  felt  by  the  hand  at  the  top  of  the  breast-bone ; 
in  the  backward  dislocation,  a  depression  or  hollow.  The  vjnoard  dis- 
location of  the  (niter  end  of  the  collar-bone,  may  be  known  by  the 
flattened  and  sunken  condition  of  the  .shoulder. 

Treatment.  —  To  put  the  bone  in  ..a  place  in  the  first  of  these  ac- 
cidents, draw  the  shoulders  back,  by  which  means  the  collar-bone 
(clavicle)  is  drawn  away  from  the  breast  bone  (stc'rnum),  and  easily 
slips  into  its  place.  To  reduce  the  dislocation  at  tin  other  end  of  the 
bone,  place  th(!  ktiee  between  the  patient's  shoulder-blades  (scapulae), 
and  draw  his  shoulders  backwards  and  upwards.  After  the  reduction, 
support  the  arm  in  a  sling. 

Dislocation  of  the  Shoulder-Joint. 

Thk  head  of  the  long  bone  of  the  arm  (humerus)  may  be  displaced 
in  three  different  directions,  —  downward,  into  the  arm-pit  (axilla); 
forward,  under  the  muscles  of  the  breast;  and  backward,  upon  the 
back  of  the  shoulder-blade. 

Fio.  U8. 


It  is  recognized  by  the  shoulder  losing  its  roundness,  and  becoming 
flat;  by  the  lengthening  of  the  arm  ;  by  the  head  of  the  bone  being 
ielt  in  the  arm-pit ;  and  by  severe  pain. 


m 


M 


1         w 


-■^r^^ttj^yrf-fr- 


mX  iwi-.j^r-iaJifewKa-^-- 


460 


BUROICAL  DISEASES. 


To  effect  the  reduction  in  the  first  form  of  dirtplacement,  put  the 
patient  on  a  bed,  or  upon  the  floor.  Put  one  heel  in  the  ann-pit, 
ugainst  the  head  of  the  hone.  Then,  taking  hold  of  the  arm  above 
the  eibow,  or  at  the  wrist,  pull  steadily,  and  push  wk.h  the  heel. 
(Fig.  158.)  The  extension  may  be  more  '■♦eady  and  powerful  by  a 
double  towel  around  the  surgeon's  neck. 

If  the  reduction  cannot  be  etrected,  relax  the  muacles  by  a  warm 
bath,  or  by  nauseating  doses  of  tartar  emetic. 

After  the  reduction,  a  sling  will  be  reciuired,  and  three  weeks'  or  a 


month's  rest 

Dislocations  of  the  Elbow  Joint. 

Of  these  there  are  six  varieties.  In  the  first,  both  bones  of  the 
fore-arm  (radius  and  ulna)  are  thrown  backwards ;  in  the  second,  both 
are  drawn  backwards  and  invmrds ;  in  the  third,  both  are  thrown 
backwards  and  outwards ;  in  the  fourth,  the  ulna  alune  is  forced  back- 
wards ;  in  the  fifth,  the  radius  is  forced  forwards ;  and  in  the  sixth, 
the  radius  is  thrown  backwards. 

In  general,  these  dislocations  are  all  easily  set.  In  the  first  four, 
the  knee  is  to  be  placed  at  the  bend  of  the  elbow,  and  the  fore-arm 
bent  upon  it,  the  surgeon  grasping  the  upper  arm  with  one  hand, 
and  the  fore-arm  with  the  other.  In  the  dislocations  of  the  radius, 
the  upper  arm  is  to  be  put  in  a  fixed  condition,  while  the  surgeon 
takes  hold  of  the  hand  and  pulls,  at  the  same  time  throwing  the  bone 
forward.  If  the  luxation  be  backwards,  there  must  be  the  same  ex- 
tension and  counter-extension,  while  the  fore-arm  is  bent. 

Treatment. —  The  fore-arm  must  be  placed  in  a  half-bent  position, 
and  a  splint  should  be  bandaged  upon  the  front  of  the  whole  limb, 
compresses  being  placed  upon  the  head  of  the  bones  opposite  the 
direction  of  the  dislocation.  This  confinement  must  be  continued 
three  weeks.  .      '.>•.. 


Fia.  168. 


Dislocations  of  the  Wrist. 

These  are  caused  by  falls  upon  the  hand.     Both  the  radius  and 
ulna  may  be  thrown  backwards  ot  forwards  upon  the  wrist,  caus- 
/  f.„  iM  i"g  a  projection  either  n\ 

front  or  behind.  (Fiir. 
159.)  The  bones  are  tc 
be  set  by  pulling  in 
opposite  directions  upon 
the  hand  and  the  fore- 
arm, and  pressing  later- 
ally, if  the  displacement  be  at  the  side  of  the  wrist. 

Treatment.  —  Put  a  straight  splint  on  the  frpnt,  and  another  on  the 
back  of  the  fore-arm  and  hand,  with  compresses  on  both  sides  of  the 
wrist,  and  a  bandage  over  the  whole.  Support  the  fore-arm  in  a  sling, 
and  keep  down  innammation  by  cold  water,  cooling  lotions,  etc. 


*nr. 


nont,  put  the 

tlie  ann-pit, 

arm  above 

k.h   till'  hcfl. 

Dwcrful  by  a 

s  by  a  warm 

weoka'  or  a 


bones  of  the 

src'ond,  both 

are  thrown 

forced  back' 

I  in  the  sixth, 

the  first  four, 
J  the  fore-arm 
ith  one  hund, 
of  tlie  radiuH, 
3  the  surgeon 
wing  the  bone 
?  the  same  ex- 
it. 

-bent  position, 

e  whole  limb, 

3  opposite  the 

be  continued 


he  radius  and 
e  wrist,  eau;*- 
iction  either  in 
)ehind.  (Fiir. 
e  bon(;s  are  tc 
y  pulling  in 
irections  upon 
and  the  fore- 
pressing  later- 

nother  on  the 
;h  sides  of  the 
arm  in  a  sling, 
ions,  etc. 


SURGICAL  DISKASKS. 


46J 


Dislocations  of  the  Bones  of  the  Hand. 

SoMK  one  of  the  carpel  bones  may  be  pushed  ujv  out  of  its  placo, 
so  as  to  form  a  projection  on  the  back  of  the  hand.  To  put  it  in  its 
place,  press  upon  it  simply,  and  then  put  comprt'sses  on  the  front  and 
back,  with  straight  splints  upon  these  and  a  bandage  over  all.  Put 
the  hand  in  a  sling. 

Dislocations  of  the  finger  joints  may  generally  be  replaced  by  bend 
ing  the  displaced  phalanx  over  the  head  of  the  bone  from  which  it 
has  been  disjoined.  Sometimes  a  good  deal  of  extension  and  counter- 
extension  are  reipiired,  for  which  purpose  a  piece  of  cord  may  be 
wound  around  the  finger,  —  the  skui  being  protected  by  covering  it 
with  a  piece  of  wetted  buck-skin. 

( 

Dislocations  of  the  Hip-Joint. 

Thksk  arc  four  in  number,  —  vpurards,  d(rvnwar(ls,  backwards  and 
upwards,  fortrards  and  ujnoards. 

To  reduce  these,  a  greater  amount  of  power  is  needed  than  in  the 
dislocations  of  any  other  bone,  —  o\ri(ig  to  the  greater  power  of  the 
muscles  which  are  to  be  overcome. 


I) 


{ 


Fia.  160 


Tia- 181. 


DislocatKms  of  this  joint  are  often  confounded  with  fracture  of  the 
lead  and  ;*ack  of  the  thigh  bone.     Tlii ;  latter  may  be  distinguished 


462 


SURGICAL  DIAKAHKR. 


from  the  Inxntion  by  the  grating  Bound  to  be  heard,  by  th«  |>onflibility 
of  pnlling  the  limb  out  to  its  natural  length,  and  by  it»  being  short* 
ened  ii|>  ll^r!lin  by  the  action  of  the  muscles  the  moment  th's  pulling 
is  given  n|>. 

The  I'pwiinl  Iklslm'tltioil  of  the  head  of  tluB  bone  upon  the  back  of 
the  haunch  b«)ne,  Ih  known  by  the  shortenirtff  of  the  limb,  and  l)y  the 
knee  and  fool  (iirui/uj;-  inirard,  —  the  foot  hipping  over  llie  opposite 
f*H)t,  and  th(!  great  toe  resting  upon  the  other  intitep.     (Fig.  1(>0.) 

The  DlNlot'iitioii  Dowiiwurd  is  known  by  the  letifi'thn,  ff  of  the 
limb,  the  projeetion  of  the  knee,  the  turniiii!^  of  the  fend  aw'  *■«««  (mt- 
ward,  and  the  b<>ndiiig  of  the  body  forward.     (Fig-  101.) 

The  l>isl<M-tith>ii  IliirkwunI  and  lIpwHrd  is  dixtinguixhed  by  the 
inclining  of  the  foot  and  knee  inward,  the  drawing  up  of  the  heel, 
and  the  resting  of  the  great  tn«  again.4t  the  ball  of  the  great  toe  (»f 
the  other  foot.     (Fig.  162.) 


Fia.KB. 


ria. leu 


The  Dislocitioii  Upward  and  Forward  is  known  by  the  Bhortenini> 
of  the  limb,  and  the  tvrninf^  of  the  foot  and  knre  outward.  (Fig. 
1P3.) 

For  replacing  the  bone,  put  the  patient  upon  a  table,  on  his  back 
Draw  a  sheet  betwecii  his  thighs,  and,  extending  it  up  by  the  side  of 
Ida  broy,  let  it  be  fastened  to  a  staple.     Put  a  padded  belt,  with  ring* 


t'.  iMinnibility 
b«'iiig  Hlu»rt- 
th'!  pulling 


thf^  Imck  of 
and  l)y  the 
lie  o|)|KMita 
1(»0.) 

A*"  of  the 
hme  out- 


itr 


\vd  by  the 
of  the  heel, 
great  t<)e  <»f 


16  shortening, 
ward.     (Fig. 

on  hirt  back 
)V  the  side  of 
with  ring* 


I 


SURGICAL  DISEASES 


463 


attnched,  around  the  Injured  limb,  just  above  the  knee.  To  thosa 
ringM,  ftirtten  one  block  of  a  pulley,  and  attach  the  other  to  a  poi't, 
giving  the  pulley-rope  to  an  asHiptant.  The  riurgeon  now  standing 
on  the  injured  side,  directs  gradual  cxtcnHion  to  be  made,  while  he, 
by  hiH  hundH,  or  by  a  band  paHsing  around  the  injured  thigh  and  over 
hia  own  bhoulderH,  lifts  the  head  of  the  bone,  and  guides  it  into  its 
)ocket 

Treatment. —  Keep  the  patient  in  bed  for  two  weeks  or  more,  with 
his  knees  tied  together  by  a  strip  of  tnuslin,  and  a  brua*'  belt  aruuml 
his  hips. 

Dislocations  of  the  Enee-Pan  or  PateLa. 

This  bone  may  be  thrown  outward,  causing  a  great  projection  on 
the  outsidt!,  and  an  inability  to  bund  the  knee. 

It  may  be  thrown  invmrff,  causing  the  same  impossibility  to  bend 
the  knee,  and  a  projection  on  the  inside. 

To  restore  the  bone  to  its  place,  put  the  heel  of  the  patic.it  upotj 
the  shoulder  of  an  assistant ;  then  press  down  the  edge  of  the  knee- 
pun  which  is  farthest  from  the  centre  of  the  joint,  thus  tilting  up  the 
other  edge  of  the  bone,  when  the  muscles,  aided  by  a  lateral  pressure, 
will  draw  it  to  its  place.  ■    . 

Treutmeilt.  —  Put  a  straight  splint  upoa  the  back  of  the  limb,  ai\cl 
make  ni<Ml<!rate  pressure  upon  the  knee  by  a  bandage.  Cold  water, 
or  cooling  washes,  should  generally  be  a(:plied.  Keep  the  patient  in 
bed  two  weeks. 

Dislocations  of  the  Enee-Joint. 

There  are  four  of  these, — forward,  backward,  inward,  and  out- 
ward. 

They  are  readily  corrected  by  extension  and  counter-extension  from 
the  ankle  and  thigh,  and  pressure  upon  the  head  of  the  displaced 
bone. 

Treatment  much  the  same  as  for  displacement  of  the  knee-pan. 

Dislocations  of  the  Ankle. 

These  may  occur  in  a  forward,  backward,  outward,  and  iriward 
direction.     (Figs.  164  and  165.) 

To  rectify  it,  bend  tlie  limb,  so  as  to  relax  the  muscles  on  the  back 
of  the  leg;  then,  while  extension  and  c(  ter-extension  are  made 
upon  the  foot  and  thigh,  press  firmly  on  the  uislocated  bone,  and  thu» 
force  it  to  its  place. 

Treatment  —  Confine  the  foot  and  leg  in  splints  made  of  thick 

fjaste-board,  soaked  in  hot  water,  and  moulded  to  the  shape  of  the 
imb,  with  a  foot-piece  at  right  angles.     Keep  the  patient  in  bed  five 


i: 

J.    ■  If 


■I 


464 


SURGICAL  DISEASES. 


or  six  weeks,  and  when  he  begins  to  walk,  support  the  ankle  with  • 
roller  bandage,  or  a  laced  gaiter. 


Fis.lM. 


ris.ur.. 


Contusions. —Bruises. 

"When  any  blunt,  hard  substance  comes  in  violent  collision  with 
the  soft  parts  of  the  body,  without  breaking  the  skin,  the  injury 
received  is  called  a  bruise.  One  of  these  accidents  generally  rup- 
tures a  great  number  of  the  very  smallest  blood-vessels,  which  let 
out  blood  under  the  skin,  producing  " black  and  blue"  or  livid  spots 
(ecchymosis).     What fist-jfighters  call  a  black  eye  is  an  example. 

Trentment.  —  Cold  applications  at  first  to  prevent  the  blood  run- 
ning out  of  the  small  vessels  under  the  skin.  After  the  inflammation 
has  subsided,  stimulating  applications,  as  vinegar  and  water,  alcohol, 
camphorated  liniment,  ammonise  and  alcohol,  equal  parts,  and  some- 
times bandages. 

Sprains.  ' 

A  SPRAIN  is  a  forcible  wrenching  and  twisting  ot  a  joint  to  such  a 
degree  as  to  stretch  and  more  or  less  lacerate  the  ligaments  of  the 
part,  and  sometimes  to  break  a  tendon,  but  without  entirely  displac- 
ing a  bone.  Its  symptoms  are,  violent  pain,  swelling,  and  discolora- 
tion of  the  parts  from  the  blood  running  into  the  cells  under  the  skin. 
In  el  ''irly  persons,  the  effects  of  sprains  are  very  tedious,  disabling 
them  for  many  weeks,  or  even  months. 

Treatment.  —  Elevate  the  limb,  keep  the  joint  perfectly  quiet,  and 
apply  cold  lotions,  or  fomentations.     When  the  inflammation  is  all 


ankle  with  a 


collision  with 
in,  the  injury 
generally  rup- 
3els,  which  let 
'  or  livid  spots 
example. 

;he  blood  run- 
!  inflammation 
water,  alcohol, 
irts,  and  some- 


joint  to  such  a 
aments  of  the 
itirely  displac- 
and  discolora- 
inder  the  skin. 
LOUS,  disabling 


ctly  quiet,  and 
nmation  is  ali 


SURGICAL  DISEASES. 


465 


past,  spply  stimulating  liniments,  and  bandages,  or  shower  the  part 
with  cold  water. 

Ruptures  of  Tendons. 

These  accidents  are  known  by  a  sudden  snap,  followed  by  pain, 
loss  of  motion  in  the  part,  and  swelling  and  discoloration. 

Treatment. —  Place  the  part  in  such  a  position  as  to  relax  the  broken 
tendon,  the  ends  of  which  mast  ba  brought  together,  and  retained  in 
contact  till  they  grow  together. 

.    Diseases  of  the  Bones. 

The  bones  are  supplied  with  blood-vessels  and  nerves ;  and  as  they 
live  and  grow  like  other  parts  of  the  body,  so  they  become  diseased 
and  die  in  like  manner. 

'    Ulceration  of  Bones. — Caries. 

Bones,  like  the  soft  parts,  when  attacked  by  violent  inflammation, 
may  ulcerate,  discharge  matter,  and  heal  by  granulation ;  or,  having 
lost  a  portion  of  their  substance,  may  sink  under  entire  disorganiza- 
tion and  death.  This  disease  passes  in  some  parts  of  the  country, 
under  the  name  of  "  fever  sore." 

Treatment.  —  Apply  splints,  and  keep  the  part  in  a  state  of  abso- 
lute rest.  Subdue  the  local  inflammation  by  the  usual  means.  K 
the  diaease  arise  from  scrofula  or  syphilis,  use  the  remedies  for  those 
diseases. 

Death  of  the  Bones. — Necrosis. 

This  is  like  mortification  of  the  soft  parts.  It  occurs  from  injuries 
and  inflammation  of  the  periosteum. 

It  is  known  by  dull,  deep-seated — sometimes  acute — pain  ;  and  is 
followed  by  increase  of  size,  from  the  formation  of  new  bone  around 
the  old,  —  the  old  being  gradually  broken  into  pieees,  and  discharged 
through  external  openings. 

Treatment  —  Poultices  and  quieting  fomentations. 

Unnatural  Growth  of  Bones. — Exostosis. 

This  disease  consists  either  of  a  tumor  of  a  bony  nature,  growinff 
upon  and  arising  from  a  bone,  or  an  enlargement  of  a  bone.  It 
springs  from  the  periosteum,  or  from  the  surface  of  a  bone,  or  from 
its  spongy  texture.  The  enlargement  or  the  tumor  may  be  white 
and  hard,  like  ivory,  or  dark-colored  and  spongy,  or  a  mixture  of  the 
twa 

.19 


466 


SURGICAL  DISEASES. 


At  first,  a  tnmor  of  this  kind  ia  not  attended  with  pain  or  incon- 
venience.  It  comes  on  slowly,  and  sometimes  remains  nearly  sta- 
tionary for  several  years. 

Treatment,  —  If  the  tumor  be  large  and  inconvenient,  remove  it 
with  the  knife.  If  not,  use  local  pressure  with  pads  and  bandages; 
also  leech,  blister,  and  restrict  the  patient  to  a  spare  diet 

Diseases  of  the  Joints. 

SoMF,  of  these  diseases  begin  in  the  cartilages,  some  in  the  avnovial 
m    nbrane,  and  others  in  the  heads  of  the  bones. 

Disease  of  the  Hip-Joint. —  Coxalgia. 

Ttiis  generally  consists  in  inflammation  of  the  synovial  membrane 
and  capsular  ligament  of  the  hip-joint,  ending  frequently  in  ulceration 
and  destruction  of  the  head  and  neck  of  the  thigh  bone. 

The  symptoms  are  fulness  in  the  groin  ;  pain,  which  is  increased 
by  motion ;  aggravated  when  the  limb  hangs  without  touching  the 
ground;  is  more  felt  in  the  knee  than  in  the  hip  itself;  and  shoots 
down  along  the  inside  of  the  leg,  as  far  as  the  instep.  The  thigh 
inclines  forward,  and  the  limb  has  the  appearance  of  being  longer 
than  the  other,  —  though  in  the  latter  stages,  it  is  really  shorter. 

Treatment.  —  Before  suppuration  takes  place,  apply  leeches  and 
blisters,  and  enjoin  perfect  rest.  After  suppuration,  keep  the  patient 
upon  his  back,  on  a  mattress,  and  mould  to  the  parts  thick  paste- 
board splints,  with  pads,  and  give  tonics.  Keep  the  bowels  open  with 
renna  and  bicarbonate  of  potash,  and  rub  the  parts  with  iodide  of 
potassium  ointment,  or  with  preparations  (282)  (283)  (195).  The 
disease  being  scrofulous,  the  iodide  of  potassium  (140)  may  be  taken 
with  advantage  internally. 

White  Swelling. —Synovial  Degenerations. 

There  are  several  diseases  of  the  knee-joint,  characterized  by  swell- 
ing and  white  color  from  tension  of  the  skin,  which  have  passed 
under  the  common  name  of  white-swelling.  The  diseases  are  not 
strictly  the  same,  but  as  they  all  affect  the  knee,  and  have  symptoms 
to  some  extent  in  common,  it  is  well  enough  to  group  them  under 
the  same  title,  —  especially  as  one  treatment  is  adapted  to  all. 

One  is  a  pulpy  disease  of  the  synovial  membrane.  It  begins  with 
a  trifling  stiflhess,  and  a  slight  swelling.  The  swelling  increases  by 
degrees,  and  on  touching  the  part,  there  is  a  sensation  as  if  it  con- 
tained fluid.  By  and  by  the  cartilages  ulcerate.  The  disease  is  in- 
curable, as  the  synovial  membrane  is  finally  converted  into  a  pulpy 
substance,  and  the  limb  has  to  be  amputated. 

Another  of  these  is  inflammation  of  the  synovial  membrane,  be- 
ginning with  ulceration  of  the  cartilages.     It  begins  with  pain  in  the 


■ 


am  or  incon* 
8  nearly  sta- 

lit,  remove  it 
id  baiidagea ; 


1  the  svnoviai 


la. 

ial  membrane 
'  in  ulceration 

is  increased 

touching  the 

f ;  and  shoots 

).     The  thigh 

being  longer 

shorter. 

r  leeches  and 
^p  the  patient 
:3  thick  paste- 
vels  open  with 
vith  iodide  of 
)   (195).     The 

may  be  taken 


,tions. 

rized  by  swell- 
1  have  passed 
ieases  are  not 
ive  symptoms 
ip  them  under 
to  all. 

It  begins  with 
J  increases  by 
1  as  if  it  con- 
disease  is  in- 
1  into  a  pulpy 

nembrane,  be- 
th  pain  in  the 


SURGICAL  DISEASES. 


467 


joint,  which  is  severe  at  one  point,  and  attains  its  height  in  a  week. 
In  a  day  or  two,  the  joint  is  swollen  from  a  collection  of  water. 

Treatment.  —  Splints  and  entire  rest,  as  in  all  chronic  diseases  of 
the  joints.  Also  a  generous  diet,  and  whatever  is  calculated  to  build 
up  tlic  health. 

Bunions. 

This  is  an  inflammation,  enlargement,  and  hardening  on  the  inside 
of  the  ball  of  tiie  great  toe.  It  is  frequently  connoctcd  with  a  distor- 
tion of  the  toe,  wiiieh  scnis  partially  out  of  joint.  The  projection 
of  the  joint  exposes  it  to  great  irritation  from  the  shoe,  and  to  re- 
peated attacks  of  innammation.     It  occasions  great  suffering. 

Treiitinent,  —  Remove  the  pressure  from  the  part,  and  when  there 
is  intlunimation,  keep  the  foot  quiet  and  elevated  upon  a  chair,  apply- 
ing leeeiies,  poultices,  etc.  Another  method  is  to  cover  the  bunion 
with  soap  plaster,  spread  on  thick,  soft  leather,  or,  put  the  toe  in  a 
separate  apartment  of  the  stoc^king,  like  the  finger  of  a  glove.     Then 


Fio.  106. 


enclose  it  in  a  separate  part  of  the  shoe,  which  is  contrived  by  fixing 

a  piece  of  firm  sole-leather  in 
the  bottom  of  the  shoe,  so  as 
to  make  a  separate  compart- 
ment for  the  toe.  By  this 
means  the  pressure  against 
the  side  is  removed.  Stick 
ing  plaster  may  be  spread  on 

wash-leather,  and  a  piece  cut  out  the  size  of  the  bunion.     This  will 

take  off  a  portion  of  the  pressure  of  the  shoe,  and  will  hasten  the 

cure. 

Fig.  166  refwresents  a  ganglion  or  tumor  formed  upon  the  synovial 

sheath  of  the  tendon  which  bends  the  finger. 

Whitlow.— Felon. — ParonychL^. 

This  is  an  abscess  of  the  fingers,  of  which  there  are  three  kinds, — 
the  first  situated  upon  the  surface  of  the  skin,  the  second  nncVr  the 
skin,  the  third  within  the  sheath  which  contains  the  tendons  of  the 
fingers,  and  sometimes  involving  the  covering  of  the  bone. 

The  latter  form  of  the  disease  is  the  most  terrible,  and  begins  with 
redness,  swelling,  and  a  deep-seated  and  throbbing  pain,  which  grad- 
ually  becomes  so  excruciating  as  to  banish  all  sleep,  and  nearly  drive 
the  patient  to  distraction.  Finally,  matter  forms  and  burrows  in  the 
deeper  parts  of  the  finger,  and  at  length  finds  an  opening,  which 
brings  relief. 

Treatment.  —  Carry  the  hand  in  a  sling ;  apply  a  leech  or  two,  and 
use  poultices.  A  poultice  made  of  equal  parts  of  powdered  slippery- 
elm  bark,  poke  root,  ground  flax-seed  and  lobelia  seeds,  mixed  with 
hot  ley,  and  changed  twice  a  day,  is  an  admirable  application. 


■■■'tJ 


A6H 


SURGICAL  DISEARKS. 


■*  When  these  methods  fail  to  stop  the  progress  of  the  abscess,  the 
finger  should  be  laid  open  with  the  scalpel,  cutting  down  to  the  bone. 
This  will  give  vent  to  the  matter,  and  the  wound  may  be  dressed 
with  poultices,  until  the  inflammation  is  subdued,  and  the  healing 
;)roce33  is  well  established,  when  some  simple  salve  may  be  applied. 

Chilblains. 

This  complaint  should  have  been  spoken  of  immediately  after 
"  frost-bite,"  but  it  was  forgott-en.  It  is  caused  by  exposure  to  cold, 
and  affects  the  fingers,  toes,  and  particularly  the  heels,  with  a  painful 
inflammatory  swelling,  of  a  red,  purple,  or  bluish  color.  The  skin 
may  be  red  in  patches,  and  slightly  swelled,  with  itching,  tingling, 
I  ain,  and  lameness;  or  there  may  be  blisters,  around  which  the  skin 
Is  blue  or  purple ;  or,  worse  yet,  there  may  be  ulceration  and  slough- 
ing. 

Trentiiieilf. —  Stimulating  liniments  are  the  remedies  usually  em- 
ployed for  this  complaint.  One  of  the  best  consists  of  six  parts  of 
sonp  liniment,  and  one  part  of  tincture  of  Spanish  flies  ;  and  another 
excellent  one  is  prescription  (307).  If  there  is  ulceration,  use  Turner's 
cerate,  or  the  resin  ointment. 


f"' 


M' 


r 


Stiff  Joint. — Anchylosis. 

This  is  of  two  kinds,  complete  and  incomplete, — complete  when  the 
bones  of  the  joint  have  become  firmly  united  by  bony  matter,  and 
incomplete  when  the  motions  of  the  jjint  are  very  mudi  interrupted, 
but  not  entirely  destroyed.  The  first  is  the  result  of  ulcerations  of 
the  cartilages  of  the  joints,  and  of  the  heads  of  the  bones ;  the  latter, 
of  fractures,  sprains,  bruises,  thickening  of  the  synovial  membrane, 
and  weakening  of  the  muscles. 

iVeatinent. — No  treatment  is  of  much  use  in  the  first-named  form  of 
the  disease.  By  sawing  through  the  bone,  and  then  daily  moving  the 
limb  back  and  forth,  a  false  joint  may  be  made,  but  it  is  apt  to  grow 
together  again,  and  finally  defeat  the  purpose  of  the  surgeon.  When, 
however,  stiffness  arises  from  the  weakening  of  the  muscles,  and  some 
other  causes  involving  the  figaments  and  tendons,  something  may 
be  done  by  daily  frictions  with  stimulating  liniments,  champooing, 
and  warm  fomentations;  and  by  gently  bending  the  joint  back  and 
forth,  several  times  every  day,  as  much  as  can  be  done  without  pain. 


Tumors. 


\ 


A  TUMOR  is  a  swelling  which  consists  of  a  new  prodttction,  not 
constituting'  any  portion  of  the  original  structure  of  the  body.  There 
are  several  kinds  of  tumors;  but  it  is  sufficient  for  njy  purpose  to 
follow  Mr.  Ferguson,  and  divide  them  into  the  malig^rU  and  noth 
malignant.  .   .  »         , 


SUROICAL  DISEASES. 


409 


abscess,  the 
1  to  the  bone, 
ly  be  dressed 

the  healing 
be  applied 


ediately  after 
losure  to  cold, 
with  a  painful 
or.  The  skin 
King,  tingling, 
iliich  the  skin 
ill  and  slough- 

8  usually  em- 
)f  six  parts  of 

;  and  another 
n,  use  Turner's 


plete  when  the 
[ly  matter,  and 
(ih  interrupted, 
'  ulcerations  of 
nes ;  the  latter, 
rial  membrane, 


•named  form  of 
lily  moving  the 
;  is  apt  to  grow 
rgeon.  When, 
scles,  and  some 
something  may 
's,  champooing, 
joint  back  and 
without  paiik 


production,  not 
e  body.  There 
ray  purpose  to 
pumi  and  rum- 


Cancer. 

This  belongs  to  the  cla.ss  of  malignant  tumors.  It  has  two  stages. 
The  first  is  that  of  induration  or  scirrhvs,  —  during  which  it  has, 
under  the  finger,  the  feeling  of  stonp  hardness.  The  second  stage  is 
that  of  ulceration  or  open  cancer. 

Cancer  most  often  attacks  the  female  breast,  the  skin,  the  mucous 
membranes,  the  tongue,  the  stomach,  the  neck  of  the  womb,  the  lips, 
etc.  It  rarely  occurs  in  subjects  under  thirty  years  of  age,  and  not 
often  in  |)ersons  under  forty-five. 

The  Symptoms  of  Cunc(>r,  when  it  appears  in  the  breast,  are,  a 
puckered  condition,  and  dull,  leaden  color  of  the  skin  ;  a  hard,  knotty, 
and  uneven   feel  ;   and  occasional   sharp  f,o.  157. 

pains.  When  it  attacks  the  skin  and  mu- 
cous membranes,  there  is  a  hard,  warty 
lump,  which  ulcerates,  after  a  time,  pro- 
ducing an  open  sore,  with  a  hard  base. 
(Fig.  167.) 

The  sore  of  a  cancer  discharges  an 
irritating,  excoriating  matter,  which  has 
a  peculiarly  fetid  odor,  so  offensive  and 
so  different  from  any  other  smell,  that  it 
is  seldom  forgotten.  The  bones  of  a 
cancerous  person  break  with  great  ease. 
Unmarried  females  are  much  more  liable  to  the  disease  than  the  mar- 
ried. The  cancerous  growth  is  com{X)sed,  in  part,  of  cells,  rounded 
or  caudate,  containing,  as  seen  under  the  microscope,  nuclei,  younger 
cells,  and  graimles.     (Fig.  168.) 


Fia.i6& 


Fio.  ).e9. 


Fio. 17a 


The  difference  between  these  cells  and  those  of  common  pus  glot>- 
ules  may  be  seen  by  comparing  Fig.  168  with  169,  —  the  latter  being 
pus  corpuscles  highly  magnified  by  a  powerful  microscope.  Fig.  170 
represents  pus  globules  not  so  much  magnified. 

Treatment. —  There  are  but  two  methods  of  treatment  which  prom- 
ise any  success.  The  first  is  to  extirpate  the  tumor  by  a  surgical 
operation  before  the  disease  has  so  far  invaded  the  constitution  as  to 
be  sure  of  returning.     The  other  is  that  adopted  by  Dr.  J.  W.  Fell, 


MM 

m 


.JbUrn 


470 


SUUOICAL  DISEASES. 


an  Araoricaii  jihysician,  who  waa  permitted  to  try  his  remedies  in 
one  of  the  EngU^h  hospitals,  and  who  drew  from  the  nurgeons  in 
charge  of  it  a  favorable  rejx)rt  of  the  results. 

Dr.  Fell's  remedies  are  mainly  blo<xl-root  and  chloride  of  zinc  (336) 
made  into  a  paste.  The  skin  over  the  tumor  is  first  destroyed,  and 
this  paste,  spread  u\K>i\  strips  of  linen,  is  applied.  This  causes  an 
eschar,  into  which  incisions  are  made,  half  an  inch  apart,  taking  care 
to  avoid  the  living  tissue.  The  same  paste  spread  in  a  like  manner 
is  then  daily  inserted  into  the  furrows.  By  this  means,  which  is  orig- 
inal with  Dr.  Fell,  the  effect  of  the  caustic  penetrates  through  all 
parts  tf  the  tumor,  causing  the  whole  diseased  mass  to  fall  on,  and 
leave  a  healthy,  granulating  surface. 

In  incipient  cancer,  where  the  disease  has  not  made  much  progress. 
Dr.  Fell  uses  the  above,  which  he  calls  a  brown  ointment  (336),  and 
in  connection  with  it  an  ointment  of  the  iodide  of  lead  (337),  using 
each  twelve  hours.  With  these,  he  claims  that  he  cures  incipient 
cancers,  with  great  readiness.  He  also  employs,  internally,  half-grain 
doses  of  pulverized  blood-root  (143),  with  arsep-o  and  cicuta. 

Dr.  Fell  claims  that  with  these  preparations,  he  has  often  cured 
fupuSf  and  has  been  very  successful  with  them  in  treating  indolent 
ulcers. 

Soft  Cancer.— Bleeding  Cancer. 
Medullary  Cancer.— Encephaloid  Tumor. — Fungus  Hematodes. 

This  varies  in  size  from  a  nutmeg  to  a  child's  head.  Its  color 
varies  from  white  to  deep  red.  At  times,  it  is  soft  and  elastic  at 
Orst ;  at  other  times,  it  is  firm  and  tense.     The  patient  is  wan  and 

ale  from  the  begitming.     The  parts  do  not  ulcerate,  as  in  scirrhus; 

ut  after  the  skin  is  broken,  a  spongy  bleeding  tumor  protrudes. 


I 


Treatment.  —  Dr.  Fell's  method. 


Black  Cancer. — Melanosis. 


Tins  is  an  organic  disease,  in  which  the  tissue  of  the  disordered 
part  is  converted  into  a  black,  hard  substance,  which  is  converted 
mto  ulcerous  cavities.  This  often  appears  in  the  lungs,  and  is  met 
with  in  the  liver  and  other  parts. 

Its  symptoms  are,  a  sallow  complexion,  great  debility,  and  dropsi- 
cal swelling  of  the  limbs  before  the  termination. 

Treatment.  —  When  it  appears  externally.  Dr.  Fell's  treatment  is 
worth  a  trial.  When  in  the  lungs,  the  inhalation  of  tincture  of  blood- 
root  and  solution  of  chloride  of  soda  (241)  should  be  used.  Two 
teaspoonfuls  may  be  put  in  Warren's  Vapor  Inhaler,  —  the  instru- 
ment being  filled  half  full  of  hot  water,  —  and  inhaled  ten  minutes, 
three  times  a  day  ;  the  blood-root  pills  (143)  being  taken  at  the  same 
time. 


SURGICAL  DISEASES. 


471 


emedies  in 
mrgeons  in 

f  zinc  (336) 
royed,  and 
causes  an 
taking  care 
ike  manner 
licli  is  orjg- 
lli rough  all 
fall  oH',  and 

ch  progress, 
(336),  and 
(337),  using 
es  incipient 
y,  half-grain 
uta. 

often  cured 
ing  indolent 


ematodes. 

d.  Its  color 
id  elastic  at 
is  wan  and 
i  in  scirrhus; 
trudes. 


le  disordered 
is  converted 
s,  and  is  met 

,  and  dropai- 


treatment  is 
;ure  of  blood- 
used.  Two 
—  the  instru- 
ten  minutes, 
1  at  the  same 


Patty  Tumor. — Adipous  Sarcoma. 

This  is  the  most  common  of  all  the  forms  of  tumor.  These  bodies 
gont'rally  have  a  soft  and  doughy  feel,  or  as  if  filled  with  wool.  Thry 
iirii  the  k-ast  inclint'd  to  bfcoiiie  inniignant,  and  consequently  the  least 
dangerous,  of  all  the  tumors.  WhaU'ver  pain  there  is,  is  caused  by 
their  size,  weight,  and  pressure.  They  are  occasionally  found  a  little 
below  the  point  of  the  shoulder,  in  the  deltoid  nuisele  of  females,  and 
are  caused  by  the  unreasonable  pressure  of  the  dress  at  that  point. 

Trpatllient. —  They  should  be  removed  by  an  operation,  which  is 
easily  performed,  as  they  separate  very  readily  from  surrounding 
parts. 

Polypus. 

The  polypi  constitute  a  class  of  tumors  growing  from  mucous 
membranes.  They  are  of  two  kinds,  —  the  soft,  jelly-like  polypus, 
and  the  fleshy  or  fibrous  polypus. 

Tlie  Soft  Polypus,  which  grows  from  the  nose,  has  not  much  feel- 
ing, and  is  not  particularly  disposed  to  bleed. 

Tlie  Fleshy  Polypus  is  firmer  and  harder  than  the  preceding,  and 
most  generally  connects  itself  with  the  womb. 

Treatment.  —  Both  kinds  of  polypi  are  either  twisted  off  with  a 
pair  of  forceps,  or  strangled  by  puttiivg  a  string,  called  a  ligature, 
around  their  neck,  which  will  cause  them  to  fall  off  in  a  short  time. 

Wens. — Encysted  Tumors. 

The  most  common  situation  of  these  is  under  the  skin  of  the  head. 
A  wen  is  simply  a  sac  full  of  various  matters,  which,  when  examined 
with  a  microscope,  are  found  to  be  oil  globules,  epithelial  cells,  and 
crystals  of  stearine.  These  contents  are  secreted  by  the  internal 
surface  of  the  sac.  They  sometimes  look  like  curd  or  rice,  sometimes 
like  suet,  and  sometimes  like  honey.  In  other  instances,  they  are 
more  water,  and  they  have  been  known  to  consist  of  hair  or  horn. 
These  tumors  are  round,  elastic,  and  movable,  and  are  without  pain. 
They  grow  slowly,  but  steadily. 

Treatment. —  The  attempt  to  excite  inflammation  and  consequently 
absorption,  by  punctures,  seatons,  or  injections,  are  dangerous,  and 
ought  not  to  be  resorted  to.  If  the  tumor  is  small,  its  opening,  indi- 
cated by  a  small  black  spot,  may  be  found,  a  probe  be  introduced 
into  it,  and  the  contents  of  the  sac  be  squeezed  out ;  and  this  may  be 
repeated  as  often  as  necessary.  But  the  proper  and  only  real  remedy 
for  these  tumors  is  their  removal  by  a  surgical  operation. 


i 

t' 


r^ii 


m>^ 


472 


SURGICAL  DISEASES 


Aneurisms. 

An  aneurism  is  a  tumor  formed  by  arterial  blood,  and  communi- 
cating with  an  artery.  A  true  aneurism  is  formed  by  the  coats  of  an 
artery  getting  weakened  by  some  cause,  and  swelling  out  so  as  to 
form  a  pouch  or  sac.  (Fig,  171.)  There  are  other  kinds  of  aneu- 
risms,  which  need  not  be  described. 

Fia.lTl. 


»,^' 


Symptoms.  —  An  aneurism  may  be  felt  as  a  tumor  somewhere 
along  the  course  of  an  artery,  and  it  beats  under  the  finger  like  the 
pulse.  The  beating  is  caused  by  a  fresh  quantity  of  blood  being 
pushed  into  this  sac  with  every  stroke  of  the  heart.  If  it  be  small, 
pressure  on  the  artery  above  it  will  so  far  shut  off'  the  blood  from  it, 
that  it  will  feel  flaccid  or  soft.  The  patient  will  often  say  that  the 
tumor  began  to  appear  after  some  violent  strain,  when  something 
appeared  to  give  way.  In  the  chest,  aneurism  will  produce  an  un- 
natural pulsation  felt  by  the  patient.  In  the  belly,  it  may  generally 
be  felt  as  a  tumor  through  the  abdominal  walls. 

Distinction.  —  Tumors  which  lie  directly  over  arteries  are  lifted  up 
every  time  the  blood  is  driven  along  under  them,  and  hence  they 
pulsate  like  aneurisms ;  but  they  do  tu)t  pulsate  when  smalt,  whereas 
aneurisms  do  from  the  beginning  of  their  growth.  Aneurisms  are 
'soft  at  first,  aiul  hard  afterwards ;  whereas  tumors  are  generally  hard 
at  first,  and  finally  soft 

Treatment.  —  In  some  few  fortunate  cases,  aneurisms  get  well  s|x)n- 
taneously.  If  the  flow  of  blootl  through  them  can  be  stopj^ed,  that 
which  is  within  them  will  coagulate,  forming  a  hard  tumor,  which 
will  gradually  waste  away.  To  cure  them,  therefore,  we  must  stop 
the  circulation  through  them ;  and  this  may  be  done,  in  some  cases, 
by  compression.  The  pressure  upon  the  art<;ry  must  of  course  be 
above  the  tumor,  and  should  not  be  so  great  as  to  stop  the  blood 
altogether,  but  only  very  materially  to  diminish  its  flow.  The  pres- 
sure is  applied  by  an  instrument  having  two  pads,  an  arc  of  steel,  a 
joint  in  the  middle,  and  a  screw  by  which  the  padded  extremities  are 
pressed  together.     (Fig.  172.) 

When  this  mode  of  treatment  is  not  practicable,  the  artery  must 
be  tied  between  the  aneurism  and  the  heart  The  patient  should  b« 
placed  in  bed,  with  the  limb  wrapped  up  to  preserve  its  temperature. 


if 


SURGICAL  DISRASKS. 


473 


1  communi- 

coats  of  an 

ut  80  aa  to 

da  of  aneuo 


somewhere 
iger  like  the 
blood  being 
'  it  be  small, 
ood  from  it, 
say  that  the 
n  something 
duce  an  un- 
lay  generally 

are  lifted  up 
1  hence  they 
naif,  whereas 
lenrisrns  are 
.Mierally  hard 


et  well  sjx)n- 
itopped,  that 
umor,  which 
e  must  stop 
some  cases, 
jf  course  be 
>p  the  blood 
The  pres- 
rc  of  steel,  a 
tremities  are 

artery  must 
it  should  be 
temperature, 


and  placed  in  an  easy  position.     Nothing  cold  should  be  applied 
to  it. 

The  force  of  the  circulation  should  be  reduced  by  the  tincture  of 
veratrum. 


Fia.  ITS. 


Fio.  178. 


Bronchocele.— Derbyshire  Neck. —  Goitre. 

Bronciiocele  is  what  is  called  an  endemic  disease ;  which  meanc. 
a  disease  which  prevails  in  certain  localities.  This  complaint  is  prev 
alont  in  Nottingham  and  Derbyshire,  England,  among  the  Alps,  and 
especially  in  the  Tyrol  and  valley  of  the  Rhone.  It  is  thought  to  be 
produced  by  the  use  of  melted  snow,  and  water  impregnated  with 
lime  and  earthy  matter. 

Symptoms. —  A  prominent,  soft,,  elastic  tumor,  occupying  the  front 
of  the  throat,  in  the  situation  of  the  thyroid  gland,  and  like  it  in  shape. 
It  is  not  tender,  and  the  skin  is  not  discolored.  In  old  cases,  the 
tumor  becomes  hard.  In  Fig.  173,  the  tumor  is  so  large  as  to  have 
pushed  the  gullet  to  one  side. 

Treatment. —  The  usual  and  perhaps  the  best  remedy  for  this  dis- 
ease is  iodine.  It  may  be  given  as  iodide  of  potassium,  with  a  bitter 
or  some  other  article  (138)  (145)  (101).  An  iodine  ointment  may  be 
applied  to  the  tumor  (185). 

The  patient  should  move  away  from  the  infected  district,  and  re- 
side, if  possible,  upon  the  sea  coast. 

Water  in  the  Scrotum. — Hydrocele. 

As  the  name  shows,  this  is  a  collection  of  water  in  the  scrotum  or 
bag  which  holds  the  testicles. 

Symptoms.  —  It  presents  a  swelling,  shaped  like  a  pear,  smooth  ou 


its  surface,  fluctuating  if  presited,  without  pain,  but  causing  a  littltr 
uiicjisincss  by  itH  wi'iglit.  On  pliu-ing  a  light(*d  candle  on  one  side; 
of  the  scrotum,  the  light  may  bt  seen  through  it. 

Distinction.  —  This  complaint  may  be  distinguished  from  a  soliii 
enlargement  of  the  testicle  by  its  not  being  so  heavy,  solid,  or  painful, 
and  by  its  fluctuating  and  being  transparent;  from  rupture,  by  itn 
forming  slowly  insti'ad  of  suddenly,  by  the  swelling  beginning  at  tlio 
lower  part  of  the  scrotum  instead  of  the  upper,  and  by  the  enlargf- 
ment  not  being  increased  by  coughing  as  it  is  in  rupture. 

Treatment.  —  In  children,  strong  scattering  washes  (3.')3)  arc  some- 
times successful.  But  most  commonly,  a  number  of  piuictures  are 
made  with  a  large  needle,  to  cause  the  fluid  to  escape  into  the  ci'll 
tissue  of  the  scrotum,  whence  it  is  removed  by  absorption. 

To  effect  a  radical  cure  in  grown  persons,  the  surgeon  is  to  grasp 
the  tumor  behind,  and  introduce  a  trocar  and  canula  into  the  sac, — 
being  careful  to  point  the  instrument  upwards,  so  as  not  to  wound 
the  testicle.  The  trocar  is  then  withdrawn,  —  the  canula  being  at 
the  same  time  pushed  well  into  the  sac,  so  that  none  of  the  fluid  may 
get  into  the  cell  tissue  outside  the  sac.  The  fluid  runs  off  through 
the  canula.  When  this  has  all  escaped,  some  stimulating  fluid,  as 
common  lime-water,  or,  still  better,  tincture  of  iodine,  is  to  be  injected 
through  the  canula  into  the  emptied  sac.  After  retaining  this  from 
two  to  five  minutes,  it  is  permitted  to  flow  out  Inflammation  fol- 
lows, which  breaks  up  the  secretion  of  water,  and  effects  a  cure  in 
two  or  three  weeks.  The  amount  of  fluid  thrown  in,  should  be  about 
one  or  two  teaspoonfuls  of  a  mixture  of  one  part  of  tincture  of  iodine 
and  two  parts  of  water.  If  the  first  operation  does  not  effect  a  com- 
plete cure,  it  may  be  repeated. 

Blood  in  the  Scrotam. — Hematocele. 

This  is  a  collection  of  blood  in  the  scrotum  from  some  injury. 

Treatment.  —  If  the  quantity  of  blood  effused  be  small,  cold  appli- 
cations may  cause  it  to  be  absorbed.  If  it  be  large,  make  a  puncture, 
and  apply  a  poultice  for  the  blood  to  ooze  into. 


/ 


Acute  Inflammation  of  Veins. — Phlebitis. 

i 

The  veins  are  subject  to  attacks  of  acute  inflammation,  which 
•  constitutes  a  very  dangerous,  and  often  fatal,  disease. 

Symptoms.  —  Fits  of  shivering,  or  perhaps  fainting,  a  rapid  pulse, 
anxiety  of  countenance,  lowness  of  spirits,  catching  pains  about  the 
heart,  and  swelling',  redness,  tenderness,  and  hardness  along  the  course 
of  the  affected  veins.  Sometimes  the  tongue  is  furred  brown  or  black, 
the  skin  is  sallow,  there  is  bilious  vomiting,  low  delirium,  and  death. 
In  cases  less  rapid,  there  are  great  swelling  and  redness  over  the  dis- 


lUfling  a  littl(> 
le  on  one  side 


from  a  solid 

id,  or  painful, 

upturt',  by  iti 

ginning  at  tiio 

y  tlie  enlarge* 

•y-i)  are  Home* 
puncturcH  aro 
into  the  cell 
on. 

on  is  to  grasp 

nto  the  sac,  — 

not  to  wound 

nula  being  at 

the  fluid  may 

ns  off  through 

ating  fluid,  as 

to  be  injected 

ling  this  from 

lammation  fol- 

bets  a  cure  in 

lould  be  about 

cture  of  iodine 

>t  eflect  a  com- 


ne  injury. 

lall,  cold  appli- 
ike  a  puncture, 


ebitis.  ' 

mation,  which 

a  rapid  pulse, 
lins  about  the 
9ng-  the  course 
rown  or  black, 
im,  and  death, 
i  over  the  dia- 


8UR0ICAL  DISRASRS. 


476 


eased  veins,  and  abscesses  form,  which,  when  opened,  reveal  clots  of 
blood,  mixed  with  pus.  Or,  the  patient,  while  mnaiiiiiig  low,  with  a 
sallow  countenance,  and  a  yellow  tongu<>,  will  coinplain  suddenly  of 
intense  pain  in  some  joint,  as  the  knee  or  shoulder, —  in  which  there 
will  be  a  ra|)i(l  formation  of  pus;  a  similar  suppuration  will  follow 
in  other  joints  as  well  us  in  the  lungs,  etc.,  until  the  patient  sinks,  and 
dies  of  exhaustion. 

TreiltllU'llt. —  Apply  leeclies  freely  over  the  inflamed  veins,  —  also 
fomentations.  Every  abscess  should  be  opened  early.  Keep  the 
bowels  moderately  open  with  some  preparation  of  salts,  and  allay 
pain  and  restlessness  l)y  morphia.  Support  the  strength  by  beef  tea, 
etc. ;  and,  if  the  pulse  be  feeble,  give  wine  or  quinine. 

The  suppuration  may  l)e  clu-cked,  in  this  as  in  other  complaints, 
by  drinking  freely  of  chamoiriile  tea.  The  power  to  control  sup- 
puraton  has  recently  been  discovered  as  belonging  to  chamomile 
flowers. 

Chronic  Phlebitis. 

This  is  a  far  less  serious  disease  than  the  preceding.  It  generally 
affects  the  veins  of  the  legs. 

Symptoms. —  Tenderness  and  hardnes!*  of  the  aflfected  vein,  with 
swelling  around  it,  and  of  the  parts  below ;  a  general  painfulness  of 
the  limb.  After  the  inflammation  has  subsided,  the  vein  feels  hard, 
like  a  cord,  because  the  inflamuiation  causes  the  blood  within  to  co- 
agulate, and  harden,  so  that  nothing  can  pass  through  the  vessel. 

Treatment.  —  Leeches,  fomentations,  or  cold  lotions,  as  the  patient 
may  choose,  purgatives,  and  rest,  with  the  limb  elevated.  Subse- 
quently, when  the  inflammation  seems  completely  subdued,  friction 
with  camphorated  oil,  and  bandages. 

Enlarged  or  Varicose  Veins. — Varix. 

Thr  veins  which  lie  near  the  surface,  especially  those  of  the  legs, 
are  apt,  by  exhausting  labor  u|ion  the  feet,  ana  by  strains,  to  get 
weakened,  so  that  their  valves  lose  their  tone,  and  their  sides  stretch 
and  give  way  in  certain  places,  letting  the  blood  bulge  out,  and  form 
pur|)le  bunches.  These  bags  of  blood,  lying  along  upon  the  surface 
of  the  limb,  form  knotty  tumors,  looking  like  blood-boils.  They  oc- 
casion a  kind  of  distress,  but  no  sharp  pain. 

Persons  of  weak,  soft,  and  relaxed  muscles  and  blood  vessels  are 
particularly  liable  to  this  complaint.  It  often  attacks  women  in  the 
family  way. 

Treatment  —  Where  only  a  few  veins  are  affected,  it  may  be 
sufficient,  in  some  cases,  to  apply  firmly  over  them  a  few  strips  of 
leather,  spread  with  soap  plaster.  But  generally  it  is  better  to  sup- 
port the  whole  limb  with  a  good  calico  bandage,  or  with  a  laced  stock- 


Wm 


;^i^ 


476 


8UR0ICAL  DI8BA8K8. 


ine,  which  Hhould  ho  applied  in  tho  morning  hcforn  the  patient  in  np 
It  IB  gi'nerully  Wfii,  hIho,  to  uhc  friction,  witTi  noinc  liniment,  or  itxiino 
ointment.  licad  water,  or  alum  water,  or  an  infuHion  of  white  oak 
bark,  may  bo  used  with  advantage.  Burdock  and  plantain  leaven, 
bound  upon  the  nkin,  and  removed  before  they  are  dry,  are  uneful. 
Bhowcring  with  culd  water  Htrcngthcnit  the  veins. 


,| 


Rupture.  —  Hernia. 

H«RNtA  (ligniBes  a  protrusion  of  any  internal  organ  from  the  cavity 
where  it  belungH;  but  the  term  i»  g(!ncrally  restrK^ted  ao  aa  to  meiui 
no  mors  than  a  prnti-usion  of  the  bowel  thrinifj^h  the  wallt  of  the  belief. 

When  the  abdominal  walls  are  weak,  frt)tn  any  cause,  no  mutter 
what,  —  lifting,  straining,  or  making  violent  muscular  exertion  of  any 
kind,  will  then  often  cause  the  bowel  to  force  itdt'lf  through  at  tli« 
most  debilitated  spot;  and  pushing  the  lining  of  the  belly,  the  peri- 
toneum, along  before  it,  a  bag  or  sac  is  formed,  in  which  the  project- 
ing bowel  is  enclosed,  forming  an  external  tumor. 

Divisions  of  Hernia.  —  Rupture  may  occur  in  several  different 
places,  and  has  accordingly  received  diiFerent  names. 

llnibilicul  Ileniia  is  a  protrusion  of  tnc  bowel  at  the  umbiliciM 
or  navel.  This  is  most  common  in  children  soon  after  birth ;  and 
women  who  are  often  pregnant  are  liable  to  it 

Venfrul  Hernia  is  that  which  occurs  at  any  part  of  the  belly  where 
other  forms  of  rupture  do  not  appear. 

Inipulniil  Hernia  is  that  in  which  the  bowel  protrudes  at  the  groins, 
or  through  the  abdominal  rings. 

Scrotal  Hernia  is  that  in  which  the  bowel  descends  into  the  bag  or 
scrotum. 

Femoral  Hernia  is  the  dropping  down  of  the  bowel  behind  wliiit 
is  called  Foupart'a  ligament,  and  appearing  as  a  tumor  at  the  upper 
part  of  the  thigh. 

Reducible  Heniia.  —  Rupture  is  said  to  be  reducible,  when  the 
bowel  may  be  put  back  into  the  cavity  from  whljh  it  came. 

Irrcducilile  Hernia.  —  Hernia  is  called  irreducible  whcMi  the  pro- 
truding bowel  cannot  be  returned  into  the  belly. 

Siranjpulated  Hernia  is  that  form  of  the  complaint  in  which  thf 
bowel  is  so  pressed  upon  at  the  point  where  it  passes  through  the 
walls  of  the  belly  that  it  is  strangled  or  constricted  so  that  its  contents 
cannot  pass  through. 

Symptoms  of  Hemia«  —  A  soft  tumor,  which  may  be  compressed, 
appears  somewhere  ab<jut  the  belly;  and  is  increased  in  size  when 
the  patient  stands  up.  It  also  swells  when  he  coughs,  or  makes  any 
exertion ;  and  grows  smaller,  or  entirely  disappears,  when  be  Ues 
down. 


patient  JH  lip. 
flit,  or  iodiiii; 
of  white  oak 
mtiiiii  Icnvcs, 
•y,  are  UHeful. 


om  tho  cavity 
MO  art  to  iiiciui 

of  the  belly, 
i«<r,  no  inutttT 

iTtion  oi  any 
lirough  at  tli« 
x'lly,  the  peri- 
c  li  the  project- 

k'cral    difFerent 

the  umbilicus 
ter  birth ;  and 

le  belly  where 

3  at  the  groins, 

into  the  bag  or 

1  behind  what 
ir  at  the  tipper 

ble,  when   the 
ime. 

vh<!n  the  pro- 

in  which  th"? 
8  through  the 
at  its  contents 

e  compressed, 

in  size  when 

Of  makes  any 

when  he  Ues 


BUnniCAL  DISKASES. 


47V 


Treutmciit. —  In  a  case  of  reducible  hernia,  the  fir^t  thing  to  be 
done  ii4  to  put  the  bowel  back  in  itH  place,  which  is  accottiplished  by 
gently  prcrtrting  and  kneading  tht;  tniiior,  and  Hwaying  it  back  and 
forth, —  being  careful  to  uhc  no  violence,  —  until  it  can  be  pushed 
within  the  abdominal  walls.  It  is  then  to  be  kept  in  its  place  by  the 
use  of  a  truss,  made  expressly  to  f't  the  case.  This  instrument  should 
he  constantly  worn  by  day,  and  by  night,  too,  if  not  too  irksome ;  but 
if  worn  by  day  only,  it  should  always  be  applied  before  rising  in  tho 
morning. 

Irreducible  Hernia  may  be  ;  Hinted  by  wearing  a  truss  wii'  a  hoh 
low  pitd,  which  will  so  evenly  a...i  lirndy  embrace  the  tumor  as  neither 
to  irritate  it,  nor  permit  any  further  protrusion  or  enlargement. 

StruilKuIttted  Ilernitl. —  If  a  person  have  worn  a  truss  for  some 
time,  and,  suddenly  leaving  it  of!',  makes  som  "olent  exertion,  either 
the  bowel  or  omentnm  is  liable  to  be  Hiiddimlj  .irced  through  a  nar- 
row aperture,  and  to  become  strangled.  In  such  case,  the  patient  has 
flatulence,  colicky  pains,  a  sense  of  tightness  across  the  belly,  and  a 
desiri!  to  go  to  stool,  but  no  ability  to  pass  anything.  Then  follows 
vomiting,  first  the  contents  of  the  stomach,  then  iimcous  and  bile, 
and,  lastly,  the  fecal  matters  from  the  bowels,  which  are  not  permitted 
to  pass  on  to  their  natural  outlet.  The  neck  of  the  hernial  sac  now 
l)ecomes  swelled,  tender,  and  painful,  the  countenance  is  anxious,  and 
the  pulse  small,  hard,  and  wiry  ;  and,  after  a  time,  the  tiutior  begins 
to  mortify,  the  patient  expresses  himself  free  from  idl  pain,  and  soon 
after  dies. 

In  the  treatment,  the  bowel  is  to  be  returned  if  possible.     To  do 
1......  the   l)ladder  should  first  be  emptied  with  a  catheter,  and  the 

patient  should  lie  dowii  with  his  shoulders  raised,  and  both  his  thighs 
bent  towards  the  belly,  and  placed  close  to  each  other,  so  as  to  relax 
all  the  ligaments  and  muscles  of  the  belly.  The  surgeon  may  nov/ 
work  gently  for  half  an  hour,  if  necessary,  trying  to  put  the  bowel 
back,  but  must  be  very  careful  not  to  excite  inflammation  by  any 
violence. 

If  he  does  not  succeed,  efforts  are  next  to  be  made  still  further  to 
relax  the  muscles,  as  well  as  to  reduce  the  force  of  the  heart's  action, 
and  to  diminish  the  size  of  the  tumor.  With  the  tincture  or  fluid 
extract  of  veratrum  viride,  the  heart's  action  and  force  of  the  circula- 
tion may  be  reduced  to  any  desirable  extent.  The  muscles  may  be 
relaxed  by  injections  of  tobacco,  made  by  steuping  one  dram  of  to- 
bacco in  one  pint  of  water  for  ten  minutes.  This,  however,  is  a 
somewhat  dangerous  remedy,  and  should  give  place  to  the  compound 
lobelia  injection.  Two  grains  of  tartrate  of  antimony  in  one  pint  of 
tepid  water,  make  a  suitable  injection. 

To  reduce  the  tumor,  apply  pounded  ice  in  a  bag,  or  a  freezing 
mixture  (354).  If  the  pain  be  acute,  give  large  doses  of  opium  or 
morphia. 

If  all  these  remedies  fail,  there  is  then  no  hope  but  in  relieving  the 
stricture  by  a  surgical  operation. 

General  Directions.  —  Rupture  is  an  exceedingly  common  affection, 


478 


SURGICAL  DISEASES. 


Perhaps  every  third  or  fourth  person  suffers  from  it  more  or  lesjj. 
P'emales,  from  motives  of  delicacy,  are  apt  to  conceal  the  misfortune, 
and  not  seek  advice.  This  exposes  them  to  danger.  Queen  Caro- 
line, wife  of  George  II.,  lost  her  life  by  such  concealment. 

A  swelling  coming  on  suddenly  in  the  groin  or  at  the  navel,  after 
considerable  exertion,  may  be  taken  to  be  a  rupture  without  much 
fear  of  mistake. 

The  complaint  being  discovered,  the  bowel  should  be  put  back 
in  its  place,  and  a  truss  be  put  on  at  once.  In  the  case  of  young 
persons,  a  truss  may  frequently  effect  a  cure,  but,  that  it  may  do  this, 
it  should  not  be  taken  off,  night  or  day,  except  to  cleanse  it,  and  tlnu 
Dniy  when  the  wearer  is  in  bed. 

Those  who  can  afford  it,  should  have  two  trusses  of  the  same  size 
and  strength,  so  that  if  one  get  out  of  order,  the  other  may  take  its 
place  while  it  is  being  repaired  ;  for,  an  hour's  absence  of  i.he  truss 
might  occasion  a  mischief  which  it  would  require  months  to  repair. 

Persons  having  a  rupture  must  be  very  careful  to  keep  costiveness 
at  a  distance  ;  for  straining  at  stool  is  highly  injurious. 


Varicocele.— Cirsocele. 

This  is  an  enlargement  or  varicose  state  of  the  spermatic  veins, 
and  may  be  mistaken  for  hernia,  inasmuch  as  standing  and  coughing 
increase  it.  But  it  feels  like  a  bag  of  worms;  and  by  this  peculiarity, 
may  be  distinguished  from  rupture.. 

Treatment.  —  Wear  a  suspensary  bandage. 

Deformities  and  Irritations  of  the  Spine. 

Lateral  Curvature.  —  There  are  several  varieties  of  curvature  of  the 
spine.  Some  of  them  are  caused  hy  the  destruction  of  some  portion 
of  the  spinal  column  by  disease.  It  will  not  be  necessary  for  me  to 
treat  of  these  fc  nus  of  curvature,  as  they  can  only  be  investigated  aud 
treated  by  the  most  skilful  surgeons.  Those  who  will  use  this  book 
chiefly,  would  htrrdly  think  of  meddling  with  them. 

The  curvature  which  arises  from  debility  of  the  bones,  ligaments, 
and  muscles,  and  which  is  very  common  among  females,  has  the 
following 

Symptoms. —  At  first  there  is  a  projection  of  one  collar-bone,  or  one 
side  of  the  chest,  or  one  shoulder  is  considerably  elevated,  and  is 
popularly  thought  to  be  ^'■growing  out"  Or  examination,  the  right 
shoulder  and  the  right  side  of  the  chest  will  be  found,  generally,  to 
be  rounded  and  lifted  up,  while  the  other  is  sunk  down  and  concave. 
At  the  same  time,  the  left  hip  sticks  out,  and  the  loins  on  the  right 
side  have  an  inward  curve.  The  spinal  column  will  have  a  curve,  as 
in  Fig.  174. 

Causes.  —  This  affection  is  caused  by  occupations  which  keep  the 
body  in  a  laterally  distorted  position,  and  tax  one  side  of  the  body 


more  or  less. 
e  misfortune, 
Queen  Caro- 
it. 

le  navel,  after 
vithout  much 

be    put  back 

;ase  of  youiis; 

may  do  tliis, 

it,  and  tlnu 

le  same  size 
may  taiie  its 
of  the  truss 

IS  to  repair. 

p  costivenesa 


ermatic  veins, 
and  coughing 
lis  peculiarity. 


Jpine. 

irvature  of  the 
■  some  portion 
iary  for  me  to 
vestigated  aud 
use  this  book 

ties,  ligaments, 
nales,  has  the 


ir-bone,  or  one 
2vated,  and  is 
tion,  the  right 
I,  generally,  to 
and  concave. 
13  on  the  right 


hich  keep  the 
e  of  the  body 


SURGICAL  DISEASES. 


479 


more  than  the  other.  It  is  produced  in  children  who  study  their 
lessons  at  school  with  one  elbow  resting  on  a  i'igh  desk.  The 
muscles,  too,  get  so  weakened  in   many  j.,(,  1^4 

females  of  luxurious,  sedentary,  and  indo- 
lent habits,  that  they  cannot  hold  the  bony 
frame  of  the  body  in  an  u|)right  position, 
and  the  jointed  column  of  bones,  called 
the  spine,  sags  down  to  one  side,  and 
draws  the  whole  skeleton  of  the  trunk  out 
of  shape. 

Tl'eatTlieilt. —  The  first  thing  to  be  done 
is  to  Iciun  what  particular  attitude  of  the 
body  has  occasioned  the  distortion.  This 
discovered,  every  possible  effort  is  to  be 
made  to  break  up  the  habit,  whatever  it 
may  be.  If  it  be  standing  on  one  foot,  or 
sleeping  on  one  side,  or  reading  or  writ- 
ing wilh  the  elbow  high,  keep  a  constant 
watch  and  strict  rule  over  the  patient. 

Exercise  in  the  open  air  should  be  free, 
and  takv.Mi  daily.  'J"ie  use  of  the  dumb 
bells  is  excellent  for  both  sexes;  bat  girls 
sliould,  in  addition,  have  all  the  variety  of  elegant  exercise  furnished 
by  calisthenics.  Wealthy  parents,  whose  daughters  are  tenderly  bred, 
sliould  vcrei'  let  them  grow  up  without  the  invigoration  which  ihiiin) 
exercises  impart. 

When  the  curvature  is  marked,  and  the  debility  considerable,  these 
vigorous  exercises  should  be  taken  for  a  time  with  moderation,  and 
the  patient  should  lie  down  and  rest  immediately  after  taking  them. 

In  many  cases  considerable  benefit  is  derived  from  the  mechanical 
support  afforded  by  supporters  of  various  kinds.  These  are  now  con- 
structed and  adapted  to  the  body,  with  considerable  skill,  by  those 
who  make  their  construction  a  study  and  a  business. 

Spinal  Irritation.  —  The  spinal  column  is  liable  at  certain  points, 
to  become  congested,  and  consequently  sore  and  irritable. 

Symptoms.  —  The  symptoms  of  this  state  of  things  are  very  varia- 
ble and  numerous,  as  all  sorts  of  sensation  of  the  skin,  from  utter 
numbness  and  insensibility  up  to  the  most  acute  sensitiveness,  des- 
cribed as  creeping,  shooting,  coldne?s,  tingling,  and  the  crawling  of 
ants.  There  may  be  neuralgic  pains,  spasm,  cramp,  trembling,  or 
palsy  of  the  voluntary  muscles ;  or  a  fixed  pain  and  tenderness  in 
some  joint  or  other  part ;  or  palpitation  of  the  heart,  dizziiiess,  and 
wind  and  pain  in  the  stomach. 

When  any  of  these  symptoms  appear,  and  cannot  be  traced  to  any 
other  cause,  we  are  to  suspect  some  irritability  of  the  spinal  column, 
and  to  search,  accordingly,  in  that  direction.  The  proper  method  of 
search  is,  to  make  firm  pressure  on  each  of  the  projections  of  the 
spine,  and  to  pass  over  the  projections  a  sponge  wrung  out  of  hot 


»'«fl 


■j*?^ 


I      » 


480 


SURGICAL  DISEASES. 


water.  If  there  be  trouble  here,  the  patient  will  now  be  likely  to 
complain  of  severe  pain  at  some  one  point.  Or,  the  tender  place 
will  generally  be  found  sooner,  by  tapping  with  the  ends  of  the  fin- 
gers, with  quick  and  sharp  strokes  along  upon  the  projecting  bones 
of  the  spine.  The  patient  will  be  pretty  sure  to  wince  when  the 
tender  point  is  reached. 

Treatment.  —  Apply  leeches,  and  follow  them  with  a  blister,  or 
stimulating  liniment,  or  some  strong,  slightly  irritating  plaster,  and 
the  tenderness  will  be  very  likely  to  disappear,  as  if  by  magic. 


Wry  Neck. —  Caput  Obstipum. 

In  this  complaint,  the  head  is  drawn  over  towards  one  of  the  shoul- 
ders, with  the  face  generally  turned  towards  the  opposite  side.  This 
is  caused  by  the  rigid  contraction  of  a  particular  muscle.  In  some 
instances,  however,  other  muscles  are  anected,  and  the  head  may  be 
drawn  in  other  directions,  or  be  twitched  about  in  various  ways. 

I  had  a  singular  case  from  New  Hampshire,  which,  though  not 
exactly  wry  neck,  was  a  kindred  disease,  and  is  worthy  of  being  men- 
tionecf.  The  subject  of  it  was  a  young  lady  of  good  physical  develop- 
ment, but  inclined  to  nervous  complaints.  H«!r  head  was  chiefly  drawn 
over  backwards,  sometimes  so  as  to  lie  for  a  short  time  flat  upon  the 
back,  with  no  power  to  raise  it.  She  was  obliged,  ordinarily,  to  let 
her  head  lean  a  little  to  one  side,  and  rest  upon  the  hand,  in  order  to 
keep  it  steady.  When  walking,  with  the  head  erect,  without  this 
Hup|)ort,  it  was  every  few  moments  jerked  over  backward  and  a  little 
to  one  side,  the  chin  being  thrown  up  in  a  most  unseemly  way.  The 
case  partook  of  the  nature  of  chorea. 

Treatment.  —  For  the  genuine  wry  neck,  where  the  muscle  which 
draws  the  head  to  one  side  is  rigid  and  inflamed,  the  treatment 
should  consist  of  leeches,  poultices,  purgatives,  blisters,  and  alteratives. 
When  th»  muscles  causing  the  distortion  are  not  rigid,  electro-mag- 
::stism,  or  the  shower  bath  may  have  a  good  effect.  In  some  cases, 
8Lrychnine  will  do  well. 

rhe  peculiar  case  mentioned  above,  completely  recovered,  under  the 
uoes  of  the  extract  of  St  Ignatius's  bean  (95),  one  pill  three  times  a 
day,  and  gradually  increased  to  nine  pills  a  day.  She  also  took  iron, 
and  was  put  upon  a  most  energetic  system  of  out-door  exercise. 
Considering  the  stubborn  and  severe  nature  of  the  complaint,  her 
complete  recovery  was  as  unexpected  to  her  friends  as  it  was  grati« 
fying. 

Foreign  Bodies  in  the  Eye. 

When  a  person  complains  of  some  substance  in  the  eye,  the  inside 
of  the  lower  eyelid,  and  lower  portion  of  the  ball,  should  first  be  ex- 
amined, the  person  being  directed  at  the  same  time  to  look  up.  If 
nothing  be  discovered  there,  the  patient  is  then  to  be  directed  to  look 


SURGICAL  DISEASES. 


481 


be  likely  to 

tender  place 

ds  of  the  fin- 

ecting  bones 

ce  when  the 

a  blister,  or 
plaster,  and 
nagic. 


;  of  the  shoul- 
B  side.  This 
cle.  In  some 
head  may  be 
as  ways. 
1,  though  not 
of  being  men- 
^sical  develop- 
chiefly  drawn 
flat  upon  the 
dinarily,  to  let 
id,  in  order  to 
,  without  this 
ird  and  a  little 
ily  way.     The 

muscle  which 
the  treatment 
md  alteratives, 
d,  electro-mag- 
in  some  cases, 

ered,  under  the 
three  times  a 
also  took  iron, 
-door  exercise, 
complaint,  her 
la  it  was  grati* 


eye,  the  inside 
lid  first  be  ex- 
X)  look  up.  If 
irected  to  look 


downward.  This  will  exjwse  to  view  the  upper  part  of  the  globe. 
At  the  same  time,  the  eyelashes  sliould  be  taken  between  the  thumb 
and  finger,  and  the  lid  turned  upward  over  some  round  smooth  thing, 
as  a  bodkin,  which  will  turn  the  lid  wrong  side  out,  and  bring  to  view 
whatever  is  on  the  inner  surface.  Aiiy  foreign  body  discovered  may 
be  removed  by  wiping  it  off"  with  the  head  of  a  pin,  having  a  silk 
handkerchief  turned  over  it.  If  this  fails  to  detach  it,  it  may  be  care- 
fully picked  up  by  running  under  it  the  point  of  a  lancet,  tooth-pick^ 
or  pen-knife. 

Stye. — Hordeolum. 

A  STYE  is  nothing  more  nor  less  than  a  small  painful  boil  at  the 
edge  of  the  eyelid. 

Treatment.  —  In  severe  cases,  apply  a  poultice ;  and  open  it  as  soon' 
as  it  begins  t'   point     After  it  has  discharged  all  it  is  likely  to,  apply, 
on  going  to  bed,  for  two  or  three  nights,  a  little  diluted  nitrate  of 
mercury  ointment.     Tonics  and  alteratives  are  frequently  required  to 
break  up  the  formation  of  styes. 

Inflammation  of  the  Edge  of  the  Eyelids. 
Ophthalmia  Tarsi. 

This  inflammation  often  involves  the  Meibomian  glands,  which 
th  n  secrete  a  sticky  mucus,  which,  not  being  wiped  away  during 
sleep,  glues  the  lids  together,  so  that,  on  waking  in  the  morning,  the 
patient  cannot  get  his  eyes  open.  The  complaint  is  generally  chronic 
and  obstinate,  lasting  a  long  time.  Weakly  persons,  with  disordered 
digestion,  are  most  subject  to  it.  In  some  cases  the  lids  ulcerate,  and 
the  lashes  fall  out.  Generally  the  lids  are  considerably  inflamed  for 
a  few  days,  and  then,  the  inflammation  subsidi'ig,  branny  scales, 
which  may  be  brushed  ofl*,  form  along  the  borders  of  the  lids,  at  the 
roots  of  tke  lashes. 

Treatment.  —  The  health  being  generally  disordered,  needs  first  to 
be  improved  by  all  possible  means,  as  by  alteratives,  tonics,  bathing, 
exercise  in  the  open  air,  travelling  if  practicable,  and  a  generous  diet 

While  the  lids  are  inflamed,  they  should  be  bathed  by  a  wash  com- 
posed of  sulphate  of  zinc,  twelve  grains ;  laudanum,  two  drams ;  and 
soft  water,  twelve  ounces.  The  redness  and  heat  having  subsided, 
and  the  bowels  being  opened  by  a  gentle  dose  of  physic,  an  astrin- 
gent wash  should  be  applied  once  or  twice  during  the  day  (208) 
(209),  and  a  small  piece  of  the  diluted  nitrate  of  mercury  omtment 
be  rubbed  along  the  borders  of  the  lid,  with  a  pencil-brush  at  night 
This  will  generally  effect  an  immediate  improvement,  and  in  tune 
will  bring  about  a  cure. 

61 


t/; 


«i.mt,. 


Disorder  of  the  Lashes. 
Trichiasis.  —  This  Bignifies  a  growing  inward  of  tiie  eyelashes. 

Dystrichiasis.  —  This  is  a  double  row  of  eyelashes,  one  of  which 
grows  inward. 

Treatment.  —  Pull  out  the  misplaced  hairs,  and  continue  to  do  so 
as  fast  as  they  appear. 

Ptosis. 

This  is  a  falling  down  of  the  upper  eyelid,  from  palsy  of  the  third 
nerve.  It  is  sometimes  attended  with  headache,  and  dizziness,  and 
may  be  the  forerunner  of  apoplexy. 

Treatment.  —  Begin  the  treatment  with  purgatives,  and  then  use 
every  means  to  improve  the  health,  especially  exercise  out  of  doors. 

Chronic  Inflammation  of  the  Lachrymal  Sac. 

When  the  mucous  lining  of  the  nasal  duct  gets  thickened  and 
obstructed,  the  patient  complains  of  great  weakness  of  the  eye,  which 
is  conetantly  weeping,  —  the  nostril  on  the  same  side  having  a  corres- 
ponding dryness.  The  tears  not  passing  down  through  the  obstructed 
duct,  collect  in  the  lachrymal  sac,  and  form  a  small  tumor  by  the  side 
of  the  nose.  By  pressing  the  finger  upon  this,  the  tears  may  be 
squeezed  out  through  the  upward  passage,  and  glairy  mucus  along 
with  them.  There  is  generally  tenderness  of  the  sac,  and  sometimes 
redness  of  the  skin.  There  is  commonly  inflammation  of  the  mucous 
membrane  lining  the  eyelids,  etc. 

Treatment —  The  acute  inflammation  of  the  sac  must  be  treated 
by  leeches,  purgatives,  and  cold  washes. 

Chronic  inflammation  of  the  sac  requires  a  special  attention  to  the 
general  health.  The  diet  should  be  carefully  regulated,  and  the  alka- 
line sponge  bath  used  every  day,  with  brisk  rubbing  after  it.  When 
the  sac  gets  very  full,  the  patient  should  try  gently  to  force  the  con- 
tents dotvn  into  the  nose  by  pressing  upon  the  upper  side  of  the 
tumor ;  and  he  may  promote  the  same  object  by  strongly  drawing  in 
his  breath  often  with  his  mouth  and  nostrils  both  tightly  shut.  The 
diluted  nitrate  of  mercury  ointment  may  be  applied  to  the  eyelids  at 
bed-time,  and  a  little  of  prescription  (211)  may  be  dropped  once  dur- 
ing the  day  into  the  inner  corner  of  the  eye. 


Purulent  Ophthalmia. — Egyptian  Ophthalmia. 

Owing  to  the  glaring  sunshine,  and  the  particles  of  sand  with 
which  the  air  is  loaded,  this  disease  is  endemic  in  Egypt.  Hence  its 
name  Egyptian  opthalmia. 


elashea. 

ne  of  which 

nue  to  do  so 


of  the  third 
izziness,  and 

lid  then  use 
t  of  doors. 

1  Sac. 

ickened  and 
le  eye,  which 
^ing  a  corres- 
16  obstructed 
)r  by  the  side 
ears  may  be 
mucus  along 
id  sometimes 
'  the  mucous 


st  be  treated 

tention  to  the 
and  the  alka- 
;r  it.  When 
force  the  con- 
r  side  of  the 
y  drawing  in 
y  shut.  The 
the  eyelids  at 
)ed  once  dur- 


2lmia. 

)f  sand  with 
t.    Hence  ita 


SURGICAL  DISEASES. 


483 


Syill|ltoillS.  —  It  begins  with  stiffness,  itching,  and  watering  of  the 
eyes,  and  a  feeling  as  if  there  were  dust  in  them.  Tlie  lids  are  a 
little  swelled,  and  become  glued  together  during  sleep.  The  mucous 
membrane  which  lines  the  lids  and  covers  the  ball,  is  intensely  red 
and  swollen,  and  discharges  a  copious  quantity  of  pus.  There  is  a 
severe  burning  pain  extending  to  the  cheek  and  temple,  with  head- 
ache and  fever.  The  eyes  cannot  be  opened.  It  is  both  contagious 
and  infectious. 

Treatment.  —  At  the  very  beginning,  apply  a  nitrate  of  silver  wash 
(211),  twice  a  day.  With  this  application,  a  low  diet,  and  five  to 
ten-drop  doses  of  fluid  extract  or  tincture  of  veratrum  viride,  every 
hour,  tills  terrible  complaint  may  often  be  broken  up. 

If  the  disease  have  reached  its  height,  and  there  is  great  fever  and 
headache,  tlie  patient  may  be  freely  purged  (31),  and  the  pain  be 
allayed  by  full  doses  of  Dover's  powder. 

The  patient  must  be  kept  in  bed,  in  a  dark  room,  with  the  head 
elevated. 

The  eyes  should  be  frequently  washed  out  gently  with  warm  water, 
or  a  decoction  of  poppies,  containing  one  grain  of  alum  to  an  ounce. 
This  must  be  done  with  a  piece  of  fine  sponge,  or  with  a  small 
syringe.  Once  or  twice  a  day,  a  few  drops  of  solution  of  nitrate  of 
silver,  two  grains  to  the  ounce  of  soft  water,  may  be  dropped  in 
the  eyes  from  a  camel's-hair  pencil.  As  soon  as  the  disease  begins 
to  give  way,  the  alum  in  the  poppy  decoction  may  be  increased  a 
little. 

Purulent  Ophthalmia  of  Children. 

This  always  begins  within  a  short  time  after  birth,  —  generally 
on  the  third  day. 

Syiiiptonis.  —  The  edges  of  the  lids  at  first  become  red,  and  glued 
together,  and  the  membrane  lining  them  is  red  and  rough.  The  eye 
remains  closed.  The  conjunctiva  or  membrane  which  covers  the 
globe,  next  becomes  intensely  scarlet,  and  so  much  swelled,  at  times, 
that  the  lids  turn  out ;  and  it  discharges  a  thick  purulent  matter. 
The  child  is  feverish  and  restless. 

Causes.  —  Exposure  to  cold  and  damp,  bad  nursing,  omitting  tc 
wash  away  from  the  eyes  the  cheesy  secretions  of  the  skin,  and  the 
contact  of  gonorrhoeal  and  leucorrhoeai  secretions  of  the  vagina  at 
birth. 

Treatment.  —  Wash  out  the  eye  frequently,  and  gently,  with  a 
weak  astringent  wash  (207)  (203),  or  put  between  the  lids  once  a 
day,  a  large  drop,  with  a  camel's-hair  pencil,  of  prescription  (208). 
When  the  disease  is  declining,  apply  to  the  lids,  with  a  camel's-hair 
pencil,  diluted  nitrate  of  mercury  ointment 


-JJ 


484 


SURGICAL  DISEASES. 


Catarrhal  Ophthalmia. 

Symptoms.  —  In  this  complaint,  the  white  of  the  eye  becomes  in- 
flamed and  very  red,  the  redness  being  superficial,  so  that  the  vessel 
can  be  moved  by  pulling  the  eyelids ;  generally  tliere  is  a  thin  mucous 
discharge,  which,  in  severe  cases,  becomes  thick  and  purulent  It  is 
caused  by  cold  and  damp. 

Tretltment. —  If  there  be  considerable  pain  and  headache,  give  pur- 
gatives (31)  (19)>  and  continue  them,  once  a  day,  till  the  symptoms 
of  active  inflammation  subside.  Apply  to  the  eyes  a  poultice  of 
slippery  elm,  and  bathe  them  frequently  with  a  decoction  of  poppy 
leaves,  lukewarm,  or  cold,  according  to  the  choice  of  the  patient 
Smear  the  edges  of  the  lids  at  night  with  fresh  lard ;  and  when  the 
inflammation  begins  to  decline,  use  diluted  nitrate  of  mercury  oint- 
ment instead.  Keep  the  eyes  well  protected  from  the  light  with  a 
shade.  A  large  drop  of  a  solution  of  nitrate  of  silver,  two  to  four 
grains  to  the  ounce  of  water,  may  be  put  into  the  eye  two  or  three 
times  a  day.  Sometimes  sulphate  of  zinc,  four  grains  to  th*.  ounce 
of  water,  will  do  well. 

"When  the  disease  reaches  the  chronic  stage,  —  the  pain  and  head- 
ache having  passed  offj  —  some  astringent  applications  will  be  re- 
quired, as  a  very  weak  solution  of  nitrate  of  silver  (208),  or  a  dram 
each  of  powdered  witchhazel  leaves  and  golden  seal,  steeled  for  ten 
minutes  in  a  gill  of  boiling  water,  and  strained  when  cotd* 


Scrofulous  Ophthalmia. 

This  disease  is  chiefly  confined  to  children  unde^  t^^ht  years  of 
age. 

Symptoms.  —  Entire  inability  to  bear  light ;  the  lids  are  spasmodi- 
cally closed,  and  the  head  constantly  turned  away  frof  i  ^he  light.  The 
blood  vessels  of  the  conjunctiva  are  not  particula.ly  injected,  with 
the  exception  of  one  or  two  large  ones  which  run  t(  >varvls  the  cornea, 
and  terminate  in  one  or  more  small  opaque  pin>ples.  The  cornea 
frctiuently  ulcerates,  and  the  complaint  is  very  obstinate,  —  being 
liable  often  to  recur. 

Treatment. —  As  in  all  scrofulous  complaints,  tt  is  important  in 
this  to  look  after  the  general  health.  No  more  ^jhysic  is  required 
than  to  keep  the  bowels  open  ;  and  even  this,  ir  costiveness  exist, 
had  better  be  done  by  bread  made  from  unbolted  wheat  flour,  by 
injections  of  cool  or  tepid  water,  and  by  exercise.  The  health  must 
be  supported  by  iron,  sarsaparilla,  stillingia,  and  quinine. 

The  eye  is  to  be  strengthened  by  cold  water  applit^d  to  the  lids,  the 
forehead,  and  the  temples.  The  eyes  may  be  bathed  likewise  with  a 
warm  decoction  of  poppies,  or  of  chamomile  flowers. 

But  one  of  the  best  applications  is  a  solution  of  nitrate  of  silver, 
one  or  two  grains  to  the  ounce  of  water,  a  few  drops  being  put  into 


SURGICAL  DISEASES. 


485 


becomes  in« 
it  the  vessel 
thin  mucous 
ulent.     It  is 

he,  give  put* 
le  symptoms 

poultice  of 
on  of  poppy 

the  patient 
md  when  the 
nercury  oint» 

light  with  a 

two  to  four 
two  or  three 
to  tht>  ounce 

in  and  head- 
will  be  re- 
8)»  or  a  dram 
ee^ied  for  tea 
id. 


L^ht  years  of 

ire  spasmodi- 
he  light.  The 
injected,  with 
Js  the  cornea. 
The  cornea 
nate,  —  being 

important  in 
iic  is  required 
tiveness  exist, 
heat  flour,  by 
B  health  must 

to  the  lids,  the 
kewise  with  a 

trate  of  silver, 
teing  put  into 


the  eye  once  or  twice  a  day.     Occasionally  a  solution  of  sulphate  of 
copper,  of  the  same  strength,  may  be  used  with  decided  advantage. 
Both  eyes  should  be  protected  by  a  shade. 

Inflammation  of  the  Cornea. —  Comeitis. 

Symptoms.  —  The  cornea  is  rough,  red,  opaque,  and  generally  prom* 
inent  There  is  some  pain  and  inability  to  bear  light,  but  not  great. 
The  pulse  is  frequent,  and  the  skin  dry. 

Treatment.  —  If  the  inflammation  be  acute,  use  leeches,  emetics, 
purgatives,  tincture  of  veratrum.  Apply  fomentations,  and  smear 
belladonna  ointment  on  the  eyebrows. 

For  the  chronic  form,  give  quinine  and  other  bitters,  and  put  blis- 
ters upon  the  nape  of  the  neck,  and  behind  the  ears.  The  wine  of 
opium,  and  the  diluted  nitrate  of  mercury  ointment,  must  be  applied 
to  the  lids. 

Inflammation  of  the  Iris. — Iritis. 

The  iris  is  covered  with  a  serous  membrane,  and  is  very  liable  to 
adhesive  inflammation. 

Symptoms.  —  In  the  first  stage,  the  iris  changes  its  color,  and  the 
pupil  is  contracted.  In  the  next  stage,  lymph  is  poured  out  upon  the 
surface  in  a  thin  layer,  sometimes,  which  looks  rusty,  and  sometimes 
in  larger  quantities,  filling  the  whole  cavity  of  the  aqueous  humor. 

Canses.  —  Injuries,  or  overworking  the  eye,  but  more  frequently  a 
taint  of  the  system  from  gout  or  syphilis. 

Treatment. —  If  there  be  considerable  inflammation,  apply  leeches 
to  the  temples,  and  keep  down  the  circulation  by  tincture  of  vera- 
trum. To  relieve  pain,  if  any,  give  Dover's  powder,  or  morphia. 
The  strengtli  is  generally  to  be  supported  by  quinine ;  and  in  many 
instances,  iodide  of  potassium  is  to  be  given  as  an  alterative.  A  little 
solution  of  atropia,  one  grain  to  the  ounce  of  water,  is  to  be  dropped 
into  the  eye  once  or  twice  a  day,  and  a  warm  infusion  of  slippery 
elm  bark,  or  of  marshmallow,  to  be  used  as  a  wash.  The  bowels  to 
be  kept  open  by  gentle  physic. 

Weakness  of  Sight. — Musca  Volitantes. 

This  is  an  affection  to  which  persons  of  weakly  constitution  are 
liable,  and  those  who  write  much,  or  examine  very  small  objects. 

Symptoms.  —  Dimness  of  sight ;  uneasiness  on  exposure  to  a  strong 
light ;  and  specks  floating  before  the  eyes,  —  often  looking  like  flies. 

Treatment. —  The  complaint  depends  on  debility,  natural  or  ac- 
quired ;  and  tonics,  as  quinine  and  iron,  and  the  shower  or  sponge 
bath,  and  out-<ioor  exercise,  are  the  proper  remedies. 


'A'  I 

".  i" 


..it..»iA. 


-.U3 


486 


SURGICAL  DISEASES. 


Imperfect  Viflion. — Amaurosis. 

The  complaint  here  refernnl  to  is  dependent  on  some  change  in 
the  optic  nerve  or  the  brain,  —  most  commonly  the  former. 

Syinptoiiis.  —  In  some  cases  the  sight  becomes  suddenly  dim,  and 
is  perhaps  soon  lost  altogether ;  but  more  often  it  is  impaired  by  slow 
degrees,  —  being  only  defective  at  intervals,  as  when  the  stomach  ia 
out  of  order,  or  the  eyes  have  been  fatigued.  At  one  time,  it  will 
begin  with  objects  appearing  dim ;  at  another,  with  their  being 
louble;  at  still  another,  with  the  ability  to  see  only  one  half  of 
objects.  In  some  instances,  the  complaint  begins  with  a  crooked, 
or  disfigured,  or  discolored  appearance  of  tilings  looked  at  Again 
it  will  begin  as  near-sightedness,  or  far-sightedness ;  or  the  patient 
cannot  measure  distances,  and  will  miss  his  aim  in  pouring  water 
into  a  glass,  or  in  putting  a  match  to  the  wiek  of  a  lamp.  The  flame 
of  a  lamp  will  appear  split.  At  times  the  eye  does  not  bear  light; 
at  other  times  it  longs  for  it,  and  objects  do  not  appear  illuminated 
enough. 

,  Distinction.  —  Amaurosis  may  be  distinguished  from  cataract  by 
there  being  no  opaque  body  to  be  seen  behind  the  pupil ;  and  by  the 
light  of  a  candle  appearing  discolored,  split,  or  lengthened,  or  iride- 
scent, whereas  in  cataract,  vision  is  only  clouded,  and  a  lighted  candle 
looks  as  if  surrounded  with  a  mist. 

CllOllces  of  Cure.  —  These  are  generally  not  very  favorable,  unless 
the  remedies  employed  very  soon  produce  good  effects. 

Treatment.  —  Electro-galvanism  is  one  of  the  most  promising  reme- 
dies. Bayberry  root,  dried  and  reduced  to  an  impalpable  power,  and 
taken  as  a  snuff",  is  occasionally  useful.  Cayenne,  steeped  in  water, 
one  grain  to  one  ounce  of  water,  and  a  little  of  it  dropped  into  the 
eye,  may  stimulate  the  palsied  nerve,  and  in  some  cases  restore  sight 

Blisters  may  be  applied  behind  the  ears,  or  a  seton  may  be  tried 
upon  the  back  of  the  neck,  with  some  promise  of  success. 

But  probably  nothing  will  do  better  than  cold  bathing,  —  a  shower 
bath  if  it  can  be  borne, —  out-door  exercise  vigorously  pursued,  and 
an  adherence  for  a  long  time,  —  perhaps  a  year,  —  to  a  strictly  vego* 
table  diet,  —  at  the  same  time  using  nervine  tonics,  etc.  (316). 

Short  and  Long  Sight. 

Short  Si^lit,  called  myopia,  depends  on  too  great  a  convexity  of  the 
cornea,  or  crystaline  lens,  or  vitreous  humor,  —  one  or  all,  —  and  the 
consequent  formation  of  the  image  of  the  object  inspected  a  little  in 
front  of  the  optic  nerve,  or  retina,  —  as  at  a,  Fig.  173,  instead  of  at  b, 
where  it  should  be  formed.  The  rays  of  light  are  brought  to  a  focus 
before  they  reach  the  retina. 

Children  are  either  born  with  this  defect,  or  it  is  brought  on  by  too 
«lose  study,  or  by  long  application  of  the  eyes  to  minute  objects. 


,^_^. 


3  change  in 

y  dim, and 
red  by  alow 

stomach  is 
time,  it  will 
their  being 
one  half  of 

a  crooked, 

at.     Again 

the  patient 

uring  water 

The  flame 

bear  light; 

illuminated 


cataract  by 

and  by  the 

led,  or  iride- 

ghted  candle 

rable,  unlcse 


mismg  reme- 
e  power,  and 
ed  in  water, 
ped  into  the 
restore  sight, 
may  be  tried 
I. 

,  —  a  shower 
pursued,  and 
strictly  veg©* 
316). 


vexity  of  the 
11,  —  and  the 
ted  a  little  in 
itead  of  at  6, 
;ht  to  a  focus 

[ht  on  by  too 
objects. 


It  may  be  remedied  frequently  by  exercising  the  eyes  in  looking  at 
distant  objects.  Children  afllicted  in  this  way  should  have  their 
studies  abridged,  and  their  exercise  in  the  open  air  increased.  "While 
studying  ihey  should  have  .some  apparatus  applied  to  them  which 
hhall  keep  the  chin  elevated,  so  that  the  head  cannot  be  dropped  too 
iow,  and  the  eyes  brought  too  near  the  book.  And  the  book  should 
t  ach  day  be  placed  a  very  little  further  from  the  eyes. 

Fia.  178. 


Glasses  worn  by  persons  having  this  defect  of  vision  should  bo 
concave,  as  at  c. 

Loil(f  Siffllt,  or  preshi/opia,  depends  on  the  humors  of  the  eye  not 
being'  convex  enoiif^h.  In  this  case,  the  image  of  the  inspected  object 
is  formed  beyond  the  optic  neri'e,  as  at  d,  Fig.  174.  This  is  one  of  the 
earliest  signs  of  advancing  ago. 

Fio.  174. 


This  defect  is  to  be  remedied  by  glasses  which  are  convex,  e.  Pet- 
eons  in  the  early  autumn  of  life,  must  not  resort  to  glasses  too  hastily, 
or,  indeed,  until  they  are  compelled  to,  nor  should  they  change  those 
first  used  too  soon.  Glasses  should  make  objects  look  distinct  and 
bright,  but  not  larger  than  natural. 

Squinting. — Strabismus. 

In  strabismus,  the  eyes  are  not  parallel  in  their  position  and  mo- 
tion. 

It  is  supposed  that  one  eye  may  become  weaker  than  the  other,  or 
that  the  visual  axis  of  the  two  may  not  be  adjusted  alike,  so  that  one 
eye,  —  perhaps  the  more  defective  one,  —  turns  aside  to  escape  the 
distorted  vision,  or  possibly  the  'injury  to  itself  which  would  follow 
the  attempt  to  make  eyes  of  unequal  power  work  evenly  together. 
The  opposing  muscles  lose  their  counterbalancing  force,  and  the  in- 
ternal rectus,  gaining  the  preponderance,  draws  the  eye  inward,  —  for 
the  squint  is  more  often  convergent  than  divergent ;  that  is,  the  eye 
turns  in  more  often  than  out.     Both  eyes  sometimes  squint. 


488 


BURGICAL  DI8EARES. 


1/ 


Treatment.  —  In  recent  caHcs,  there  i»  some  chance  of  curing  this 
complaint  without  a  surgical  operation.  The  patient  should  not  be  in 
the  society  of  other  B<|uinting  persons,  so  as  to  learn  it  by  imitation. 

In  the  first  place  care  :;hould  be  taken  that  the  bowels  are  kept  in 
good  condition,  and  that  the  general  health  is  well  fortified  by  bath- 
ing, tonics,  and  exercise.  The  patient  should  be  made  to  stand 
before  a  glass,  and  while  he  closes  the  sound  eye,  look  steadily  at 
•ome  object  with  the  squinting  eye.  I^et  him  do  this  till  the  eye  is  a 
little  tired  ;  then  let  hint  open  the  sound  eye,  when  the  squinting  one 
will  turn  aside.  But  by  compelling  it,  in  this  way,  several  times  a 
day,  to  work  in  a  straight  line,  it  may,  perhaps,  be  taught  to  remain 
parallel  with  the  other. 

Nervine  tonics,  as  strychnine  (86)  (94)  (95)  (316),  will  sometimes 
do  good  service ;  and  electro-galvanism  has  been  found  useful  in 
many  cases. 

But  in  old  and  obstinate  cases,  the  only  cure  is  found  in  dividing 
the  muscle  which  pulls  the  eye  to  orje  side,  —  the  internal  rectus,  if 
the  eye  is  drawn  in,  —  the  external  rectus,  if  it  is  drawn  out. 


Affections  of  the  Ear. 

These  are  so  common,  that,  in  almost  every  family,  they  require 
attention,  at  one  time  or  another.  And  deafness,  which  so  oft«n 
results  from  these  disorders,  ia  so  serious  a  misfortune,  that  every 
affection  of  the  ear  should  receive  early  attention. 

Examination  uf  tiie  Meatus.  —  For  examiring  the  meatus,  or  ex- 
ternal passage  of  the  ear,  there  is  perhaps  no  better  instrument  than 
a  Si.nple  silver  or  glass  tube,  of  the  size  Fio.  175. 

and  shape  represented  in  Fig.  175. 

To  make  the  examination  properly,  place 
the  patient  either  in  a  sitting,  kni.'eiing,  or 
standing  posture,  as  may  be  most  conven- 
ient, with  the  ear  directly  under  a  good 
stream  of  gas,  or  lamp,  or  sun-light.  Then  take  hold  of  the  ear  with 
the  thumb  and  finger,  and  gently  draw  it  outward  and  backward,  and 
with  the  other  hand  introduce  the  small  end  of  the  tube  or  speculum, 
and  carry  it  forward  as  far  as  it  will  go  without  producing  pain. 
Then  by  gently  swaying  the  large  end  of  the  tube  back  and  forth,  a 
stream  of  light  may  be  made  to  illuminate  all  sides  of  the  passage. 
If  the  lining  of  this  passage  is  smooth,  dry,  pearly-white,  and  snining, 
and  is  without  wax,  it  may  be  regarded  as  healthy.  At  the  close  of 
the  passage,  the  tympanum  may  be  seen,  and  should  be  semi-trans- 
parent, dry,  and  grayish-white.  Within  this,  may  be  seen  the  handle 
of  the  malleus,  coming  from  above  downward  and  forward.  This 
bone  runs  about  half  way  across  the  tympanum,  and  divides  it  into  an 
upper  front,  and  a  lower  back  part.  This  lower  back  portion,  when 
viewed  through  the  speculum,  is  more  glistening  tha;;  the  upper  and 
front  part,  and  a  bright  spot  of  light  is  seen  on  its  most  rounded 
portion,  which  is  just  below  and  behind  the  point  of  the  malleus. 


curing  this 
Id  not  be  in 
imitation. 

are  Itept  in 
?d  by  batii- 
e  to  stand 

flteadily  at 
tiie  eye  in  a 
uinting  one 
•nl  tinnes  a 
;  to  remain 

sometimes 
useful  in 

in  dividing 
al  rectus,  if 
dt. 


hey  require 

ch  so  ofieii 

that  every 


itus,  or  ex- 
ument  than 


he  ear  with 
kward,  and 
t  speculum, 
ucing  pain, 
md  forth,  a 
he  passage, 
nd  snining, 
le  close  of 
semi^trans- 

the  handle 
ard.  This 
8  it  into  an 
"tlon,  when 

upper  and 
st  rounded 
le  malleiuk 


8URUICAL  DISEASES. 


489 


Inflammation  causes  this  innermost  part  of  the  meatus  to  become 
thickened,  vascular,  or  granular,  —  like  the  conjunctiva  of  the  eye 
when  it  is  inflamed ;  it  also  causes  it  to  secrete  and  discharge 
matter. 

Inflammation  of  the  Meatus. — Otorrhoea. 

This  is  quite  n  common  complaint  among  delicate  children ;  and 
may  occur  as  the  result  of  scarlet  fever,  or  be  excited  by  currents  of 
cold  air,  by  rotten  teeth,  or  by  deranged  stomach  and  bowels. 

Symptoms. —  Fever,  headache,  intense  pain  in  the  ear,  and  swelling 
of  the  glands  of  the  ncfk.  After  a  time,  a  reddish,  watery  discharge 
comes  on,  which  soon  grows  thicker  and  mattery.  The  fever  dis- 
appears with  the  appearance  of  the  thick  matter.  An  examination 
with  the  speculum  shows  the  whole  meatus  to  be  swollen,  vascular, 
and  covered  with  a  slimy  matter. 

Unless  great  attention  be  given  to  cleanliness,  the  discharge  be- 
comes  very  abundant  and  fetid,  and  lasts  for  a  long  time ;  and  if 
neglected,  will  be  likely  to  lead  to  very  serious  consequences,  even 
the  decay  of  some  of  the  bones  of  the  head. 

Treatment —  While  the  inflammation  is  acute,  and  there  is  fever 
and  pain,  the  diet  should  be  confined  to  mere  liquids,  —  as  rice-water, 
gruel,  etc.,  and  the  bowels  should  be  opened  with  some  preparation  of 
salts,  —  the  ear  being  gently  syringed,  occasionally,  with  warm  water, 
or  decoction  of  poppies,  and  being  covered  with  a  warm  poultice  of 
flax-seed,  or  bread  and  milk.  In  place  of  a  poultice,  a  soft  linen  bag, 
filled  with  bran,  and  dipped  in  hot  water,  may  be  kept  on  th.e  ear. 
If  there  be  great  pain  and  headache,  put  leeches  behind  the  ear. 

The  pain  and  fever  being  gone,  and  the  mattery  discharge  having 
come  on,  the  case  is  to  be  treated  like  other  chronic  diseases  of  mu- 
cous membranes  in  ecrofulous  constitutions,  by  tonics,  alteratives, 
warm  baths,  and  out-door  exercise. 

The  ear  may  now  be  gently  syringed  out  with  castile  soap  and 
water,  and  immediately  after  with  a  weak  solution  of  alum,  or  sul- 
phate of  zinc,  one  grain  to  a  dram.  This  may  be  done  twice  a  day. 
Or,  a  little  of  a  mixture  of  two  drams  of  solution  of  sugar  of  lead 
and  half  a  pint  of  wator,  nmy  be  dropped  into  the  meatus,  and,  after 
remaining  two  or  three  minutes,  be  allowed  to  run  out.  If  the  dis- 
charge be  very  fetid,  two  drams  of  solution  of  chloride  of  lime,  with 
half  a  pint  of  water,  will  make  a  suitable  wash  with  which  to  syringe 
it,  —  applying,  once  a  day,  a  solution  of  nitrate  of  silver,  five  grains 
to  the  ounce  of  water. 

Should  the  discharge  stop  at  any  time,  and  pain  and  fever  come 
on,  lay  aside  these  astringent  applications,  and  f*^  back  at  once  to  the 
leeches,  purgatives,  poultices,  and  fomentation  * 


'  1 


•1 


4U0 


SURGICAL  DISEASES. 


Wax  in  the  Ear. 

Thk  ear  Bometimes  becomes  completely  filled  with  wax,  mixed 
with  hairs  and  llaiies  of  tf>carf-Hkin. 

Treatment. —  Let  the  ear  be  gently  syringed  from  time  to  time 
with  wartii  soap  suds,  so  as  thoroughly  to  clear  out  the  whole  maHa 
of  matter.  The  water  may  be  quite  warm,  and  a  little  cotvon  should 
be  loosely  inserted  after  the  syringing. 


Earache. — Otalgia. 

Rymptomo.  —  This  ia  simply  neuralgia  of  the  ear,  and  comes  on  In 
fits  of  excruciating  pain,  which  shoots  over  the  head  and  face.  It 
may  be  distinguiuhed  from  inflammation  of  the  car,  by  the  sudden- 
ness and  intensity  of  the  pain ;  by  its  not  throbbing,  not  increasing 
in  intensity,  not  being  attended  by  fever,  and  not  coming  and  going 
without  apparent  cause. 

Treatment.  —  Fill  or  remove  all  rotten  teeth,  which  may  be  sus- 
pected as  the  cause  of  the  suflfermg.  Give  iron,  particularly  the 
citrate  combined  with  strychnine  (31G). 


luflammation  of  the  Tympannm.— Deafness. — Otitis. 

Symptoms.  —  In  the  acute  form  of  the  disease,  there  is  violent  pain, 
ringing  noises  in  the  ear,  and  delirium.  When  the  suppuration  takes 
place,  there  is  a  chill,  and  a  heavy,  tensive  pain. 

In  the  chronic  form  of  the  complaint,  the  lining  membrane  of  the 
tympanic  cavity,  has  ita  vessels  a  little  enlarged,  with  blood  some- 
times effused  into  its  substance,  or  lymph  upon  its  surface,  or  the 
membrane  is  thickened,  and  sometimes  covered  with  tuberculous 
concretions,  or  there  are  fibrous  bands  occupying  nearly  the  whole 
of  the  cavity. 

Symptoms. —  These  are  slight,  —  the  first  perceptible  change  being, 
generally,  deafness  in  one  or  both  ears.  There  may  be  a  woolly  sen 
■ation,  with  noises  or  ringing,  and  slight  aching  pains. 

Treatment.  —  As  the  deafness  in  these  cases  generally  depends  on  • 
chronic  inflammation  of  the  tympanic  membrane,  the  best  remedies  ar« 
those  which  improve  the  condition  of  the  digestive  organs  and  gen- 
eral health,  as  regular  diet,  bathing,  pure  air,  and  exercise,  with  tonics 
and  alteratives.  Occasionally,  a  leech  or  two,  or  a  blister  behind  the 
ear,  will  be  serviceable.  But  generally  dry  cupping  behind  and  in 
front  of  the  ear  will  answer  the  purpose  for  calling  the  blood  away 
from  the  thickened  membrane. 

If  the  inflammation  be  acute,  it  must  be  combatted  with  purging, 
blisters,  poultices,  and  fomentations. 


7 


th  wax,  mixed 

time  to  timfl 
he  whole  mass 
cotion  should 


d  comes  on  in 
1  and  face.  It 
by  the  sudden- 
not  increasing 
ning  and  going 

may  be  sus- 
>articularly  the 


ess. — Otitis. 

is  violent  pain, 
ppuration  takes 

embrane  of  the 
h  blood  some- 
surface,  or  the 
th  tuberculous 
arly  the  whole 

change  being. 
3  a  woolly  sen 

y  depends  on  • 
st  remedies  ar« 
gans  and  gen- 
86,  with  tonics 
ter  behind  the 
behind  and  in 
le  blood  away 

with  purging, 


8UR0ICAL  DISKASES. 


491 


When  deafncHs  is  caused  by  innnmmation  in  the  eustachian  tubert, 
or  irotn  tMilargeimMit  of  the  ton-^ilw,  etc;.,  the  tonHlls  must  be  cut  oH", 
and  a  solution  of  nitrate  of  silver,  twenty  groins  to  the  ounce,  must 
be  thrown  upon  the  mouths  of  the  tubes  with  u  shower  syringe. 

Bleeding  from  the  Nose.  —  Epistnxia. 

Tretltmeut. —  In  fiill-bl'xulcd  prrsons,  witli  redness  of  face,  and  sub- 
ject to  hc'iidaclic,  and  di/./incss,  bh'cding  from  the  nose  may  be  sulu- 
tiirv,  and  necessary  to  ward  off  apoplexy,  and  should  not  be  too  sud- 
denly stopped. 

When  the  bleeding  is  such  as  to  require  to  have  it  ariested,  |)lug 
the  nostrils  with  Die  scraping  Iroin  a  fur  hat,  or  with  lint,  dippiul  in  a 
strong  solution  of  iilum,  or  tannin,  or  Monsel's  pcrsalt  of  iron,  one 
part  to  ten  parts  of  water. 

Ingrowing  Toe-Nail. 

To  most  persons,  the  above  words  will  suggest  some  unpleasant 
associations,  for  there  are  few  but  have  had  some  painful  experience 
with  this  artection.  It  is  generally,  like  corns  and  some  other  trouble- 
some things,  the  penalty  indicted  for  wearing  tight  shoes.  It  gener- 
ally appears  upon  the  great  toe.  The  constant  pressure  of  a  narrow 
boot  or  shoe  against  the  siilc  of  the  toe,  causes  the  edge  of  the  nail 
to  sink  into  the  (lesh,  and  cause  inflammation  and  pain,  and  finally 
ulceration.  Nature,  attempting  to  repair  the  mis- 
chief, sends  out  granulations,  which,  being  per))et- 
ually  irritated,  shoot  up  into  unhealthy  growths, 
called  proud  flesh.  Thenct'forward,  the  sutl'erings 
of  the  patient  become  incessant ;  and  he  cainiot 
now  even  compromise,  as  he  would  be  glad  to  do, 
by  putting  on  shoes  of  ample  dimensions,  but  is 
obliged  to  negotiate  a  peace  by  putting  away  the 
shoe  altogether,  or  by  cutting  a  hole  through  it  to 
take  off  the  pressure.  At  the  risk  of  giving  the 
reader  a  few  dismal  twinges  every  time  he  looks 
Upon  this  page,  we  place  here,  in  Fig.  176,  a  good 
representation  of  this  tormenting  disorder,  as  a 
suitable  warning  against  the  folly  of  giving  the  toes  narrow  quarters. 

Treatment.  —  Make  a  lye  by  putting  half  a  pint  of  hard-wood  ashes 
into  a  quart  of  hot  water  ;  bathe  the  toe  in  this,  while  warm,  twenty 
minutes,  every  day.  Immediately  after  each  bathing  apply  a  poultice, 
made  of  ground  slippery  elm  and  weak  lye,  changing  the  poultice 
twice  a  day.  As  fast  as  the  inflammation  is  subdiicd  by  this,  press  a 
little  fine  lint  gently  under  the  edge  of  the  nail.  At  each  subsequent 
dressing,  cut  off  as  much  of  the  nail  as  is  raised  out  of  the  tender 
ilesh,  with  the  keen  point  of  a  penknife.  Continue  to  do  this  till  the 
whole  offending  portion  is  cut  away. 

If  the  above  treatment  does  not  reduce  the  inflammation  and  great 


Fio.  176. 


'it 


'  ( 


Ifl 


492 


SURGICAL  DISEASES. 


tenderness,  spread  some  extract  of  belladonna  upon  lint,  —  lay  this 
upon  the  diseased  part,  and  put  a  poulHce  over  it. 

When  the  disorder  begins  to  make  its  appearance,  it  is  a  good  plan 
to  scrape  the  nail  very  thin  on  top ;  this  will  cause  ii  to  grow  upon 
the  upper  surface,  and  to  give  way  at  the  tender  part,  so  as  to  obvi- 
ate, sometimes,  the  necessity  of  any  other  treatment. 

The  following  is  the  best  treatment.  Wash  the  toe  in  warm  water, 
and  make  the  parts  dry  with  cotton  wool.  Then  gently  press  cotton 
wool  in  between  the  toe  nail  and  the  tender  projecting  flesh,  and  ex- 
tend it  along  the  groove  back  between  the  skin  and  nail.  Next,  wet 
the  end  of  a  piece  of  nitrate  of  silver,  and  rub  it  thoroughly  upon  th© 
nail,  close  to  the  cotton,  not  allowing  it  to  touch  the  tender  fieshji 
then  put  on  a  thin  layer  of  cotton  wool,  and,  in  two  or  three  hours,  a 
poultice  around  the  toe. 

In  two  days,  the  nail  will  be  perfectly  black,  apd,  as  far  as  the  ni- 
trate was  well  applied,  will  be  separated  from  the  parts  underneath,  and 
may  be  taken  oft  without  pain. 

If  the  nail  is  very  thick,  scrape  off  the  black  and  deadened  part  in 
two  days,  and  apply  the  nitrate  again.  This  treatment  is  a  vast  im- 
provement on  the  old  and  cruel  practice  of  tearing  off  the  live  nail. 

Chafing  and  Excoriation. 

When  the  neck,  arm-pits,  thighs,  etc.,  of  children,  get  chafed  or 
excoriated,  a  remedy  may  be  found  by  keeping  the  parts  clean,  and 
by  dusting  them  with  powdered  slippery  elm,  starch,  or  hair-powder. 
If  this  does  not  effect  a  cure,  apply  Turner's  cerate,  or  wash  the  parts 
with  a  solution  of  sulphate  of  zinc,  or  nitrate  of  silver,  five  grains  to 
the  ounce  of  soft  water. 

Grown  persons  may  treat  these  troubles  very  much  in  the  same 
way,  or  by  wearing  cotton  between  parts  which  rub  together. 

Foreign  Substances  in  the  Nose. 

When  any  foreign  substance  gets  lodged  in  the  nose,  close  the 
mouth  and  the  opposite  nostril,  and  then  blow  forcibly  through  the 
ebstructed  side.  If  this  is  not  successful,  press  the  thumb  against  the 
nose  above  the  obstructing  body,  and  then  make  a  hook  of  a  piece 
of  wire  or  knitting  needle,  and  pressing  it  up  over  the  offending  sub- 
stance, pull  it  down. 

Foreign  Substances  in  the  Ear. 

If  flies  and  other  insects  get  into  the  v  ar,  fill  the  ear  with  sweet 
oil,  and  then  syringe  it  out  with  warm  water.  Sometimes  it  will  be 
sufficient  to  hold  the  head  down  on  one  side,  and  have  the  ear  filled 
With  water,  —  remaining  quiet  in  this  position  for  a  short  time,  when 
the  insect  will  rise  to  the  surface.  If  any  hard  substance  be  got  into 
the  ear,  lie  down  quietly  upon  the  affected  side,  and  send  for  a  phy- 
Mcian. 


nt,  —  lay  tlii* 

3  a  good  p)an 
grow  upon 
so  as  to  obvi- 

warm  water, 
press  cotton 

flesh,  and  ex- 
Next,  wet 
hly  upon  th© 
ender  flesh j| 

three  hours,  % 

far  as  the  ni- 
iderneath,  and 

dened  part  in 
;  is  a  vast  im- 
le  live  nail. 


get  chafed  or 
rts  clean,  and 
r  hair-powder, 
rash  the  parts 
five  grains  to 

in  the  same 
sther. 


3se,  close  the 
f  through  the 
lb  against  the 
ak  of  a  piece 
>fl'ending  sub- 


r  with  sweet 
Ties  it  will  be 
the  ear  filled 
■t  time,  when 
3  be  got  inta 
nd  for  a  phy- 


SURGICAL  DISEASES. 


493 


Foreign  Substances  in  the  Gullet. 

If  the  substance  have  not  gone  beyond  the  reach  of  the  thumb  and 
finger,  thrust  them  down  as  far  as  possible,  and  try  to  pull  it  out ;  or, 
a  small  curved  pair  of  forceps  will  reach  still  lower  than  the  fingers. 
Or,  this  failing,  let  some  one  place  one  hand  firmly  on  the  chest  of 
the  choking  person,  and  give  him  a  smart  blow  or  two  between  th« 
shoulders  with  the  other  hand.  If  the  substance  be  down  some  way 
ill  the  gullet,  it  may  be  pushed  along  into  the  stomach  by  some 
smooth,  blunt  instrument 

Foreign  Bodies  in  the  Windpipe. 

Sometimes  foreign  bodies  will  remain  a  long  time  in  the  windpipe, 
and  will  only  create  some  inflan  nation  and  cough,  but  not  any  im- 
inediate'y  dangerous  symptoms.  When  the  body  has  gone  entirely 
below  the  epiglottis,  but  little  can  be  done,  except  to  give  a  pinch  of 
BnufT  to  cause  sneezing,  and  to  direct  the  patient  to  expel  the  air  ex- 
plosively from  the  lungs  by  a  few  energetic  and  sudden  coughs.  This 
may  drive  the  offending  body  out 

Bleeding  from  Wounds. 

If  bleeding  occur  from  any  part  where  a  bone  lies  near  the  surface, 
as  the  head  or  face,  it  may  generally  be  stopped  by  pressing  firmly 
against  the  bone  with  a  finger,  or  a  piece  of  cork,  or  by  binding  on 
tightly  a  hard  pad.  If  this  does  not  succeed,  lift  up  each  edge  of  the 
wound,  and  examine  carefully  to  see  if  any  small  stream  of  blood  is 
spouting'  out  in  jets.  If  so,  an  artery  is  wounded,  and  the  point  of 
small  forceps  or  tweezers  must  be  dipped  in  where  the  jets  come 
from  ;  the  spouting  mouth  taken  hold  of  and  drawn  out ;  and  a 
strong  silk  thread  passed  around  it,  and  tied  below  the  forceps.  The 
white  and  gaping  mouth  of  the  vessel  may  then  be  seen. 

If  the  bleeding  be  profuse  from  an  arm,  the  whole  current  of  blood 
to  that  limb  must  be  cut  oft",  which  may  be  done  by  some  person 
pressing  a  thumb  firmly  into  the  neck  behind  the  middle  of  the  collar- 
bone. This  will  dam  up  the  blood  in  the  great  artery  of  the  arm,  aa 
it  comes  out  of  the  chest  The  handle  of  a  door-key,  wrapped  in 
several  folds  of  linen,  may  be  pressed  upon  this  place  for  a  long  time 
until  medical  assistance  can  be  had. 

Dangerous  bleeding  from  the  thigh  or  leg,  may  often  be  stopped  by 
pressing  the  great  artery  just  below  the  crease  of  the  groin. 

If  the  bleeding  be  below  the  middle  of  the  upper  arm,  or  middle 
o.  the  thigh,  pass  a  handkerchief  once  or  twice  around  the  limb,  as 
far  above  the  wound  as  possible,  t  nd  tie  it  tightly.  Slip  a  stiff"  stick 
under  this,  and  turn  it  round,  like  the  handle  of  an  auger,  until  the 
liandkerchiei  becomes  so  tight  as  to  stop  the  bleeding.  This  arrange- 
ment is  called  a  stick-tourniquet,  and  is  intended  to  answer  the  same 
purpose  with  the  instrument  represented  by  Fig.  146.    (See  p.  878.) 


m 


•  '4 


fcc.  i_  .  .:...„ 


li'    I      CT 


494 


SURGICAL  DISEASES. 


Apparent  Death  from  Nozioas  Vapors. 

When  persons  become  insensible  from  breathing  foul  air  in  a  deep 
well  or  other  place  where  it  collects,  let  them  be  immediately  exposed 
to  the  open  air,  and  cold  water  be  sprinkled  upon  the  face  and  head, 
and  strong  vinegar  be  rubbed  about  the  nostrils.  As  soon  as  tlicrc  is 
ability  to  swallow,  give  some  drinks,  as  lemonade,  or  a  few  drops  of 
aromatic  sulphuric  acid,  dropped  into  a  tumblerful  of  water,  and 
slightly  sweetened.     A  stimulating  inject'.on  (246)  may  be  given. 

Apparent  Death  from  Burning  Charcoal. 

Some  persons  very  thoughtlessly  attempt  to  warm  their  sleeping  or 
sitting  rooms  with  a  portable  furnace,  or  open  pan  filled  with  burning 
charcoal,  or  live  coals  from  a  wood  fire.  This  is  very  wrong,  as  such 
coals  while  burning  throw  off  large  quantities  of  carbonic  acid  gas,  a 
deadly  poison.  This  being  heavier  than  atmospheric  air,  falls  to  the 
bottom  of  the  room,  and  for  a  time  may  do  no  damage ;  but,  if  there 
be  no  chimney-draught,  or  open  door  or  window,  it  will  rise  above 
the  heads  of  those  in  the  room,  and  bring  on  asphyxia  and  death. 

Let  such  cases  be  treated  the  same  as  the  preceding,  with  the  addi- 
tional measure  of  attempting  to  excite  breathing,  as  in  the  case  of 
persons  apparently  dead  from  drowning. 

To  Recover  Persons  Apparently  Drowned. 

Drowning  persons  die  by  what  is  called  asphyxia.  The  air  being 
(shut  off  from  the  lungs,  breathing  stops,  and  the  immediate  accumu- 
lation of  carbonic  acid  in  the  blood,  paralyzes  the  nervous  system,  and 
insensibility  immediately  follows.  The  heart  continues  to  beat,  how- 
ever, from  five  to  twenty  minutes  after  the  occurrence  of  insensibility 
and  apparent  death. 

Recovery  may  take  place  at  any  time  before  the  heart  ceases  to 
beat,  and  has  been  brought  about  in  some  cases  even  after  this  organ 
has  become  still.  It  has  taken  place,  in  some  few  instances,  as  late  as 
half  an  hour  after  being  under  water,  but  it  can  scarcely  be  expected, 
even  under  the  best  treatment,  later  than  twenty  minutes  from  the 
time  o^  submersion ;  and  even  as  late  as  this,  the  chances  are  much 
against  restoration. 

Treatment. —  The  best  treatment  is  that  recommended  by  Dr.  Mar- 
shall Hall. 

Treat  the  patient  instantly,  on  the  spot,  in  the  open  air,  and,  except 
in  severe  weather,  expose  the  face  and  chest  to  the  breeze. 

Then,  to  Clear  the  Throat,  place  the  patient  gently  on  the  face,  with 
one  wrist  under  the  forehead.  All  the  fluids,  and  the  tongue  now 
fall  forward,  leaving  the  passage  to  the  windpipe  free.  If  there  be 
breathing,  wait  and  watch.  If  there  be  no  breathing,  or,  if  there  have 
been,  and  it  has  failed, 


SURGICAL  DISEASES. 


495 


ors. 

air  in  a  deep 
ately  exposed 
ice  and  licad, 
)on  as  tlicrc  is 

f(!W  drops  of 

f  water,  and 

3e  given. 

coal. 

sir  sleeping  or 
with  burning 
kTong,  as  such 
lie  acid  gas,  a 
ir,  falls  to  the 
;  but,  if  there 
'ill  rise  above 
md  death, 
with  the  addi- 
n  the  case  of 


wned. 

The  air  being 
diate  accumu- 
JLS  system,  and 
.  to  beat,  how- 
»f  insensibility 

eart  ceases  to 
fter  this  organ 
ices,  as  late  as 
y  be  expected, 
utes  from  tiie 
iices  are  much 

d  by  Dr.  Mar- 
ir,  and,  except 

the  face,  with 

!  tongue  now 

If  there  be 

,  if  there  have 


Then,  to  Excite  Breathing,  turn  the  patient  well  and  instantly  on 
his  side,  and  excite  the  nostrils  with  snuff,  or  the  throat  with  a  feather, 
and  dash  cold  water  on  the  face,  previously  rubbed  warm.  If  there 
be  no  success,  lose  not  a  moment,  but,  instantly, 

Next,  to  Imitate  Brenthinjif,  replace  the  patient  on  his  face,  raising 
and  supporting  the  chest  well  on  a  folded  coat  or  other  article  of 
dress.  Now  very  gently  turn  the  body  on  the  side,  and  a  little  be- 
yond, and  then  quickly  back  upon  the  lace,  and  repeat  these  turnings, 
back  and  forth,  deliberately,  otlitriently,  and  perseveringly,  fifteen  times 
in  a  minute,  occasionally  varying  the  side.  These  motions  will  cause 
a  kind  of  artificial  breathing;  for  while  the  patient  rests  upon  the 
breast,  the  weight  of  the  body  compresses  this  cavity,  and  expels  the 
air,  which  is  the  same  as  the  outgoing  breath,  or  expiration  ;  when 
he  is  turned  on  the  side,  the  pressure  is  removed,  and  the  air  rushes 
in  as  in  natural  inspiration,  or  the  ingoing  of  the  breath.  When  the 
patient  is  on  the  face,  make  even  and  elHcicnt  jiressure  along  up  the 
back  of  the  chest,  discontinuing  it  immediately  before  turning  the 
body  u|)on  the  side.  This  upward  gliding  pressure  helps  expel  the 
air.  Of  course  it  must  be  stopped  the  moment  the  body  is  in  a  posi- 
tion upon  the  side  to  let  it  in.  The  result  of  these  movements  is 
breatkiiiff,  and,  if  not  too  late,  life. 

Then,  to  lujliiee  firoiiltition  and  Warmth,  rub  the  limbs  upwards 
(and  of  course  this  should  be  done  during  the  previous  measures) 
with  firm  grasping  pressure,  and  with  energy,  using  handkerchiets, 
and  warm  soft  flannels  if  at  hand.  This  pushes  the  blood  along  up 
towards  the  heart  through  the  veins.  In  this  way,  too,  the  limbs  are 
warmed  and  dried,  and  maybe  now  clothed,  —  the  bystanders  sup- 
plying the  garments.  Avoid  the  continuous  warm  bath,  and  the 
position  on  or  inclined  to  the  back.  Beside  the  above,  pour  into  the 
nostrils  a  teaspoonful  of  aromatic  spirit  of  ammonia,  and  thrust  a 
feather  into  the  nostrils,  dipped  in  water  of  ammonia.  Give  also  a 
stimulating  injection,  composed  of  a  pint  of  water  with  a  tablespoon- 
ful  of  ground  mustard,  and  a  teaspoonful  of  pulverized  cayenne,  and 
put  a  mustard  poultice  upon  the  perineum  and  anus. 

Apparent  Death  from  Ligfhtning. 

A  STROKE  of  lightning  wi'V  frequently  produce  asphyxia  by  pnr- 
alyzing  the  muscles  of  resp,  'ation.  In  such  case,  the  same  means 
for  recovery  should  be  used  as  in  apparent  death  from  drowning.  Or, 
the  apparently  dead  person  may  be  placed  in  a  current  of  fresh  air, 
and  cold  water  dashed  upon  the  face,  neck,  and  breast,  and  warm 
friction  be  applied  if  the  body  is  cold. 

Apparent  Death  from  Hanging. 

Persons  found  hanging,  who  have  committed  suicide,  are  to  be  cut 
down  instantly,  and  the  same  means  employed  to  reestablish  breath- 


#1 


!' 


496 


SURGICAL  DISEASES. 


ing  as  in  cases  of  drowning.  It  may  help  to  restore  the  breathing,  to 
bathe  the  forehead  and  face  with  vinegar,  or  t"  eture  of  camphor,  and 
to  pass  hartshorn  frequently  under  the  nostrils. 

Clothes  Catching  Fire. 

It  is  perhaps  n.ireasonable  to  look  for  presence  of  mind  when  this 
frightful  accident  occurs,  yet  it  is  never  more  needed  than  at  such  a 
time. 

The  instant  a  lady  »''erceives  her  clothes  to  be  on  fire,  and  in  a  blaze, 
she  should  seize  the  wei^irest  large  rug,  cloak,  blanket,  cov«;rlet,  or  any 
equivalent  article,  and,  wrapping  it  tight  around  her,  throw  herself 
flat  upon  the  floor,  taking  care  to  keep  the  protecting  covering  close 
to  her  until  the  fire  is  completely  smothered.  If  she  does  this  witk 
energy,  and  effectually,  she  will  put  out  the  fire  instantly. 

If  she  continue  on  her  feet,  the  blaze  will  rapidly  ascend,  and  burn 
her  vital  parts.  H  she  run  to  seek  relief  from  others  not  present,  the 
motion  of  the  air  will  fan  the  flame  into  a  swifter  work  of  destruc* 
tion. 

If  it  be  a  child  that  is  on  fire,  let  any  person  present  treat  it  as 
above.  If  it  be  badly  burned  before  the  fire  is  extinguished,  put  it 
instantly  into  a  tub  of  cold  water,  or  da/h  cold  water  upon  it,  to 
prevent  the  burn  from  becoming  deep. 

Accidents  on  the  Water. 

If  upset  in  a  boat,  or  otherwise  thrown  into  the  water,  and  are  not 
able  to  swim,  draw  the  breath  in  well,  and  keep  the  mouth  shut  tight. 
Do  not  struggle  and  throw  the  arms  up ;  but  yield  quietly  to  the 
water,  hold  the  head  well  up,  and  stretch  out  the  hands  only  beloio 
the  water.  To  throw  the  hands  or  the  feet  up,  will  pitch  the  head 
down,  and  cause  the  whole  person  to  go  immediately  under  water. 
Keep  the  head  above,  and  everything  else  under  water. 

Poisoning  Accidents.— Antidotes  of  Poisons. 

Accidents  from  poisons  are  of  such  common  occurrence,  that 
every  person  should  know  the  proper  remedies,  and  not  be  obliged  to 
wait  the  arrival  of  a  physician  before  the  proper  corrective  is  applied, 
The  most  common  remedies,  with  the  methods  of  applying  them, 
will  be  given  under  the  proper  heads  below.  The  mineral  poisons 
will  be  spoken  of  first     (See  p.  880.) 

Poisoning  by  Ammonia. 

Water  of  ammoni'.,  or  hartshorn,  if  taken  in  an  undiluted  state, 
acts  as  a  violent  poison. 

When  this  accident  happens,  give  vinegar  instantly,  mixed  with  a 
little  water.  Vinegar  is  an  acid,  and  ammonia  is  an  sukali ;  and  acids 
and  alkalies  neutralize  each  other.  ■    , 


3  breathing,  to 
camphor,  and 


lind  when  this 
van  at  Huch  a 

and  in  a  blaze, 

overlet,  or  any 

throw  herself 

covering  close 

Joes  thia  with 

end,  and  burn 
lot  present,  the 
9rk  of  destruc* 

;nt  treat  it  as 
guished,  put  it 
er  upon  it,  to 


er,  and  are  not 
)uth  shut  tight 
quietly  to  the 
nds  only  belouf 
pitch  the  head 
f  under  water. 


^oisons. 

2currence,  that 
»t  be  obliged  to 
;tive  is  applied, 
ipplying  them, 
lineral  poisons 


mdiluted  state, 

,  mixed  with  a 
kali ;  and  acids 


SURGICAL  DISEASES. 


497 


Poisoning  by  Antimony. 

Tartar  emetic,  and  wine  of  antimony,  are  sometimes  taken  by 
accident  in  large  doses,  so  as  to  act  as  poisons,  and  cause  dangerous 
vomiting  and  prostration. 

Give  a  tea  of  slippery  elm,  flax-seed,  marshmallow,  etc. ;  also  syrup 
!of  poppies,  paragoric,  or  laudanum  in  twenty-drop  doses.  To  neiH 
tralize  the  poison,  give  a  strong  solution  of  tannin,  or  an  infusion  of 
oak  bark,  or  nutgalls.  • 

Poisoning  by  Arsenic. 

Use  the  stomach  pump  instantly,  if  one  is  to  be  had ;  if  not,  give 
twenty  grains  of  e  ilphate  of  zinc  (white  vitriol)  in  a  little  warm 
water;  and  promote  the  vomiting  by  filling  the  stomach  with  large 
draughts  of  warm  or  cold  milk,  sweetened  water,  or  flax-seed  tea. 
Or,  vomiting  may  be  Induced  still  more  quickly,  by  giving  a  large 
tablespoonful  of  strong  ground-mustard,  mixed  with  a  teacupful  of 
water. 

But  the  best  antidote  for  arsenic  is  hydrated  sesquioxide  of  iron. 
Mix  a  tablespoonful  of  this  with  water,  and  give  this  amount  every 
five  or  ten  minutes,  until  half  a  dozen  doses  are  taken. 

Treat  the  inflammation  of  the  stomach  which  follows,  by  blisters, 
a  bland  liquid  diet,  mucilaginous  drinks,  etc. 

Poisoning  by  Verdigris,  or  Acetate  of  Copper. 

Cooking  utensils  made  of  copper  never  ought  to  be  tolerated  ;  yet 
they  are  used ;  and  it  is  from  the  verdigris  which  forms  upon  them 
that  most  of  the  cases  of  poisoning  by  copper  happen. 

Give  an  emetic  instantly,  and  then  two  teaspoonfuls  of  carbc  ite 
of  soda  (bread  soda)  in  a  tumblerful  of  water,  to  be  repeated  in  ^.en 
minutes.  White  of  eggs,  diffused  in  water,  and  mucilaginous  drinks 
are  proper. 

Poisoning  by  Corrosive  Sublimate. 

This  is  the  common  bed-bug  poison,  and  is  often  taken  by 
mistake. 

Mix  up  quickly  the  whites  of  a  dozen  eggs,  with  two  pints  of  cold 
water,  and  give  a  glassful  of  the  mixture  every  two  minutes  till  the 
stomach  can  contain  no  more.  If  there  are  not  eggs  enough  at  hand, 
take  what  there  are,  and  make  up  the  deficiency  with  milk.  Wheat 
flour,  mixed  with  water,  is  a  good  remedy.  Use  the  stomach  pump, 
if  it  is  at  hand.  Treat  the  resulting  inflammation  with  leeches  and 
fomentations. 

63 


i 


II    <■■■ ^■^A.-^flM 


ir 


498 


SURGICAL  DISEASES. 


Poisoning  by  Sugar  of  Lead,  or  Acetate  of  Lead. 

Give  a  ground-mustard,  or  a  sulphate  of  zinc  emetic ;  then,  give 
diluted  sulphuric  acid,  or,  either  epsom  or  glauber's  salts. 

Poisoning  by  Strong  Lye. 

Atrono  lye  Is  sometimes  swallowed  by  children.  The  remedy  ii 
vinegar,  or  oil.  Vinegar  will  convert  the  lye  into  acetate  of  potash, 
and  any  of  the  oils  will  unite  with  it,  and  form  soap ;  and  neither 
the  acetate  of  potasli,  nor  soap,  will  materially  injure  the  stomach. 

Poisoning  by  Nitric,  Muriatic,  or  Sulphuric  Acid. 

When  either  one  of  these  acids  is  swallowed,  not  a  moment  of 
time  is  to  be  lost.  Fill  the  patient  full  of  calcined  magnesia  stirred 
up  in  water.  This  is  the  best  remedy ;  but  if  it  is  not  to  be  had, 
give  half  an  ounce  of  soap  in  a  pint  of  water.  If  neither  are  at 
hand,  give  chalk,  or  whiting,  in  water,  or  even  pound  fine  some  of  the 
plastering  of  the  room,  and  give  it  in  water. 

Poisoning  by  Nitrate  of  Potash,  called  Nitre,  or  Saltpetre. 

Induce  vomiting  by  luke-warm  water,  and  by  tickling  the  throat 
with  a  feather;  but  avoid  irritating  the  stomach  with  the  ordinary 
emetics. 

Poisoning  by  White  Vitriol. 

Provoke  vomiting  by  arm  drinks,  and  by  tickling  the  throat,  and 
give  freely  carbonate  of  soda,  in  water. 

Poisoning  by  Oxalic  Acid. 

This  resembles  epsom  salts,  and  is  liable  to  be  taken  for  salts  by 
mistake.  The  two  can  always  be  distinguished  by  touching  a  little 
to  the  tongue.     Epsom  salts  taste  bitter ;  oxalic  acid,  very  sour. 

In  cases  of  poison  from  oxalic  acid,  give  magnesia  in  water  aa 
quickly  as  possible.  When  this  is  not  at  hand,  give  chalk,  or  lirae^ 
or  saleratus.     Use  the  st(  raach  pump,  if  it  is  to  be  had. 

Vegetable  Poisons. 

The  vegetable  poisons  are  quite  numerous,  and  many  of  them 
quite  as  virulent  and  rapid  as  any  in  the  mineral  kingdom. 


SURGICAL  DISEASES. 


499 


of  Lead. 

3;  then,  give 


le  remedy  ig 
ite  of  potash, 
and  neither 
s  stomach. 

ric  Acid. 

a  moment  of 
gnesia  stirred 
ot  to  be  had, 
leither  are  at 
e  some  of  the 


Saltpetre. 

ng  the  throat 
the  ordinary 


he  throat,  and 


1  for  salts  by 
uching  a  little 
Tj/  sotir. 
I  in  water  aa 
chalk,  or  lirae^ 


lany  of  them 
in. 


Poisoning  by  Aconite. 

Give  an  emetic  of  ground-nmstard  or  sulphate  of  zinc,  or  use  the 
stomach  pump,  instantly,  and  then  give  stimulants,  as  brandy,  gin, 
whiskey,  rum,  etc. 

Poisoning  by  Opium,  Morphine,  and  Laudanum. 

Use  the  stomach  pump,  if  at  hand ;  if  not,  a  powerful  emetic  of 
sulphate  of  zinc,  or  sulphate  of  copper ;  or,  if  these  are  not  at  hand, 
a  tiiblespoonful  of  g.  jund-mustard  in  a  teacupful  of  warm  water. 
If  vomiting  is  not  induced  at  once,  tickle  the  throat  with  a  feather,  or 
with  the  finger.  If  sleep  is  impending,  take  the  patient  into  the  open 
air,  and  keep  him  walking ;  dash  water  upon  his  face,  etc.  If  he 
still  falls  into  sleep,  and  appears  to  be  near  dying,  apply  means  for 
artificial  breathing  as  for  persons  apparently  dead  from  drowning. 

Poisoning  from  Belladonna,  Hyoscyamus,  Stramo- 
nium, and  Coninm. 

These  are  all  narcotics,  and  when  accidentally  taken  in  poisonous 
doses,  the  treatment  is  to  be  the  same  as  for  poisoning  by  opium. 
Strong  coffee  is  said  to  counteract  the  effect  of  these  articles. 

Poisoning  by  Dogwood,  Ivy,  etc. 

Give  some  of  the  salts  as  a  cathartic,  and  apply  a  solution  of  sugar 
of  lead,  or,  still  better,  a  decoction  of  witchhazel  bark. 

Poisoning  by  Spanish  Flies. 

Give  large  draughts  of  sweet  oil,  sugar  and  water,  milk,  or  flax- 
seed tea.  For  the  inflammation  of  the  bladder,  which  is  produced 
by  it,  apply  leeches,  and  a  liniment  composed  of  camphor  and  sweet 
oil.  To  relieve  the  strangury  or  scalding  of  the  water,  give  camphor 
internally. 

Poisoning  by  Prussic  Acid. 

This  is  the  most  deadly  of  all  known  poisons.  One  drop  of  the 
pure  acid  will  cause  immediate  death.  Give  water  of  ammonia  01 
hartshorn,  one  part  diluted  with  six  parts  of  water,  freely. 

Poisoning  by  Strychnine. 

The  same  treatment  as  for  poisoning  by  opium,  excepting  that 
sweet  milk  should  be  freely  administered.      This  has  been  recom- 


■<" 


BURGICAL  DISEASES. 


tncndod  by  one  respectable  physician,  at  lea?t,  who  says  he  has  found 
it  to  be  a  specific.  Camphor,  two  ounces  dissolved  in  a  quart  of 
whiskey,  and  given  freely^  is  also  said  to  bu  an  antidote. 

Care  of  the  Teeth. 

A  DECAY  and  loss  of  the  teeth  is  common  even  among  the  yonng. 
Few  persons  at  the  age  of  twenty  have  sound  teeth. 


Betting  of  the  Teeth. — Caries. 

This  is  not  confined  to  any  age,  temperament,  or  condition  of 
society. 

The  teeth  become  diseased,  die,  and  drop  away,  while  all  the  other 
organs  are  sound  and  active. 

The  Creator  doubtless  intended  that  all  the  .nembers  of  the  sam 
body  should  be  equally  durable ;  but  certain  laws  of  nature,  violated 
by  us  habitually,  turn  upon  us,  as  it  were,  in  anger,  and  smite  us  full 
in  the  face,  breaking  our  teeth,  and  robbing  us  of  the  means  of  pre- 
serving the  health  which  we  do  not  appear  to  prize. 

When  rotting  begins  in  the  teeth,  its  progress  is  more  or  less  rapid, 
and  their  destruction  is  certain,  unless  it  is  arrested  by  artificial 
means. 

The  enamel  is  nature's  fortification  to  protect  the  teeth  against  ex- 
ternal injuries.  When  this  is  broken,  or  worn  away,  the  bone  of  the 
tooth  becomes  exposed,  and  rotting  begins  immediately.  Whatever 
has  a  tendency  to  crack,  break  up,  or  destroy  the  enamel,  therefore,  is 
to  be  carefully  avoided. 

Hot  Drinks,  or  hot  food,  coming  suddenly  in  contact  with  the  en- 
amel, are  liable  to  crack  it,  and  expose  the  bony  substance  of  the 
tooth.  The  enamel  is  exceedingly  brittle,  much  like  glass  in  its  struc- 
ture, and  is  easily  cracked  when  exposed  to  sudden  transitions  from 
heat  to  cold,  and  from  cold  to  heat 

Laxurlons  Living  often  deranges  the  general  health,  and  causes 
acid  and  unhealthy  secretions  in  the  mouth,  which  act  injuriously 
upon  the  enamel. 

Acids  are  injurious  to  the  enamel ;  and  when  taken  as  medicine, 
should  be  well  diluted,  and  in  some  cases,  drank  through  a  tube,  so 
as  not  to  come  in  contact  with  the  teeth.  Sugar  is  not  directly  inju- 
rious to  the  teeth,  as  many  suppose  ;  but  if  allowed  to  reman  about 
and  between  them,  it  may  generate  aa  acid  which  is  destructive  to 
the  enamel. 

A  Crowded  Condition  of  the  teeth  in  the  mouth  causes  the  enamel 
to  wear  away,  and  leads  to  rotting;  in  which  case,  early  attention 
and  advice  from  a  dentist,  is  quite  important  ' 

Food  Lodg^ed  'tetween  tlie  Teetli,  and  in  their  depressions,  is  a  cause 
of  extensive  decay.     Animal  and  vegetable  matter,  when  exposed  to 


SURGICAL  DISEASES. 


601 


he  has  found 
1  a  quart  of 


^  the  young. 


condition  of 

J  all  the  other 

i  of  the  sam 
iture,  violated 
smite  us  full 
neana  of  pre- 

or  less  rapid, 
by  artificial 

th  against  ex- 
le  bone  of  the 
y.  Whatever 
il,  therefore,  is 

with  the  en- 
)st,ance  of  the 
as  in  its  struc- 
insitions  from 

I,  and  causes 
ct  injuriously 

as  medicine, 
jgh  a  tube,  so 
i  directly  inju* 

reman  about 
destructive  to 

!s  the  enamel 
arly  attention 

3ns,  is  a  cause 
en  exposed  to 


warmth  and  moisture,  soon  generate  an  acid  which  corrodes  the  en- 
amel. The  teeth,  consequently,  often  begin  to  decay  in  parts  where 
one  presses  upon  an  other,  and  in  depressions,  where  food  lodges  and 
remains.  This  shows  the  necessity  of  cleansing  the  mouth  and  teeth 
often,  —  particuhirly  after  meals. 

Merniry,  when  taken  to  the  extent  of  salivation,  —  whether  it  be 
calomel,  corrotfive  sublimate,  blue  pill,  or  any  other  form  of  it, — 
ca '  es  inflammation  of  the  membranes  about  the  teeth,  and  indi- 
recv     produces  caries. 

Acidity  of  the  stomach,  the  contact  of  decaying  teeth  and  dead 
stumps  with  sound  ones,  diseased  and  ulcerated  gums,  and,  above 
all,  a  filthy,  unclean,  and  unwholesome  condition  of  the  mouth,  are 
active  causes  of  diseased  teeth. 

Improper  Tuotli  Powders,  as  those  containing  gritty  particles,  are 
to  be  avoided. 

Tobacco,  by  deranging  the  general  health,  may  be  indirectly  inju- 
rious to  the  teeth.  Smoking  blackens  the  teeth  ;  and  though  chewing 
may  be  useful  in  deadening  the  sensibility  of  the  nerve  of  a  decaying 
tooth,  this  alone  is  not  a  sufficient  reason  for  so  uncleanly  and  disa- 
greeable a  habit,  while  so  many  agents  may  be  found  to  produce  the 
same  effect. 

Tartar. —  This  is  derived  from  the  saliva,  and  is  found,  when  ex- 
amined by  the  microscope,  to  be  composed  of  myriads  of  living 
animals.  When  first  deposited  around  the  teeth,  it  is  in  a  soft  state  ; 
but,  when  not  brushed  away,  it  soon  hardens,  and  changes  from  a 
yellow  to  a  brown,  and  sometimes  to  a  black  color ;  and  often  in 
children,  it  becomes  a  dark  green.  It  destroys  the  beauty  of  the 
teeth,  giving  them  a  filthy  and  revolting  look  ;  the  setting  of  the 
teeth  in  their  sockets  is  weakened ;  their  appearance  is  elongated ; 
the  periosteum  or  covering  of  the  fang  becomes  inflamed  and  tender ; 
and,  if  the  proper  remedy  be  not  applied,  the  teeth  will  become,  ^v/oa- 
ened,  and  finally  fall  from  their  sockets.  It  causes  the  gums  to  be- 
come inflamed,  swollen,  tender,  and  ulcerated,  and  loads  the  breath 
with  a  disagreeable  fetor.  Its  direct  influence  on  the  teeth  is  not 
great ;  but  it  vitiates  all  the  secretions  of  the  mouth,  and  is  thus  a 
very  efficient,  though  an  indirect  cause  of  decaying  teeth.  In  all 
cases  it  should  be  immediately  and  carefully  removed,  and  some 
astri^.^ent  wash,  made  from  peruvian  or  oak  bark,  bo  applied  to 
reduce  the  inflammation  and  swelling  of  the  gums. 

"  Tooth-Ache. 

This  is  generally  caused  by  an  exposure  of  the  nerve  which  fills 
the  internal  cavity  of  the  tooth.  This  exposure  is  caused  by  a  frac- 
ture, or,  more  commonly,  by  the  rotting  away  of  a  part  of  the  tooth. 
This  nerve  is  extremely  sensitive ;  and,  by  coming  in  contact  with 
the  air  and  acrimonious  substances,  inflammation  is  excited,  and 
tooth-ache  is  the  consequence. 


fi02 


BtlROICAL  DISEASES. 


Teeth  aometinies  ache  when  they  are,  to  appearance,  jwrfectly 
Houud.  This  may  be  caused  by  bony  enlargements  of  the  ends  of 
the  fangH,  inHumination  of  the  periosteum,  a  peculiar  irritability  and 
ague  of  the  fact',  which  excite  neuralgia,  etc. 

Pain  of  a  sound  tooth  is  soinctinics  caused  by  sympathy  with  a 
(l(H-uying  one,  by  a  disordered  stomach,  or  by  scurvy,  pregnancy,  tar- 
tar, or  whatever  excites  painful  sympathetic  action  in  the  nerves  of 
the  face. 

Treatment — Tooth-ache  may  be  quieted  by  placing  a  drop  of  oil 
of  cloves,  or  cajeput,  or  a  drop  of  creosote  upon  a  piece  of  cotton, 
iuid  inserting  it  into  the  cavity  of  the  tooth,  and  bringing  it  into  con- 
tact with  the  exposed  nerve. 

Pains  of  the  face  and  jaw,  when  not  the  consequence  ol  rotten 
teeth,  may  be  relieved  by  holding  brandy,  or  whiskey,  or  rum,  or 
diluted  tincture  of  cayenne,  or  hot  water,  in  tiie  mouth,  and  by  ex- 
ternal applications  of  laudanum,  Oliver's  |)laMter,  a  mustard  plaster, 
or  hops  steeped  in  alcohol,  or  a  blister  behind  the  ear.  But  for  teeth 
too  much  decayed  to  be  saved  by  filling,  there  is  no  remedy  so  proper 
as  extraction. 

Filling  Teeth. 

There  is  no  operation  of  the  dentist  of  more  real  and  lasting 
benefit  to  the  patient  than  that  of  filling  rotten  teeth. 

A  tooth  that  is  well  filled  before  its  nerve  is  exposed,  is  as  servicea- 
ble as  a  sound  one,  and  nearly  as  durable.  Its  preservation  for  many 
years  is  perfect  and  complete. 

It  is  necessary,  in  the  performance  of  this  operation,  to  remove 
very  carefully  all  rotten  and  foreign  matter  lodged  in  the  cavity;  to 
make  \he  cavity  of  a  dovetail  shape,  so  as  to  retain  the  filling ;  to  wijie 
it  perfectly  dry ;  and  to  press  the  gold  in  so  as  to  make  the  cavity 
perfectly  water  and  air  tight.  A  tooth  filled  in  this  way  may  be  pre- 
served many  years,  and  in  many  cases,  during  life. 

"When  decay  has  gone  so  far  as  to  expose  the  nerve  and  render  a 
tooth  painful,  the  nerve,  in  all  cases,  should  be  destroyed  before  the 
cavity  is  filled  ;  otherwise  there  may  be  soreness,  and  sometimes  ex- 
treme pain,  making  the  extraction  of  the  tooth  absolutely  necessary. 

A  tooth  filled  after  the  nerve  is  destroyed  is  not  as  good  as  if  filled 
before  the  nerve  was  exposed  ;  the  walls  of  the  cavity  are  thinner  and 
weaker,  and  consequently  are  more  liable  to  break  and  crumble  away 
when  brought  into  contact  with  hard  substances  ;  and  the  filling  will 
be  more  likely  to  oe  loosened.  There  is  likewise  some  danger  of 
ulceration  and  absorption  at  the  roct  of  a  tooth,  when  filled  in  this 
condition,  which  makes  it  very  important  that  teeth  should  be  filled 
early. 

Gold  foil  is  preferable  to  all  other  substances  for  filling  teeth.  If  it 
is  properly  pressed  and  polished,  it  will  remain  in  the  laouth  for  many 
years  without  any  sensible  loss  of  its  substance. 


-"■'■"«n 


=^ 


ice,  |)erfectly 

the  ends  of 

ritability  and 

pathy  with  a 
egnancy,  tar- 
;he  nervea  of 

a  drop  of  oil 
cp  of  cotton, 
g  it  into  con< 

lice  oi  rotten 

or  rum,  or 

I,  and  by  ex- 

tard  plaster, 

3ut  for  teeth 

E^dy  8o  proper 


and  lasting 

9  as  servicea- 
tion  for  many 

m,  to  remove 
he  cavity;  to 
:ling;  towijie 
ke  the  cavity 
f  may  be  pre- 

and  render  a 
Bd  before  the 
ometimes  ex- 
y  necessary, 
od  as  if  filled 
e  thinner  and 
irumble  away 
he  filling  will 
ne  danger  of 
filled  in  this 
ould  be  filled 

I  teeth.  If  it 
uth  for  many 


«r*= 


BURQICAL  DI8EA8KS. 


603 


The  First  Teeth. 

It  18  an  imperative  duty  of  parents  to  ace  that  their  children's  teeth 
have  early  and  careful  attention. 

The  health  and  durability  of  the  permanent  teeth  depend  materi- 
ally on  the  healthy  condition,  regularity,  and  durability  of  the  tempo- 
rary ones.  It  may  setJiii  strange  that  diseasi-s  of  the  first  set  of  teeth 
should  influence  the  set  which  is  to  follow;  but  when  wo  consider  that 
the  rudiments  of  the  second  set  already  exist  when  the  first  are  out, 
it  is  not  unreasonable  to  suppose  they  may  inherit  disease  from  their 
predecessors. 

Cleaning  the  Teeth. 

The  most  important  rule  to  be  observed  in  the  preservation  of  tho 
teeth,  is  to  keep  them  perfectly  clean,  and  never  to  allow  any  foreign 
substance  to  remain  on  or  about  them.  A  decaying  tooth  shoidd 
never  be  allowed  to  remain  in  the  moutli  ;  it  causes  others  to  decay. 

If  tartar  have  been  allowed  to  collect,  have  it  removed  immedi- 
ately. The  teeth  should  be  carefully  and  thoroughly  brushed  daily 
with  warm  water,  and  the  occasional  use  of  a  detifrice  that  is  impal- 
pably  fine,  and  that  contains  no  acid. 

A  Brush  has  no  bad  efTect  upon  the  teeth,  as  some  suppose,  for  the 
parts  of  the  teeth  most  exposed  to  the  friction  of  a  brush  are  never 
the  first  to  begin  to  decay.  This  beginning  of  decay  takes  place  in 
their  depressed  surfaces,  and  where  they  touch  each  other.  A  soft 
brush  is  better  for  the  teeth  than  a  stiff  one,  because  the  latter  is 
apt  to  fret  the  gums,  and  cause  them  to  recede,  which  gives  the 
teeth  a  lengthened  appearance. 

Teeth  in  a  crowded  condition  should  never  be  fi'od,  unless  they 
begin  to  decay. 

Tooth-Picks,  made  of  quill,  or  wood,  or  ivory,  should  be  used  after 
meals,  and  all  particles  of  food  lodged  between  the  teeth  should  be 
removed. 

In  Sickness,  the  rules  for  cleanliness  of  the  teeth  should  be  more 
rigidly  enforced  than  at  any  other  time,  as  then  they  are  more  ex- 
posed to  destructive  agents,  ind  are  liable  to  participate  in  the  gen- 
eral debility  and  disease  of  the  system. 

Influence  of  Diseased  Teeth  upon  the  Health. 

The  bad  effects  of  a  diseased  and  unclean  mouth  upon  the  general 
health,  are  of  more  serious  consequence  than  most  people  are  aware. 
In  twenty-four  hours,  we  breathe  twenty  thousand  times ;  and  what 
must  be  the  effect  upon  the  delicate  structure  of  the  lungs,  when,  for 
days,  months  and  years,  the  air  we  breathe  is  drawn  through  a  depos- 


fr 


0(A 


8UROICAI.  DISEASES. 


itory  of  filth,  and  in  poisonctl  by  being  mixed  with  cfT    via  arising 
from  decayed  and  dineaHed  mutter  in  the  moath. 

The  intermittent  fevers  of  the  West  are  caused  by  the  effluvia  aris- 
ing from  the  decaying  matter  of  iuw  grounds  and  marshes,  which 
can  hardly  be  more  pernicious  than  the  ciHuvia  from  the  impurity 
and  corruption  generated  in  an  unclean  mouth,  filled  with  decaying 
teeth.  Dr.  Huys  says  "  no  BjKicies  of  animal  mutter  is  so  offensive  to 
the  health  anci  vitality  of  the  adjoining  substance,  whether  nerve,  or 
membrane,  or  any  part  or  portion  of  the  living  body,  ad  decaying 
bone." 

Fumigation  of  Infected  Chambers  and  Other  Plactis. 

Nitric  Acid  Fumigation.  —  The  efficiency  of  nitric  acid  in  the  form 
of  gas,  in  arresting  contagion,  and  in  cleansing  infected  rooms,  ships, 
and  other  olaces,  's  woll  established.  To  obtain  the  gas,  poi'-  one 
ounce  of  sulphuric  acid  upon  two  ounces  of  nitrate  of  potash  in  a 
large  tea  cup, — the  cup  being  placed  in  a  basin  containing  hot  water. 
The  gas  or  vapor  will  be  inmicdiately  disengaged. 

This  quantity  will  thoroughly  cleanse  a  small  apartment,  but  if 
used  in  a  sick  room,  should   bo  placed  at  some  distance  from  the 

Eatient     In  a  large  room,  two  cups  will  be  required ;  and  if  a  whole 
ouse  is  to  be  fumigated,  let  several  be  placed  in  various  apartments, 
and  the  doors  and  windows  be  closed  for  half  an  hour. 

Chloride  of  Zinc. —  A  solution  of  the  chloride  of  zinc  has  great 
power  in  arresting  contagion,  and  in  cleansing  infected  places.  A 
small  quantity  of  it  will,  iu  a  few  minutes,  cleanse  the  most  offensive 
apartments. 

Chloride  of  Lime.  —  This  is  one  of  the  most  powerful  disinfecting 
or  cleansing  agents  known.  To  prepare  it  for  une,  add  four  gallons 
of  water  to  a  pound  of  the  chloride  of  lime ;  stir  the  mixture  well, 
and  after  allowing  it  to  settle  for  a  short  time,  pour  off"  the  clear 
solution,  and  keep  it  in  well-corked  bottles. 

Ciiloride  of  Soda.  —  This,  in  disinfecting  power,  is  about  equal  to 
the  chloride  of  lime.  In  order  that  it  may  retain  its  properties,  it 
must  be  kept  from  the  light,  in  a  well-stopped  glass  bottle.  When 
used,  it  must  be  mixed  in  the  proportion  of  one  ounce,  or  two  large 
spoonfuls,  to  the  pint  of  water.  It  is  excellent  for  cleansing  car- 
buncles, gangrenous  sores,  Lad  ulcers,  ulcerated  sore  throat,  and  fetid 
discharges  of  every  kind.  A  weak  solution  should  be  frequently  ap- 
plied. 

Uses  of  Chlorides  of  Lime  and  Soda.  —  These  articles  almost  in- 
stantly destroy  every  bad  smell,  and  all  effluvia  arising  from  animal 
end  vegetable  decomposition,  and  entirely  prevent  their  bad  influ- 
ence. 

While  infectious  or  contagious  diseases  prevail  in  large  towns  or 
cities,  the  rooms  should  be  sprinkled,  morning  and  evening,  with 


ii 


via  ariHing 

cHluvia  arifl. 
rshcB,  which 
the  impurity 
ith  decaying 
)  offenHive  to 
ht-r  nerve,  or 
ad  decaying 


Br  PlaOtig. 

in  the  form 
ooma,  ships, 

IH,    pop-    OHO 

potash  in  a 
ig  hot  water. 

Tient,  but  if 

ce  from  the 

d  if  a  whole 

apartments, 


ic  has  great 
1  places.  A 
ost  offensive 


disinfecting 
four  gallons 
lixture  well, 
aff  the  clear 


)ut  equal  to 
properties,  it 
ttle.  When 
or  two  large 
eansing  car- 
at, and  fetid 
equently  ap- 

i  almost  in- 
rom  animal 
r  bad  infiu- 

^e  towns  or 
ening,  with 


SURGICAL  I)ISKA8RS. 


QOO 


some  of  one  of  these  solutions.  Some  of  it  should  be  placed  in  the 
(iiii'ercnt  rooms,  in  shallow  dishes,  —  the  small  bed-rooms  being  par- 
ticularly remembered. 

in  houses  where  there  arc  typhoid  and  putrid  fevers,  and  infectious 
complaints,  it  is  highly  proper  to  sprinkle  the  solution  about  the 
rooms,  and  occasionally  upon  the  bed-linen  ;  and  the  air  of  the  room 
should  be  frequt!ntly  renewed.  A  wineglassful  added  to  the  clmmber- 
ressel  or  the  bed-pan  will  prevent  all  smell. 

Before  sending  the  bed  and  other  linen  to  the  wash,  let  it  be  im- 
mersed, five  or  six  minutes,  in  one  of  these  solutions,  diluted,  as  mere 
washing  will  not  always  remove  the  infection.  But  the  linen  should 
be  irniriediately  rinsed  in  pure  water  after  the  immersion  ;  to  allow  it 
to  dry  without  such  rinsing  might  injure  it. 

By  pouring  a  quart  rf  one  of  these  mixtures,  added  to  a  pailful  of 
water,  into  drains,  sewers,  or  cesspools,  and  repeating  the  application 
as  may  be  required,  will  destroy  all  their  offensive  eflfuvia. 

Meat  will  keep  for  some  time,  without  any  taint,  and  without  the 
molestation  of  L.es,  if  immersed  in  one  of  these  solutions  for  an  in* 
stant,  and  hung  up ;  and  all  tainted  meat,  fiah,  game,  etc.,  will  be 
rendered  sweet  by  a  little  sprinkling  of  the  same. 

To  purify  water  in  cisterns,  and  destroy  the  animalcules  in  it,  add 
to  every  one  hundred  gallons,  about  a  pint  of  one  of  the  solutions. 

The  washing  of  bedsteads  with  one  of  the  solutions,  and  putting 
it  into  all  the  crevices,  will  destroy  bugs. 

A  room  just  painted  may  be  slept  in  safely,  if  one  of  the  mixtures 
be  sprinkled  about,  and  left  in  shallow  dishes. 

Stables,  slaughter-houses,  hog-styes,  privies,  and  all  places  from 
which  ofiensive  smells  arise,  may  be  thoroughly  purified  by  these 
mixtures. 

Being  guardians  of  the  public  health  of  such  wide  application,  and 
of  so  great  utility,  it  is  surpri/ing  that  they  are  not  more  used. 

Freezing  Mixtures.         ' 

In  treating  wounds,  inflammations,  etc.,  it  is  often  quite  important 
to  have  ice,  which  is  not  to  be  obtained  without  manufacturing  it 
Accordingly,  I  give  here  a  few  directions  for  its  immediate  production. 

The  salts  used  should  be  in  a  crystalized  state,  with  as  much  water 
in  them  as  possible  without  being  damp.  They  should  be  coarsely 
pulverized  at  the  time  of  using,  and  put  into  the  water  contained  in 
a  basin,  or  other  suitable  vessel.  The  water  to  be  frozen  should  be 
inclosed  in  a  thin  vessel,  and  immersed  in  the  freezing  mixture.  To 
obtain  extreme  degrees  of  cold,  the  ingredients  and  the  vessel  should 
be  cooled  by  one  mixture,  before  being  mixed  for  another. 

To  five  drams  of  pulverized  hydrochlorate  of  ammonia,  and  five 
drams  of  pulverized  nitrate  of  potash  (nitre),  add  two  ounces  of 
water,  in  a  tin,  stone-ware,  or  glass  vessel,  and  you  may  freeze  water, 
sea-water,  milk,  vinegar,  or  oil  of  turpentine.  It  will  cause  the  ther- 
mometer to  sink  from  50"  above  zero,  to  10*  above ;  that  is,  forty 
degrees. 


so^ 


SURGICAL  DISXASES. 


A  mixture  of  five  drams  of  sulphate  of  soda,  and  four  drama  of 
diluted  sulphuric  acid,  will  sink  the  thermometer  seven  degrees  lower 
than  the  above,  namely,  down  to  3'  above  zero,  or  twenty-nine  degrees 
below  the  freezing-  point. 

If  six  drams  of  sulphate  of  soda,  four  drams  of  hydrochlorate  of 
ammonia,  two  drams  of  nitrate  of  potash,  and  four  drams  of  diluted 
nitric  acid  be  put  together,  the  mixture  will  lower  the  thermometer 
60° ;  that  is,  to  10°  below  zero,  or  42°   below  the  freezing  point. 

Beside  the  above,  the  following  combinations  may  be  used  : 

Muriate  of  ammonia,  five  ounces ;  nitrate  of  potash,  five  ounces ; 
water,  sixteen  ounces.     Mix. 

Nitrate  of  ammonia,  four  ounces ;  crystalized  carbonate  of  soda. 
four  ounces  ;  water,  four  ounces.     Mix. 

Nitrate  of  ammonia  and  water,  equal  parts.     Mix. 

Nitrate  of  ammonia,  and  nitrate  of  potash,  five  parts  each ;  sul- 
phate of  soda,  eight  parts  ;  and  water,  sixteen  parts.     Mix. 

Phosphate  of  soda,  nine  parts  ;  diluted  nitric  acid,  four  parts.     Mix. 

Sulphate  of  soda,  eight  parts  ;  muriatic  acid,  five  parts.     Mix. 

Sulphate  of  soda,  six  parts ;  nitrate  of  ammonia,  five  parts ;  di- 
luted  nitric  acid,  four  parts.     Mix. 

Freezing  Mixtures  with  Ice.  —  Snow  or  pounded  ice,  two  parts ; 
salt,  one  part.  Mix.  This  will  sink  the  thermometer  to  5°  below 
zero. 

Snow  or  pounded  ice,  four  parts ;  salt,  two  parts ;  muriate  of  am- 
monia, one  part  In  this  mi,.vure  the  thermometer  will  go  down  to 
12°  below  zero. 

Snow  or  pounded  ice,  twenty-four  parts  ;  common  salt,  ten  parts ; 
muriate  of  ammonia,  five  parts ;  nitrate  of  potassa,  five  part*.  Mix. 
Gives  18°  below  zero. 

Snow  or  pounded  ice,  twelve  parts ;  common  salt,  five  parts ;  nitrate 
of  ammonia,  five  parts.     Mix.     Gives  25°  below  zero. 

Snow,  eight  parts;  muriatic  acid,  five  parts.  Mix.  Gives  27°  below 
zero. 

Snow,  seven  parts ;  diluted  nitric  acid,  four  parts.  Mix.  Gives  30° 
below  zero. 

Snow,  four  parts ;  chloride  of  calcium,  five  parts.  Mix.  Gives  40" 
toelow  zero. 

Snow,  three  part? ;  potassa,  four  parts.  Mix.  Gives  51°  below 
zero,  or  83°  below  the  freezing  point,  ' 

Dr.  Ira  Warren's  Paracentesic  Instrument. 

Puncturing  the  chest  for  drawing  off  water  in  extensive  pleuritic 
effusion,  as  practised  of  late,  has  proved  one  of  the  most  valuable 
operations  in  modern  surgery.  Like  most  new  operations,  however, 
it  has  been  embarrassed  by  imperfect  instruments. 

The  annexed  cut  represents  an  improved  instrument  which  I  have 
just  invented,  by  which  this  operation  is  made  extremely  simple  and 
easy.     At  the  right  hand  is  the  puncturing  instrument,  including  the 


four  drama  of 

degrees  lower 

tp-nine  decrees 

drochlorate  of 
ams  of  diluted 
e  thermometer 
ng  point, 
e  used : 
h,  five  ounces ; 

onate  of  soda. 


irts  each ;  sul- 
Mix. 

ur  parts.     Mix. 
rts.     Mix. 
five  parts ;  di- 
ce, two  parts; 
er  to  5"  below 

muriate  of  am- 
rill  go  down  to 

salt,  ten  parts ; 
ve  part«.     Mix. 

e  parts;  nitrate 

jrives  27"  below 

ilix.    Gives  30» 

lix.     Gives  40° 

ves  51°  below 

ument. 

;nsive  pleuritic 
most  valuable 
tions,  however, 

t  which  I  have 
ely  simple  and 
;,  including  the 


SURGICAL  DISEASES. 


507 


external  canula,  and  the  trochar  inserted  in  it.  At  the  letter  i  is  a  slid- 
ing guard  which  moves  back  and  forth,  and  may  be  set  at  the  point  of 
desired  depth  to  which  it  is  desirable  to  puncture,  and  made  fast  by 
a  screw.  By  this  arrangement  it  may  be  driven  home  to  the  desired 
depth,  without  any  fear  of  going  too  far,  or  of  falling  short  of  the 
mark.  The  guard  also  servos  in  a  measure  to  keep  the  instrument 
steady  during  the  operation,  and  to  prevent  inflicting  pain  by  having 
it  oscillate  about.  At  ^  is  a  tubular  attachment,  opening  into  the 
canula ;  to  this  an  India-rubber  hose  is  attached,  which  connects,  at 
the  other  end,  with  the  cock,  a,  upon  the  exhausted  receiver,  o.  To  a 
cock,  c,  on  the  other  side  of  the  receiver,  another  rubber  hose  is  fast- 
ened, which  cr  nects  at  the  other  end  with  an  air-pump. 

Fia.  177. 


The  mode  of  operating  is  exceedingly  simple.  First,  exhaust  the 
receiver;  then  quickly,  yet  gently,  plunge  in  the  instrument,  and,  leav- 
ing the  canula,  withdraw  the  trocar  till  the  point  passes  the  connect- 
ing tube  at  6,  when  the  water  will  immediately  flow,  in  a  full  stream, 
into  the  exhausted  receiver,  o.  The  working  of  the  apparatus  is  ex- 
tremely beautiful.  Five  pints  of  water  may  be  taken  away  with  it  in 
five  minutes, — an  amount  which  cannot  be  got  with  the  old  instru- 
ment in  much  less  than  half  an  hour.  If  the  patient  cannot  bear  to 
have  it  drawn  so  rapidly,  the  stream  may  be  wholly  or  partially  ar- 
rested, at  any  moment,  by  entirely  or  partly  closing  the  cock,  a. 

The  reader  will  see  that  the  apparatus  is  so  arranged  that  the  ad- 
mission of  air  into  the  chest  is  entirely  impossible. 

The  artist,  in  making  the  drawing  for  me,  has  inserted  the  instru- 
ment much  further  forward  than  the  point  usually  selected. 

My  apparatus  has  a  second  puncturing  instrument,  a  little  larger  in 
aize,  for  the  purpose  of  operating  in  ascites,  or  dropsy  of  the  beuy. 


A  BRIEF  TREATISE  ON  THE 


HOMCKOPATHIC  TREATMENT  OF  DISEASES. 


BT  ▲.  X.  SllAIX,  X.O. 


■^ 


Ik  the  following  pages  will  be  found  a  reliable  guide  in  the  administra- 
tion of  homoBopathic  remedies  for  the  various  ills  known  to  occur  in  almost 
every-day  life.  Nearly  every  disease  incident  to  the  human  family  is  briefly 
considered,  and  the  corresponding  treatment  explicitly  stated.  It  must  be 
borne  in  mind,  that  homosopathio  remedies  are  addressed  to  vital  forces, 
whose  derangement  may  be  seen  in  the  manifold  forms  of  disease.  But,  in 
order  to  obtain  the  desired  effect  from  the  administration  of  any  remedy  for 
a  given  case,  a  certain  principle  must  be  observed  in  its  selection.  Thia 
principle  is  believed  to  V  ^  competent  guide  in  affiliating  remedies  to  dis- 
eased conditions.  The  discovery  of  a  universal  law  of  cure,  which  points 
out  the  direct  relationship  between  all  diseases  and  their  remedies,  is  as- 
cribed to  Hahnemann,  the  founder  of  the  homoeopathic  system  of  medicine. 
By  numerous  experiments  vith  drugs  upon  healthy  individuals,  he  ascer- 
tained that  uiseases  are  cr.rable  by  such  medicines  as  are  capable  of  pro- 
ducing similar  oharacteri*:>tics :  as,  for  instance,  chamomile  will  produce  a 
colic,  and  will  cure  a  similar  one  from  some  morbific  cause ;  hence,  the 
formula,  '■'•Similia  aimilibus  curantur"  is  the  principle  that  guides  in  tlie 
administration  of  remedies.  Every  medicine  has  a  specific  range  of  action 
in  the  body :  one  will  act  on  one  set  of  organs,  and  another  on  another 
bet ,  fom?.  will  direct  their  energies  so  as  to  affect  one  locality,  and  others 
to  another.  The  only  way,  therefore,  of  ascertaining  how  a  remedy  will 
direut  iits  action  to  any  local  or  general  disease  is  by  trying  it  first  upon 
healthy  persons  in  order  to  ascertain  its  range  of  action.  As  disease  mani- 
fests its  action  by  symptoms,  so  remedies  show  their  action  by  symptoms, 
in  a  similar  manner ;  and,  when  a  disease  presents  itself  for  treatment,  a 
remedy  must  be  selected  whose  pathogenetic  effects  upon  those  in  health 
resemble  the  phenomena  of  the  disease.  The  homoeopathic  materia  medioa 
if  made  ap  of  a  poUeotion  of  remedies  that  have  been  thus  tried.    Those 

608 


SEASES. 


the  administra- 
>cour  in  almost 
'amily  is  briefly 
d.  It  must  be 
to  vital  forces, 
isease.  But,  in 
any  remedy  for 
election.  This 
emedies  to  dis- 
e,  which  points 
remedies,  ia  as- 
sra  of  medicine, 
luals,  he  ascer- 
sapable  of  pro- 
will  produce  a 
se;  hence,  tlie 
t  guides  in  the 
•ange  of  action 
ler  on  another 
ity,  and  others 
a  remedy  will 
ig  it  first  upon 
a  disease  mani- 
by  symptoms, 
>r  treatment,  a 
bose  in  health 
nateria  medica 
tried.    Those 


HOM(EOPATniC   TREATMENT   OF   DISEASES. 


509 


employed  in  this  treatise  are  of  this  character,  and  are  comprised  in 
the  following 


•  LIST   OF  REMEDIES. 


1.  Aconite.  3. 

2.  AIoM.  6. 
t3i  Alnmina.  6. 

t4.  Amjionina  oarb.  6. 
fS.  Antimonium  cnid.  6. 

6.  Apia  mellifloi .  6. 

7.  Arnica  mont&ta.  8. 

8  Arsenicum  nlln<at.  6. 
to  Aorum  metallicom.  5. 

10.  Anacardium.  3. 

11.  Baptiaia.  1. 

12.  Belladonna.  3. 
tl3.  Bismuth  subnit.  X 

14.  Bryonia  alba.  3. 
tlS.  Calcarea  carb.  6. 

16.  Calendula.  1. 

17.  Camphora.  3. 

18.  Capsicum.  3. 

19.  Cantharis.  3. 

20.  Cannabis  sat.  3, 
m.  Carbo  anlmaUB.  6. 
t22.  Carbo  veg.  6. 

23.  Causticum.  6. 

24.  Chamomilla.  3. 

25.  China.  3. 

26.  Chelidoniom  maj.  3. 

27.  Cimioifuga  raoem.  1. 

28.  Cicuta  virosa.  3. 

29.  Cina.  S. 

30.  Cocculus  indicns.  8. 

31.  Coffea  crada.  6. 

32.  Colcblcnm.  3. 

33.  Colocynthifl.  3. 

34.  Conium  mac.  91 

35.  Grocoii  satiya.  ai 

36.  Onpram  aoet.  6L 


37.  DigiUlis.  3. 

73.  Kitrum.  6. 

t38.  Dioscorea  villoea.  2. 

74.  Nitric  acid.  6. 

39.  Drosera  rotundifolia,  3. 

76.  Nux  vomica.  6, 

40.  Dulcamara.  3. 

76.  Nux  moschaU.  6. 

t41.  Elaterium.  3. 

77.  Opium.  3. 

42.  Bnphorbium.  3. 

78.  Oleander,  3. 

43.  Euphrasia.  3. 

79.  Petroleum.  6. 

t44.  Feirum  redact.  3. 

80.  Phosphorus.  6. 

45.  Gambogia.  3. 

81.  Phosphoric  acid.  6. 

46.  Oelsemium.  1. 

t82.  Platina.  6. 

t47.  Graphites.  6. 

83.  Phytolacca  decandra.  1. 

48.  Olonoinum.  6. 

84.  Pulsatilla.  6. 

49.  Helleborus  nig.  6. 

86.  Podophyllum  pelt  8. 

tfiO.  Hepar  sulph.  6. 

86.  Rhus  tox.  3. 

M.  HyoBcyamus  nig.  S. 

87.  Rnta  graTeolens.  3. 

62.  Hamamelis.  1. 

88.  Sabina.  3. 

63.  Ignatia  amara.  3. 

89.  Sambucus  nig.  3. 

84.  lodium.  6. 

90.  Sanguinaria,  3. 

65.  Ipecacuanha.  3. 

01.  Seoale  comutnm.  8. 

66.  Iris  yersioolor.  3. 

92.  Senega.  3. 

t67.  Kali  carb.  6. 

93.  Sepia  sucooB.  8. 

t58.  Kali  bichromicum.  3. 

t94.  Silioea.  6. 

59.  Laohesis  trig.  6. 

95.  Spigelia.  3. 

60.  Ledum  palustre.  3. 

96.  Spongia.  3. 

61.  Laurocerasus.  3. 

t97.  Stannum.  6. 

t62.  Leptandria.  3. 

98.  Staphysagria.  S, 

t63.  Lycopodium  clav.  6. 

99.  Stramonium.  3. 

64.  Lobelia  inflata.  3. 

tlOa  Sulphur.  6. 

65.  Mercurius  corrosivug.  6. 

101.  Sulphuric  acid.  8. 

t66.  Mercurius  vivus.  6. 

102.  Tartar  emet  & 

t67.  Mercurius  iod.  3. 

103.  Uva  ursi.  1. 

t68.  Mercurius  biniod.  3. 

104.  TJrtica  urens.  3. 

60.  Mercurius  soL  & 

105.  Vemtrom  album.  & 

70.  Mezerinm.  3. 

106.  Ver  j/Tum  virlde.  L 

71.  Moschua.  6. 

flOe.  Zinc:^.mmet.a 

72.  Natrom  muriat.  6. 

I 


XmCTUBES  FOB  EXTERNAL  USE. 


1.  Aconite. 

2.  Arnica. 

3.  Baptista. 

4.  Calendula. 


6.  Cantharis. 

6.  Conium. 

7.  Cattstioum. 

8.  Hypericum. 


9.  Rnta  graveoleni. 

10.  Staphysagria. 

11.  Urtica  urena. 


*  The  remediea  marked  |  ihoold  be  bought  m  trUuratiOfU.  Ask  the  phurnaclat  to  prepare  then 
all  on  the  dedmal  loale,  and  ■0|  alio,  the  dilutlonj.  The  trituratlona  may  be  given  dry  on  the  tongne, 
r.  email  powder  the  size  of  a  pea;  or  the  aame  amount  or  more  dluoIvAd  in  half  a  tumblerftil  of  water,  ■ 
taaapoonftd  at  one  doM^  when  It  U  dednble  to  repeat  the  medidn*  at  abort  Interrala. 


,■  I 


510 


ROMCEOPATEUO   TREATMENT   OT  DISEASEa. 


RULES    FOR   THK    ADMINISTRATION    OF    REMKDIKS. 

As  specific  directions  will  be  found  in  the  treatment  of  eacli  disease 
treated  of  in  this  work,  only  a  few  general  rules  are  necessary-. 

1 .  In  acute  cases,  the  chosen  remedy  may  be  repeated  every  hour  or 
two  hours,  until  a  change  occurs  ;  then  it  ia  prudent  to  wait  awhile  for  the 
result. 

2.  If  there  is  no  favorable  reaction  within  a  few  hours,  or,  in  ver}-  acute 
pain,  within  half  an  Uour,  select  another  remedy  according  to  the  indica- 
tions i'  and,  should  no  favorable  reaction  follow  the  administration  of  this, 
select  another,  and  so  on. 

3.  "When  convalescence  follows  the  administration  of  a  remedy,  it  need 
not  be  repeated  uulr  "„  the  recuperation  reaches  a  certain  point  and  then 
ceases  ;  in  which  event,  select  a  remedy  according  to  indications. 

4.  The  same  remedy  may  be  repeated  in  case  of  continued  convalescence 
becoming  interrupted,  provided  there  is  no  change  other  than  amelioration 
of  symptoms. 

5.  A  change  of  remedies  is  admissible  in  obstinate  cases,  when  one  has 
been  employed  for  some  time  without  the  desired  effect.  In  chronic  cases 
it  is  well  to  try  the  remedy  at  least  a  week  before  changing. 

6.  In  chronic  diseases,  the  remedies  need  not  be  repeated  oftener  than 
once  or  twice  in  twenty-four  hours,  and  even  at  longer  intervals. 

FORMS   OF   MEDICINES   FOR  ADMINISTRATION. 

There  are  four  forms  in  which  homoeopathic  medicines  are  prepared  for 
use:  1.  Mother  tinctures  prepared  from  fresh  plants  ;  2.  Triturations  pre- 
pared from  metals,  salts,  earths,  and  herbs  ;  *  3.  Dilutions  prepared  from 
the  tinctures  ;  and,  4.  Globules  medicated  with  the  solutions.  The  last  two 
are  generally  employed,  and  the  first  two  occasionally,  in  household  prac- 
tice. When  water  is  employed  as  a  medium  for  the  administration  of  either 
form,  five  drops  of  the  tincture  or  dilution,  or  ten  globules,  or  three  or  four 
grains  of  the  trituration,  may  be  thoroughly  mixed  in  half  a  tumbler  of 
water,  and  a  dessertspoonful  of  this  mixture  will  suflQce  for  a  dose.  Tlie 
tumbler  containing  the  medicine  should  be  carefully  covered,  and  kei)t 
away  from  the  light  and  from  any  corrupting  odor ;  and  all  other  medicines, 
teas,  tonics,  and  stimulants  are  strictly  prohibited  during  its  administration  ; 
and  all  medicated  poultices,  lotions,  and  the  like,  must  be  avoided,  because 
of  their  interference  with  the  medicinal  action  of  the  remedy. 

RULES    FOR   PRESERVING   THE    PURITT   OF    MEDICINES. 

1.  The  medicines  should  be  kept  in  a  small  box  or  chest,  exclusively  for 
this  use,  carefully  closed,  and  in  a  cool  place.  Examine  the  corks  often  to 
see  that  they  are  perfectly  tight. 

*  DilutionB  are  recommended  to  be  prepared  on  the  decimal  tcalt^ 


»f  each  diseaae 

■y- 

ever}'  hour  or 
awhile  for  tlie 

,  in  very  acute 
to  the  iudica- 
itratiou  of  this, 

•emcdy,  it  need 

point  and  then 

ions. 

1  convalescence 

an  amelioration 

i,  when  one  has 
n  chronic  cases 

ed  oftener  than 
'■als. 


•e  prepared  for 
riturations  pre- 
prepared  from 
The  last  two 
lousehold  prac- 
tration  of  either 
or  three  or  four 
If  a  tumbler  of 
•  a  dose.  Tiic 
ired,  and  ke[)t 
tfier  medicines, 
idministration  ; 
TOided,  because 


ES. 

exclusively  for 
!  corks  often  to 


BOMOOFATHIO  TBEATHENT  OF   DISEASES. 


511 


2.  Be  careftll  to  keep  the  vials  corked  always  with  the  same  cork,  or  one 
that  has  never  been  used  for  any  other  purpose  ;  and  be  particularly  careAil 
not  to  misplace  the  corks,  or  fail  to  replace  the  identical  one  each  time  when 
a  vial  is  uncorked  for  use. 

3.  Never  put  medicine  into  a  vial  that  has  been  already  used  for  one  of 
a  different  kind,  unless  it  be  thoroughly  washed  and  baked. 

4.  Every  vial  should  be  labelled,  to  prevent  mistakes  ;  and  every  glass, 
spoon,  or  cup  should  be  careMly  cleansed  before  using  it  in  the  preparation 
of  a  remedy. 

5.  Never  use  the  same  spoon  in  giving  medicines  of  a  different  kind  to 
different  persons  sick  in  the  same  house. 

ANTIDOTES  TO  HE'^ICIKES. 

In  some  exceeding  impressible  conditions,  the  remedy  chosen  may  pro 
duce  intense  aggravation  of  suffering,  which  may  be  relieved  by  the  admin- 
istration of  a  drop  of  the  Spirits  of  camphor.  If  Belladonna  should  pro- 
voke an  aggravation,  Aconite  will  antidote  its  effect,  and  so  will  Camphor; 
and  this  latter  is  regarded  the  general  antidote  of  homa?opathic  reme- 
dies, two  of  whidi  should  seldom  be  given  in  alternation,  because  of  tlie 
liability  of  their  neutralizing  the  effects  of  each  other.  For  the  same  reason 
it  will  not  do  to  change  from  one  remed}'  to  another  suddenly.  A  period 
of  from  four  to  six  houis  should  intervene  in  acute  cases,  except  in  emer- 
gencies of  great  pain,  and  from  one  to  two  days  in  chronic  affections. 

EXTERNAL   APPLICATIONS. 

Compresses  wet  with  cold  water,  covered  with  a  dry  bandage,  are  always 
a  convenient  and  successful  resort  for  bruises,  sprains,  and  injuries  in  gen- 
eral. Tepid  applications,  or  cold  when  agreeable,  in  the  same  way,  may 
be  applied  to  local  inflammatory  affections.  Warm  poultices,  to  hot  and 
inflamed  surfaces,  will  often  exert  a  salutary  influence.  The  tinctures 
named  for  external  use  may  at  times  be  employed  in  full  strength ;  but 
lotions  made  of  a  teaspoonful  of  any  one  of  them,  to  a  cupful  of  cold  water, 
is  the  usual  form  of  applying  them.  Mustard  poultices  may  be  employed, 
either  in  full  strength,  or  tempered  by  adding  to  the  ground  mustard  a  duo 
proportion  of  meal.  Simple  cerate,  cold  cream,  and  healing  salves  may  be 
employed  when  needed ;  but  any  strongly  medicated  poultice,  plaster,  salve, 
or  ointment  must  not  be  used  when  taking  homoeopathic  remedies. 

BATHING. 

Persons  of  debilitated  constitutions  should  not  bathe  too  frequently ;  for 
those  of  robust  constitutions,  this  luxury  may  be  indulged  in  to  almost  any 
extent.  Bathing  in  very  cold  water  la  not  recommended.  Tepid  baths  are 
the  most  beneficial,  and  should  be  takea  regularly  throughout  the  year. 


■ 


512 


HOMCEOPATHIO   TREATMENT  OF  DISEASES. 


Hot  baths  are  weakening  and  relaxing.  They  may  be  employed  for  children 
in  convulsions,  and  to  overcome  rigidity  of  the  skin.  Sulphur  baths  are 
sometimes  recommended  for  rheumatism ;  but  they  should  be  taken  with 
caution ;  and  this  remark  is  applicable  to  all  vapor-baths.  Sea-bathing  is 
good  for  dyspepsia,  and  those  inclined  to  biliary  derangements.  Consump- 
tives  derive  but  little  benefit  ftom  any  kind  of  bathing  aside  fVom  necessary 
ablutions.  The  addition  of  salt  to  the  water  is  recommended  in  cases  of 
debility. 

DIET  AKD  BEOIMEK. 

But  little  need  be  said  about  diet  here,  as  that  which  is  appropriate  !» 
pointed  out  in  the  following  pages,  as  apart  of  the  treatment  for  each  indi- 
vidual case.  It  may  be  remarked  simply  that  no  medicinal  condiment  or 
food,  no  stimulant  or  other  medicinal  beverage,  can  be  employed  when 
taking  homceopatiiic  remedies ;  and,  further,  all  patients  must  be  placed  in 
the  best  possible  condition  for  recovery.  They  must  have  clean  and  well- 
ventilated  apartments,  and  plenty  of  fresh  air.  They  must  have  clean  and 
well-aired  bedding.  They  must  have  proper  clothes  and  food  to  correspond 
with  the  appetite  and  wants  of  the  system.  An  experienced  nurse  is  of 
great  importance,  especially  in  feven. 


»yed  for  children 

Iphur  baths  are 
be  taken  with 
Sea-bathing  13 

nts.  Consump- 
from  necessary 

ided  in  cases  of 


appropriate  U 
it  for  each  indi- 
al  condiment  or 
employed  when 
1st  be  placed  in 
clean  and  well- 
have  clean  and 
d  to  correspond 
ced  auxse  is  of 


DISEASES  INVOLVING  THE  VARIOUS  ORGANS. 


Simple  Fever. 

This  disease  is  a  simple  acceleration  of  the  pulse,  with  flushes  of 
heat ;  and  when  brought  on  by  fatigue,  give  four  globules  of  Arnica; 
if  from  cold,  Aconite;  if  from  grief,  Ignatia;  if  from  indigestion, 
Belladonna;  if  froja  dampness  and  chill,  Oelsemium,  or  Bhus  tox. 

Inflammatory  Fever. 

In  most  cases  this  disease  commences  with  pain  in  the  head  and 
full  pulse,  more  or  less  thirst,  less  of  appetite,  constipation  of  the 
bowels,  and  dry,  hot  skin.  One  drop  of  the  dilution,  or  four  globules, 
of  Aconite  may  be  given  in  the  first  stage,  every  hour,  until  the  skin 
becomes  moist,  and  the  pulse  somewhat  reduced.  Belladonna  may 
follow  Aconite,  and  be  given  in  the  same  doses  and  intervals,  until 
there  is  a  mitigation  of  the  pain  in  the  head ;  or  if  the  patient  becomes 
weak,  and  subject  to  aggravation  of  suffering  from  the  slightest  mo- 
tion, give  a  drop,  or  four  globules,  of  Bryonia,  every  hour,  until  there 
is  a  change  ;  with  restlessness,  and  when  from  checked  perspiration, 
HJius  tox.,  same  dose  as  Bryonia.  In  the  case  of  urinary  obstruction, 
give  four  globules  of  Cantharis;  or  of  flatulent  colic,  four  globules 
of  GhamomUla,    The  diet  should  be  farinaceous  gruel  or  toast. 

Typhoid  Feven 

In  general,  the  commencement  of  this  disease  is  denoted  by  las- 
situde, headache,  and  considerable  acceleration  of  the  pulse.  Then 
follow  stupor  or  delirium,  coldness  of  the  surface,  and  great  prostra- 
tion. Four  globules,  or  one  drop,  of  Aconite  may  be  given  at  first, 
every  two  hours ;  to  reduce  the  pulse  and  moisten  the  skin  (by  many 
Baptisia,  in  drop  doses,  hourly,  of  the  tincture  is  preferred  to  Aco- 
nite), Bryonia  may  be  used  after  Aconite,  a  dose  every  three  hours. 
If  the  patient  becomes  drowsy,  give  Bhus  tox. ;  cleanse  the  surface 
of  the  patient  daily  with  a  towel  wet  with  tepid  water ;  and,  if  he 
will  take  any  nourishment,  give  him  beef-tea  or  mutton-broth ;  milk 
is  allowable,  and  rice  gruel.  When  convalescent,  allow  some  light 
wine  three  times  a  day.  For  the  diarrhoea  of  Typhoid,  Arsenicum, 
four  globules,  after  each  discharge,  is  good. 

-.   ,-       Bilious  Remittent  Fever. 

This  disease  is  so  named  because  it  comes  on  by  considerable  gastric 
derangement,  headache,  and  fever,  which  appears  to  be  subject  to  eleva- 
tions and  depressions,  without  any  distinct  intermissions.    In  the  first 


DISEASES   INVOLVING    TIIK    VAKIOUS   OlIOANS. 


or  iuflarainatoiy  stage,  give  four  globules,  or  a  drop,  of  the  dilution  of 
Aconite,  and  follow  it  with  a  like  dose  of  Ipecacuanha,  and  repeat  every 
Lour,  until  the  nausea  and  vomiting  are  better.  If  the  bowels  are  couHti- 
pated,  give  Nux  vomica  at  night,  —  a  single  dose  of  four  globules.  If 
there  is  colic,  give  Cohrynth,  If  there  is  vomitiug  of  greenish  bilious 
matter,  give  Bryonia  or  Pulaatilla.    Diet  same  as  in  inflammatory  fever. 

Intennitteut  Fevert 

The  symptoms  by  which  this  fever  is  distinguished  are  yawning,  stretch- 
ing, shuddering,  and  chilliness,  followed  by  beat,  pain  in  th(!  back,  limbs, 
head,  etc. ;  and  afterwards  a  copious  perspiration,  and  then  an  interim 
of  complete  intermission.  Arsenicum,  where  the  chilliness  and  heat  are 
simultaneous,  and  where,  during  the  cold  stage,  there  is  intense  thirst  for 
cold  drinks ;  Arnica,  where  there  is  soreness  of  the  flesh,"  as  if  bruised ; 
Belladonna,  where  headache  and  ctiilliness  down  the  back ;  China,  where 
there  is  ringing  in  the  ears ;  Sulphur,  in  cases  of  long  standing,  where 
much  Quinine  has  been  given ;  Bryonia,  where  there  are  glairy  vomitings 
during  the  chill  and  fever,  and  where  all  the  suflerings  are  aggravated 
by  motion.  Apia,  atttcks  chronic,  and  preceded  by  nettle-rash,  —  followed 
well  by  Nat,  mur.,  eith>u'  to  be  given  three  times  daily.  All  the  medicines 
may  bo  administered  in  drop  doses  of  the  dilutions,  or  four  globules ;  and 
repeated  every  two  hours  between  the  paroxysms. 

Yellow  Fever, 

Common  to  the  Southern  States  during  the  warm  season.  Nearly  all 
the  symptoms  of  an  ordinary  bilious  fever,  in  an  aggravated  form,  char- 
acterize this  disease ;  and  the  victims  become  so  sallow,  and  the  surface 
BO  yellow,  as  to  give  rise  to  the  name  "  Yellow  Fever."  When  the  stage 
of  febrile  excitement  exists,  give  Aconite.  When  the  nose  bleeds,  give 
Belladonna.  When  vomiting  of  black  or  dark  bilious  matters  occurs, 
give  Arsenicum.  For  the  prostration,  or  diarrhoja,  give  Carbo  vegeta- 
bilia,  and  when  the  most  offensive  odor  comes  from  the  breath,  give 
Baptiaia.  Arsenicum  and  Carbo  vegetabilia  are  the  most  prominent  rem- 
edies. The  usual  drop  or  four- globule  doses  may  be  repeated  every  two 
hours,  and  aometimea  every  hour.    Diet,  —  barley-water  and  gruel. 

Eiuptiva  Fevers. 

Nettie-Rash  is  a  pale-red,  stinging  eruption,  that  sometimes  is  attended 
with  vomiting,  and  sometimes  with  some  other  derangement  of  the  stom- 
ach. Ipecac,  and  Nux  vomica  ar«  indicated  for  the  vomiting,  and  Apis 
mellijica^  Rhua  tox.,  and  Sulphur  for  the  burning,  itching,  and  stinging; 
Croton  tig.  cures  nearly  all  cases,  a  favorite  remedy  with  physicians.  Doses 
as  usual,  and  repeated  every  hour  or  two  hours  uutil  relieved. 

Scarlet-Bash  is  the  roseola,  or  red  eruption,  and  is  much  like  the 
nettle-rash,  only  less  anno^ng.  Bryonia,  Pulaatilla,  are  the  ordinary 
remedies ;  and  either  may  be  given  in  doses  of  four  globules  every  two 
hours ;  Aeon  .  if  wakeful  and  restless. 

Scarlet-Fever  usually  begins  with  vomiting,  quick  pulse,  aore  throat, 
headache,  and  great  restlessness.     Bdladonnat  when  there  ia  a  bright 


DISEASES    INVOLVINO    TIIK    VAKIOUS   OUOANS. 


515 


tlio  dilution  of 
n(J  repeat  every 
wels  are  consti- 
ir  globules.  ]f 
greenish  bilious 
natory  fever. 


iwning,  stretch* 
hi!  back,  limbs, 

hon  an  interim 
HH  and  beat  are 
ntense  thirst  for 
,"  as  if  bruised ; 
I ;  China,  where  • 
standing,  where 
glairy  vomitings 

are  aggravated 
rash,  —  followed 
.11  the  medicines 
ir  globules;  and 


son.  Nearly  all 
ated  form,  char- 
,  and  the  surface 

When  the  stage 
ose  bleeds,  give 

matters  occurs, 
ve  Carbo  vegeta- 
;he  breath,  give 
;  prominent  rem- 
jeated  every  two 
nd  gruel. 


times  is  attended 
lent  of  the  stora- 
niting,  and  Apis 
g,  and  stinging ; 
ysiciaos.  Doses 
id. 

9  much  like  the 
re  the  ordinary 
•bules  every  two 

ilse,  sore  throat, 
lere  ia  a  bright 


scarlet  eruption ;  Calcnren  carbnnica,  when  the  child  is  of  a  scrofulous 
habit;  Arxetiicnm,  when  there  is  great  prostration  ;  HdleboruH,  wImmi  tlicre 
are  dropsical  syniptonis  ;  lin/onia,  when  tliu  eruption  is  slow  coming  out. 
Repeat  the  medic  inos  in  the  usual  doses  every  hour.  Diet,  —  nourishing 
drinks,  toast,  and  tea. 

Measles  come  on  with  cough,  pain  in  tlio  head,  sneezing,  redness  of 
the  eyes,  and  sometimes  attended  with  nausea  and  vomiting.  Bryonia 
will  hasten  the  appearance  of  the  eruption  ;  Ipecac,  should  it  disappear 
too  suddenly,  with  consequent  increase  of  cough,  or  vomiting ;  IVionphonm 
will  obviate  tiie  inllammatory  effect  upon  the  lungs  ;  and  Drosera,  will  cure 
the  entailed  cough.     Diet,  simple  and  light. 

Erysipelas,  either  vesicular  or  plilegmonous,  is  denoted  by  a  red, 
burning,  and  fiery  appearance  of  the  face,  ami  sometimes  by  a  HuUar 
eruption,  resembling  ^-blisters.  llhuH  tox.,  Belladonna,  and  Bryonia)a.\Q 
l)r<)niiuent  remedies,  —  Belladonna,  when  the  head  and  face  are  most 
implicated;  Rhus  tox.,  when  there  is  eruption  on  the  extremities,  and 
great  weakness  ;  and  Bryonia,  when  the  suffering  seems  greatly  aggravated 
by  motion  ;  Arsenicum,  should  there  be  great  prostration,  thirst,  and  rest- 
Icsness, —  on:  of  the  best  remedies  in  severe  cases.  Any  of  these  remedies 
maj'  be  rendated  every  hour.  Diet,  —  barlej'-gruel,  rice-water,  beef-tea, 
mutton-broth,  toaf  t,  and  tea. 

Chicken-Pox.  —  A  pustular  eruption,  attended  with  slight  fever  and 
gastric  derangement.  One  or  two  doses  of  Ihilsatilla  will  generally  remove 
all  the  suffering  attendant  on  this  disease. 

Varioloid  is  another  pustular  disease,  more  severe,  as  it  comes  on  with 
pain  in  the  head  and  back,  as  if  the  latter  would  break  ;  and,  being  a  near 
relation  to  Small- Pox,  both  may  be  considered  under  tlie  same  head. 

8mall-Pox,  of  which  varioloid  is  a  modification,  comes  on  with  intense 
fever,  spitting,  pain  in  tlie  head  and  back  and  lower  extremities.  All 
the  hufferings  are  intense.  Nux  vomica  will  remove  the  pain  in  the 
back ;  Bryonia  will  hasten  the  eruption  ;  Puhatilla  will  aid  in  carrying 
it  otT.  As  soon  as  tiie  appetite  returns,  feed  the  patient  quite  gener- 
ously. In  the  smi*ll-pox  delirium,  you  can  give  Stramonium;  and, 
to  prevent  pitting,  break  the  pustules,  and  cover  them  with  Styptic 
Collodion . 

Eheumatio  Fevers. 

Inflaiiimatory  Bheuniatism  is  accompanied  by  pain  in  the  liiiibs,  in- 
flammation of  the  joints,  swelling  of  the  same,  and  great  pain  and  difS- 
culty  in  moving  about.  Aconite  reduces  tlie  fever ;  Bryonia  relieves  tiie 
pain  in  moving  about ;  Pulsatilla,  the  inflammation  of  the  knee-joints ; 
Colocynth,  that  of  the  hip-jointa ;  Nux  vomica,  the  pain  and  rheumatism 
of  the  back ;  and*  Sulphtir  and  Rhus,  the  stiflTness  that  ensues  during 
convalescence ;  Rhus  is  indicated  if  the  cause  be  check  of  perspiration, 
or  exposure  to  wet.     Diet,  — bread  and  buttei',  steak,  and  other  meats. 

Chronic  Rheumatism  is  more  confined  to  the  muscles  than  the  joints, 
and  is  often  the  sequel  of  the  acute  form.  Sulphur  is  one  of  the  reme  • 
dies  much  relied  upon  in  curing  this  disease.  Nux  vomica  may  be  given 
after  Sulphur,  when  there  is  pain  in  the  back  or  sciatic  nerve,  and  Rhus 
tox.  when  there  is  a  general  stiflfness  of  the  limbs.  The  medicines,  in  the 
usual  doses,  may  be  repeated  every  tj^  hours. 


,4 


'■% 


bit 


DISEASES  INVOLVINO  THE  VARIOUS  OBQANS. 


LunilNm^  is  simply  rheumatism  of  the  back,  in  the  lumbar  region,  and 
so  stiffens  one  that  ho  cannot  stand  erect.  Sulphur,  four  globules  at 
ni^lit,  and  Pulsatilla,  four  globules  in  tlie  morning,  will  generally  euro 
this  trouble.  Oimictfuga  is  a  very  valuiiblo  remedy,  given  hourly, 
ill  water. 

Sciatica  is  simply  neuralgia  of  the  sciatic  nerve,  and  may  be  cured 
in  %  short  time  by  a  galvanic  battery.  lihus  is  often  useful.  Bel- 
ladonna, or  its  active  principle.  Atropine,  is  a  valuable  remedy  to 
administer  internally.  The  diet  in  all  fonus  uf  rheuaiatiioii  whether 
acute  or  chronic,  may  be  generous. 

Toothache. 

When  caused  by  a  cold,  Nux  vomica  ;  when  from  caries  of  the  tooth, 
Mercuriua  viv.;  at  the  menstrual  period,  Pulsatilla;  neuralgic,  Bella- 
donna, or  UhamomWa ;  Aconite  when  there  is  heat  in  the  gums. 
Dose  as  usual,  repeated  every  hour. 

Diseases  of  the  Alimentary  Oanal.       -     -' 

liiflammattoii  of  the  Tonsils  is  the  result  of  a  cold  which  affects  this 
Incality,  and  causes  a  swelling  and  sometimes  a  suppuration  of  these  parts. 
Wlien  they  first  begin  to  inflame,  give  Aconite,  and  follow  with  Bella- 
•lonna :  repeat  every  two  hours.  Mereurius  viv.,  Lacheais,  and  Mereurius 
lodatus  are  also  good  remedies. 

Quinsy  is  the  same  as  Tonsillitis,  and  requires  the  same  treatment. 

Putrid  Sore  Throat  comes  on  by  little  vesicles  making  their  appear- 
ance in  the  mouth  and  fauces,  or  throat,  which  soon,  by  reason  of  a  low, 
constitutional  fever,  change  color,  run  together,  and  constitute  the  offen- 
sive sore  mouth  which  we  denominate  putrid.  Arsenicum,  Mereurius 
vivua.  Nitric  acid,  and  Stdphur,  or  Suiph.  acid,  will  generally  cure. 
Dose  and  repetition  as  before. 

Canker  of  the  Mouth. 

This  troublesome  disorder  is  caused  by  a  disordered  condition  of  the 
stomach,  and  requires  Arsenicum  when  the  breath  is  foul,  the  throat 
:lry,  and  attended  with  much  thirst ;  Carbo  vegetabilis,  when  the  system 
is  in  a  lo'7  condition,  and  there  is  much  coldness  on  the  surface  of  the 
body  ;  Bvlcamara,  when  produced  by  a  cold ;  Hepar  sulph.,  when  the 
canker  seems  indolent,  and  slow  in  commg  to  a  crisis ;  Natrum  muriaticum, 
when  it  assumes  the  character  of  Scurvy,  or  Mercuriim  viv. 

Dose  and  Administration.  —  Dissolve  from  two  to  five  drops  of  the 
dilution  in  half  a  tumbler  of  water,  and  give  a  teaspoonful  every  two 
hours.     Diet,  —  avoid  salt  provisions ;  use  meat-broths,  toast  and  tea. 

Inflammation  of  tiio  I'ongae. 

The  first  indications  of  this  difficulty  are  soreness  and  difficulty  in 
using  the  tongue  in  deglutition  or  eating.  When  caused  by  mechanical 
injuiy,  or  fr  )m  accidental  biting  with  the  teeth,  give  Arnica^  four  glob- 


DISEASES  INVOLVING  THE  VARIOUS  OBQANS. 


517 


nr  region,  and 
globules  at 
{onerally  cura 
fiven  hourly, 

may  bo  cured 
iHoful.  Hel' 
le  remedy  to 
tkm,  whether 


of  the  tooth, 

uralgic,  Bella- 

in  the  gums. 


lich  affects  thii 

of  these  parts. 

ow  with  Bella- 

and  Mercuriua 

treatment. 

g  their  appear- 
eason  of  a  low, 
itute  the  offen- 
nim,  Mercurim 
generally  cure. 


ondition  of  the 
foul,  the  throat 
i^hen  the  system 
1  surface  of  tlie 
ulph.,  when  the 
i-um  muriaticum, 

V. 

ve  drops  of  the 
lonful  every  two 
oast  and  tea. 


md  difficultjrin 
id  by  mechanical 
micay  four  glob- 


ules, and  wash  the  mouth  with  a  dilution  of  ten  drops  of  tincture  of 
Arnica  in  half  a  tumbler  of  water.  If  from  other  cnuses,  give  Aamite  or 
Belladonna  in  the  same  way.  When  inflammation  of  the  tongue  takes  the 
form  of  ulcers,  jgivo  Arsenicum;  of  blisters,  Mercuriua  or  LacheaU; 
when  the  tongue  inflames  and  cracks,  give  Nitric  or  Sulphuric  acid. 

Pharyngeal  Sore  Throat. 

This  is  an  inflammation  of  the  pharynx,  or  of  the  opening  into  the  upper 
portion  of  the  pa8sa<?e  from  thomoutij  irUo  the  stomach.  It  is  sometimes 
quite  serious,  and  is  usually  termed  "  Quinsy  Sore  Throat."  Aacmife 
may  bo  given  at  first,  and  this  may  be  followed  by  Belladonna,  and  this 
again  by  Mercuriua  viv.  Should  it  become  evident  that  suppuration 
must  take  place,  give  Hepar  sulph.  Whichever  remedy  is  given,  let  it  be 
repeated  every  hour  until  h.aolioration  or  change.  Baryta  curb,  is 
often  the  specitic. 

Dyspepsia,  Indigestion. 

Difficult  digestion,  whatever  form  it  assumes,  is  termed  Dyspepsia, 
and  must  be  treated  in  accordance  with  the  symptoms,  and  the  cause  that 
has  produced  them.  Dyspepsia  brought  on  by  intemperance  in  drinking 
intoxicating  liquors  requires  Nux  vom. ;  if  from  a  cold,  and  the  patient 
is  chilly  and  feverish,  Belladonna,  or  perhaps  Bryonia;  if  from  eating 
fat  meat  oi-  rich  fo«d,  Pulsatilla ;  if  from  grief,  Ignatia.  Dose,  one 
drop,  or  four  globules,  repeated  every  three  or  six  hours,  according  to  the 
degree  of  suH'ering. 

Ileartburu,  or  Waterbrash.  —  A  burning  at  the  pit  of  the  stomach, 
and  a  constant  inclination  to  regurgitate  sour,  acrid,  or  bilious  matter, 
is  termed  Waterbrash,  and  is  but  a  form  of  Dyspepsia,  and  indicates 
Mercuriua,  Nux  vomica,  Pulsatilla,  Arsenicum,  Cimicifuga,  &c., 
given  as  above. 

Cardialgia,  or  Oastralgla,  is  nearly  allied  to  the  above,  only  at- 
tended  with  pain  in  the  stomach,  as  well  us  burning,  sour,  or  acrid 
risings.  Arsenicum,  Nux  vomica,  Bryonia,  Calcarea,  Ghamomilla, 
Coffea,  Colocynth.,  and  Pulsatilla  are  remedies  indicated  m  this 
difficulty ;  and  each  may  be  given  and  repeated  every  hour,  in  the 
usual  doses,  until  relieved. 

Dyspeptic  Headache  is  simply  a  sympathetic  action  of  the  stomach 
upon  the  head,  causing  considerable  pain.  Bryonia,  Belladonna,  Coc- 
cuius,  Nux  vomica,  and  Arsenicum,  constitute  the  group  of  remedies  to 
give  relief  or  cure.  When  cold  water,  taken  into  the  stomach,  is  found 
to  disagree  with  the  stomach,  either  Nux  vomica,  Arsenicum,  Pulsatilla^ 
or  Chma  will  afford  relief.  When  any  kind  of  food  disagrees  with  the 
stomach,  causing  distress  and  headache,  give  either  Ferrum,  Camphor, 
Chamomilla,  Pulsatilla,  or  Sulphur,  in  the  usual  dose  of  one  drop  or 
four  globules.  If  caused  by  beer,  Colocynth  ;  by  milk,  Calcarea,  Pulsa- 
tilla, Nux  vomica.  When  animal  food  proves  difficult  of  digestion,  or 
fat  meat  or  gravies,  drawn  butter,  Pulsatilla,  Jgnatia,  Nux  vomica.  Coo 
etUus,  &c.  Dyspepsia  is  so  commcn  a  disease,  and  afflicts  so  groat  a  va- 
riety of  temperaments  and  habits,  we  will  be  explicit  in  pointing  to  specitic 


/ 


-..?' 


ol8 


DISEASES  INVOLVING  THE  VABIOUS  ORGANS. 


treutinont.  For  hypochondriacal  persons,  Sulphur,  Nux  vomica,  Ignatia, 
tor  liysterical  persons,  Sepia,  Pulsatilla,  Uyo9ei/amu»,  and  Lacht»i* , 
Un'  those  of  a  sanguine  tuinperamunt,  Ndx  vomica  ;  for  tlie  syniputhetic, 
Pulsatilla;  for  the  bilious,  Mercurius  viv. ;  and  for  tiio  melancholic, 
Nitric  and  Phosphoric  acid,  Aurum  metallicum,  &c.  VV'ien  those  of  a  wiv- 
vous  teinporament  are  afflicted  with  Dyspepsia,  wo  H'ld  Valerian,  Uy^t' 
eyainus,  Pulsatilla,  Ignatia,  and  Moschus  good  remedies;  Miose  of  a 
scrofulous  habit  require  Oalcarea,  Arsenicum,  and  Sulphur,  students 
afflicted  with  Dyspepsia  require  JVkr  vomica,  Chind,  and  x'ltrrum.  Doca 
and  repetition  as  before. 

Sea-Sickness. 

There  is  no  remedy  that  will  prevent  sea-sicknoss,  and  no  condition  of 
nciilth  capable  of  always  resisting  it.  But  the  effects  of  the  sickness, 
which  are  often  distre.ssing,  can  be  removed  by  Oocoalus,  Nux  vomica^ 
Mild  Ignatia.  If  there  remains  an  inclination  to  retch  after  the  sickness 
bi)8  piisHod,  give  Ipecac.     Petroleum  i8  often  tiiken  a»  u  preventive 

with  8UCC088.  •     ". 

,     Maoous  VomitiDg.    , 

This  is  simply  sickness  at  the  stomach,  which  may  arise  from  its  irrlta- 
ble  condition,  and  result  in  vomiting  of  slime,  or  mucus.  The  remedies 
that  will  obviate  the  difficulty  are  Ipecac.,  liheum,  PuisoAilla^  and  Vta- 
trum.     Usual  dose  and  repetition.  * 

Vomiting  of  Blood. 

This  may  be  caused  by  mechanical  injury  of  the  stomach,  and  requires 
Arnica;  if  caused  by  pregnancy,  Arsenicum;  if  from  retained  menses, 
Phoivph.  or  Pulsatilla;  if  from  acrid  humors,  Arsenicum  or  Ipecac^; 
if  from  suppressed  eruption,  Sulphur. 

Oastritia,  or  Inflammation  of  the  Stomaoh. 

This  is  indicated  by  severe  pain  in  the  stomach,  continuous  vomiting, 
heat  over  the  region  of  the  stomach,  quick  and  feeble  pulse,  cold  feet, 
and  pain  in  the  head.  The  remedies  for  Gastritis  are  Aconite, 
Bism.  subnit.,  Arsenicum,  Belladonna,  Ipecac,  Tart,  emetic,  Vera- 
trum.  Lobelia,  and  Oocculus,  and  sometimes  ^ux  vomica.  Dose 
and  repetition  as  ufiual. 

Oastrodynia,  or  Oramps  in  the  Stomach. 

A  pain  in  the  stomach,  with  cramp,  is  very  distressing,  and  cannot  he 
mistaken  ;  for  the  cramp  is  a  sudden  spasmodic  action  v/f  the  muscles  of 
the  stomach,  which  seems  like  taking  the  breath  out  of  one.  Paha- 
tilla,  N-ux  vomica,  and  Golocynth  are  the  remedies.  Any  one  of 
them  will  be  likely  to  afford  prompt  relief.     Dioscorea  is  useful. 

Inflammation  of  the  Bowels. 

A  severe  pain  in  the  bowels,  with  distention,  and  such  soreness  to 
the  touch  that  weight  or  pressure  cannot  be  borne,  betokens  inflamma- 


DISEASKS  mVOLVINO  THE   VARIOUS  ORGANS. 


619 


;-v 


it'oa,  fynatia, 
[kI  Lachtttin , 
sympiitliutic, 
inolunchulic, 
hose  of  a  w-.x- 
ilerian,  Hy"t- 
;  ^hose  of  a 
Mr ,  students 
mint.     Doee 


condition  of 
the  sickness, 
Nux  vomica  ^ 
the  sickness 
u  preventive 


rom  its  irrlta< 
The  remedies 
I/a,  and  P^to- 


I  and  requires 
ained  menses, 
n  or  Ipecac^ ; 


I.  . 

nous  vomiting, 
Ise,  coid  feet, 
?»re  Aconite, 
emetic,  Vera- 
omica.    Dose 


and  cannot  he 
;he  muscles  of 

one.  Paha- 
Any  one  of 
I  is  useful. 


\c\\  soreness  to 
kens  inflamma- 


tion. Aconite  may  bo  given  in  the  usual  dose,  every  half-hour  ut  first. 
If  perspiration  occurs,  and  tlie  vomiting  continues,  give  Bryonia  in  the 
same  way.  If  there  is  tympanitis,  or  distention,  so  that  percussion  upon 
the  bowels  causes  them  to  sound  liko  u  drum,  TerebitUhe,  Arsenicum,  and 
Mereurius  must  bo  consulted.  If  tiie  discliurges  from  tho  bowels,  wliiio 
the  inflammation  lusts,  aro  acrid,  give  Amenicum,  and  follow  with  Bry- 
onia. If  there  is  struiigury,  or  inability  to  puss  urine,  Cantharin.  It 
would  bu  better,  in  treating  so  formidable  a  disease  as  this,  to  drop  ten 
drops  of  the  selected  remedy  into  half  a  tumbler  of  water,  and  give  a 
teaHpoonful  ovory  half-hour  or  hour,  until  aniulioration  or  cliunge. 
C'Oniprosseii  on  tho  abdomen  are  indicatud. 

Ohronio  iDflammation  of  the  Bowelsi 

Acute  inflammation  of  the  bowels  sometimes  passes  off,  leaving  them 
susc(;ptible  to  (tntuiled  inflammation  from  trivial  causes  ;  tho  mucous  coat 
may  have  been  left  in  a  semi-ulcerated  condition,  from  which  there  will 
bu  occasional  vomiting,  and  rauco-purulent  diarrhoea.  The  remedies  for 
this  disease  are  Nitric  and  Sulphuric  acid,  Arsenicum,  Sulphur,  and  PhoS' 
phorus.  The  doses  may  be  as  usual ;  but  the  remedy  may  not  be  repeated 
more  than  twice  a  day. 

Inflammation  of  the  Peritoneum. 

Peritoneal  inflammation  is  oflen  considered  in  connection  with  inflam- 
mation of  the  bowels,  and  requires  nearly  the  same  remedial  treatment. 
The  disease  is  known  by  the  extreme  Bensitiveness  of  the  abdomen  to 
touch  ;  and  the  tenderness  is  so  great  as  to  bo  unable  to  bear  the  weight 
of  bed-clothes.  Aconite  given  in  the  nsual  doses  every  half-hour,  until 
the  skin  becomes  moist,  and  then  Belladonna,  or  Verat.  viride.  It 
there  is  thirst,  Arsenicum;  Pulsatilla,  if  in  females.  Nux  vomica, 
if  the  bowels  are  constipated.  If  dropsy  of  tho  abdomen  follow, 
give  Helleborus  nig.,  or  Apis  mellifica.  Diet,  —  a  very  light  gruel 
of  corn-starch  or  farina. 

Diarrhea. 

A  looseness  of  the  bowels,  which  may  be  watery,  bilious,  pappy,  pain- 
less or  with  pain.  A  merely  relaxed  condition  of  the  bowels  may  bo 
cured  by  a  sing|i3  dose  of  four  globules  o^  Pulsatilla  ;  or,  if  not  arreste'l 
by  this,  give  Mereurius.  A  watery  diarrhoea  may  bo  arrested  with 
vhamomilla,  Nux  vomica,  or  Veratrum;  a  bilious  diarrl-.oea,  with  Arseni- 
aiin  and  Mereurius;  a  painlesL  and  involuntary  diarrhoea,  with  Phosphoric 
acid.  Diarrhoea  with  colic  requires  Chamomilla  and  Oolocynth;  tinged 
with  blood,  Ipecac;  with  undigested  food,  Pulsatilla.  From  fruit, 
often  China.  The  dose  and  administration  must  accord  with  the 
case.  Either  of  the  remedies  may  be  given  in  water,  a  teaspoonful 
every  hour;  five  drops  of  the  dilution,  or  ten  globules  in  half  a 
tumbler  of  water,  may  be  the  mode  of  preparation.  The  diet  for 
persons  suffering  from  diari'hcea  may  be  mutton-l)roth,  beef-tea, 
boiled  milk,  or  toast  and  tea,  us  the  patient  may  elect. 


'    ! 


DISEASES   INVOLVING   THE   VARIOUS   ORGANS. 


Dysentery.  ;  ; 

One  of  the  most  formidable  and  prostrating  diaeasee  is  Dysentery.  It 
nsiially  begins  with  a  diarrhoea,  though  occasionally  with  constipation,  after 
a  season  of  lassitude,  and  increases  until  mucous  discharges  from  the  bowels 
follow.  The  disease  is  characterized  by  much  straining  when  trying  to 
evacuate  the  bowels.  This  straining  is  involuntary  and  painfhl.  Just  be- 
fore there  is  an  inclination  for  a  sux)l,  there  is  usually  a  sharp  pain  in  the 
lower  portion  of  the  abdomen.  Dysenteric  discharges  are  mucus  mixed 
with  blood,  or  pure  blood,  or  no  blood  at  all.  For  dysentery  with  no  blood 
in  the  stools,  and  yet  much  tenesmus,  Oamboge;  when  the  tenelsmus  is  low 
down,  Aloes;  when  the  mucus  is  tinged  with  blood,  Mercurius  corrosivus, 
the  leading  remedy,  especially  if  the  tenesmus  is  pu.JifUl.  To  arrest  a  dys- 
entery where  the  discbarges  are  pure  blood,  and  very  painlal  straining  and 
thirst,  Arsenicum.  For  much  tenesmus,  and  dischai^e  of  mucus  mixed 
with  blood.  Ipecac.  Whichever  remedy  is  administered,  let  the  usual  dose 
be  given  in: tic  lately  after  each  stool,  until  relieved.  The  diet  in  this  dis- 
ease is  somewhat  important.  Water  cannot  be  allowed  in  great  quantities, 
but  small  bits  of  ice  may  be  held  in  the  mouth  of  the  patient ;  barley-water, 
flavored  with  lemon,  may  be  allowed  as  a  drink ;  rice-water ;  and,  if  the 
patient  has  any  appetite,  be  may  be  allowed  mutton-soup,  beef-tea,  and 
lamb-broth;  but  chicken-broth  must  be  entirely  prohibited.  Enemas  of 
cold  water  or  rice  water,  after  each  discharge,  are  beneficial. 


Ohronio  Dysentery. 


Symptoms  mnch  like  those  of  the  acute,  but  occurs  frequently  as  a  weak- 
ness left  after  a  protracted  attack  of  the  acute  form.  Sulphur,  Sulph.  acid, 
CcUcarea  ccrb.,  Ferrum,  and  Carbo  vegetabiUe-  are  remedies  empLyed  to 
overcome  the  diflSculty.  Sulphur  may  be  given  in  daily  doses  for  a  while, 
and  then  Nitric  acid  or  Sulph.  actd,  or  Calcarea,  until  a  cure  is  completed. 
Diet  in  Chronic  Dysentery  should  be  very  sustaining,  and  wine  may  some- 
times be  allowed. 

Oholera  Morbus. 

This  disease  begins  with  severe  pain  in  the  stomach  and  bowels,  and  then 
severe  vomiting  and  purging,  until  seemingly  there  is  nothing  left  to  be  dis- 
charged from  the  system.  Arsenicum  and  Verai.  alb.  are  the  leading  reme- 
dies ;  Nux  vomica  may  be  given  to  stop  the  vomiting ;  Ipecac.,  Tart,  emetic, 
Podophyllum  are  severally  good  remedies,  and  any  one  of  them  may  com- 
plete the  cure ;  four  globules  may  be  given  every  fifteen  minutes  until  relief 
is  obuiiued. 

Asiatic  Oholera. 

More  formidable  than  Cholera  Morbus  is  Asiatic  Cholera,  as  its  attacks 
are  insidious :  first,  by  painless  diarrhcea,  which  seems  to  indicate  that  all 
the  contents  of  the  alimentary  canal  are  in  a  soluble  condition.  Floods 
of  rice-water  discharges  pass  from  the  bowels,  and  the  same  matter  is 
vomited  prcfiisely.  After  a  time,  the  lower  extremities  begin  to  cramp, 
and  then  the  cramps  come  in  the  abdomen;  and,  if  the  disease  1'-  30^ 


btSKASES  IMVULVIMG  THE  VARIOUS  ORGANS. 


521 


Dysentery.  It 
istipation,  after 
rom  the  bowels 
when  trying  to 
iftil.  Just  be- 
arp  pain  in  the 

mucus  mixed 
f  with  no  blood 
cne&mus  is  low 
rins  corromvus, 
'o  arrest  a  dys- 
1  straining  and 

mucus  mixed 
the  usual  dose 
liet  in  this  dis- 
reat  quantities, 
;  barley-water, 
er ;  and,  if  the 

beef-tea,  and 
1.    Enemas  of 


ntly  as  a  weak- 
er, Sulph.  acid, 
is  empLyed  to 
ises  for  a  while, 
•e  is  completed, 
dne  may  some- 


owels,  and  then 
g  left  to  be  dis- 
e  leading  reme- 
!.,  Tart,  emetic, 
hem.  may  t^m- 
utes  untU  relief 


I,  as  its  attacks 
idicate  that  all 
lition.  Floods 
lame  matter  is 
egin  to  cramp, 
disease  i'*  :io; 


arrested,  the  patient  soon  passes  into  collapse,  and  then  to  the  grave.  The 
treatment  of  this  disease  m  the  early  stage  is  very  important.  Very  few 
cases  need  to  prove  fatal,  if  timely  resort  to  the  proper  treatment  is 
had.  As  soon  as  the  patient  is  attacked  with  diarrhoea,  let  him  go  to  bed, 
and  take  Veratrum  album.  If  he  has  great  thirst,  let  him  take  Arseni- 
cum. If  without  pain,  Phosphoric  acid.  If  with  vomiting  and  purging, 
and  great  prostration,  in«  versicolor.  Other  remedies,  such  as  Ulaterum, 
Secale  comutum,  Camphor,  &nd  Mercurius  tiu.  maybe  consulted. 
Cuprum  acel.,  if  with  violent  cramps.  The  medicines  may  be  ad- 
ministered every  thirty  minutes.  In  the  collapse  stage,  give  Muri- 
atic acid, — ten  drops  in  half  a  tumbler  of  water,  a  teaspoonful  every 
twenty  minutes.  But  little  time  can  run  to  waste  at  any  stage  of  the 
disease  ;  every  moment  requii'es  vigilance  and  attention.  Should  the 
disease  pass  over,  and  the  patient  is  left,  he  must  first  have  a  stimu- 
lating diet,  and  then  more  and  more  generous,  as  ho  can  bear  it. 

OojistipatioD,  Costiveness. 

A  confined  condition  of  the  bowels  is  .carcely  a  disease  by  itself,  but  a 
symptom  that  attends  many  maladies.  In  a  torpid  state  of  the  liver,  it  is 
generally  manifest,  and  requires  a  treatment  tending  primarily  to  aftl-ct 
this  organ,  and  thence  the  bowels.  When  there  is  a  sense  of  fulness  in 
the  rectum,  Bryonia ;  when  a  tedious  constipation,  that  indicates  great 
torpidity  of  the  bowels,  Lycopodium  ;  a  constipation  following  a  diarrhcea 
requires  Mercurius  viv.  or  Sulphur  ;  a  constipation  resulting  from  a  col- 
lection of  hardened  fseces  requires  Sulphur  and  Niix  vomica,  or  Stli- 
cea.  Two  doses  a  day,  of  any  of  the  remedies,  will  be  sufficient. 
A  diet  for  those  addicted  to  habitual  constipation  is  important :  corn- 
meal  mush,  bix)wn  bread  or  bran  bread,  prunes,  apples,  and  other 
kinds  of  fruit  are  recommended. 

Invermination,  Wonns. 

This  trouble  is  indicated  by  the  child  picking  its  nose,  and  by  vora- 
cious appetite,  restlessness  at  night,  colic,  and  sometimes  diarrhoea  and 
pale  exp.'ession  of  the  face.  The  remedies  for  this  difficulty  are  Santo- 
nin, Cina,  Spiffelia^  China,  and  Sulphur.  AS'a«tomn  will' suit  better  for 
the  long  round  worms,  and  Cina,  Calcarea,  and  Nux  vomica  for  the  pin- 
worms.     Dose  and  administration  as  usual,  three  times  a  day. 

Frotrasion  of  the  Intestine. 

Falling  of  the  bowels,  as  the  protri'  -  is  usually  termed,  is  caused  by 
protracted  diarrhoea,  and  straining  at  i  .'liile  the  intestine  is  weak  and 

relaxed.  Podophyllum,  Mercurius  vi.  ,  Ignatia,  and  Aloes  aro  remo' 
dies  that  will  cure  the  difficulty.  Either  may  be  given  three  times  a  day. 

A  tate  and  Ohronio  Inflammation  of  the  Liver. 

Denoted  by  pain  in  the  right  side,  below  the  ribs,  sometimes  ge- 
rere  and  at  otiiers  dull.    If  there  is  fever,  give  Aconite  or  Verat. 


I 


i 


522 


DISEASES   INVOLVING   THE   VARIOUS   ORGANS. 


viride,  and  follow  with  2fux  vomica  in  Acute  Hepatitis,  and  repeat  every 
hour  until  relief  or  change.  If  much  thirst,  give  Arsenicum.  In  the 
chronic  form,  a  daily  dose  of  Sulphur  or  Sepia,  Mercurius  viv.,  Nux 
vomica,  Pulsatilla,  or  Podophyllin,  will  do  as  much  for  the  patient  aa  any 
treatmeit  in  the  world. 

_    •'  ■       ,       Jaundioe.  ' 

When  the  gall-duct  of  the  liver  becomes  obstructed,  and  the  bile  is 
prevented  ft-om  passing  off  in  the  usual  way,  it  seeks  an  escape  through 
the  skin,  and  gives  it  a  yellow  color.  This  is  Jaundice.  Podophyllin, 
Chelidonium,  Mercurius,  Dulcamara,  Leptandria,  and  J^ux  vomica  arc 
competent  to  cure  the  severest  cases.  Carbo  vegetabilis,  in  a  crude  form, 
may  be  given  in  massive  doses  when  an  offensive  odor  comes  from  tlie 
mouth  or  breath.  The  patient,  having  no  appetite,  must  be  supplied  with 
some  farina  or  rice,  cooked  in  tiie  most  delicate  way. 

Inflammation  of  the  Spleen. 

The  spleen,  being  an  associate  purificatory  organ  with  the  liver,  is 
liable  to  similar  affections.  When  Inflamed,  it  is  manifest  by  pain  in  the 
left  side,  below  the  ribs.  The  same  remedies  that  affect  the  liver  will 
also  affect  the  spleen.  For  congestion  of  the  spleen  caused  by  running, 
immodeiate  laughter,  etc.,  China,  a  single  ordinary  dose,  will  answer. 

Painter's  Oolio. 

The  effects  of  lead  upon  the  alimentary  canal  are  sometimes  disastrous ; 
and  painters  who  work  much  in  mixing  the  various  preparations  of  white 
lead  are  liable  to  imbibe  sufficient  of  its  poisonous  quality  to  give  them  a 
most  distressing  colic :  hence  its  name.  The  remedies  employed  in  auti- 
doting  the  effects  of  the  lead  are  Opium  and  Alumina,  or  Colocynth. 
Should  the  first-named  remedy  fail  to. afford  relief,  try  the  next,  and  so  on, 
in  doses  of  throe  drops  of  the  dilution  in  a  spoonful  of  water.  Olive  oil, 
a  wineglassful  every  three  hours,  is  good. 

Piles,  Hemorrhoids. 

There  occurs  in  the  rectum  a  class  of  small  tumors,  caused  by  conges- 
tion of  the  hemorrhoidal  veins ;  and  these  sometimes  become  so  swollen 
as  to  protrude  from  the  anus.  Sometimes  these  protruding  tumors  are 
numerous,  and  resemble  a  bunch  of  grapes.  They  are  exceedingly  painful, 
and  destructive  of  comfort.  To  care  them  is  of  the  utmost  importance. 
Constipation  being  often  one  of  the  proximate  causes,  such  remedies  as 
overcome  this  condition  must  be  called  into  use.  Nux  tiomica,  taken  at 
night,  has  often  proved  salutary.  SiUphur,  when  the  tumors  are  painftil, 
and  s*,ing  and  burn  so  as  to  be  almost  unbearable.  For  Bleeding  Piles, 
Hamamelis  Virgin  !ca  is  particularly  recommended.  For  excessively  burn- 
ing piles,  Arsenicum;  and  for  those  of  a  blue  color,  Oonium,  or  Muriatic 
axiid.  Each  cf  these  remedies  may  be  employed  in  the  liquid  form,  and 
three  drops  of  the  dil'  tion  may  be  taken  in  a  spoonful  of  water  every 
night.  The  tincture  of  Podophyllum  is  also  a  valuable  remedy,  and 
may  be  administered  as  above ;  and  so  also  is  Collinsonia.    To  designate 


Dll-    ASES  OK  THE   RESPIRATORY  ORUANS. 


1)2T 


NS. 


ind  repeat  cvcrj' 
lenicum.  hx  tlu> 
urius  viv.,  Nux 
e  patient  as  any 


and  the  bile  is 
escape  through 
3.  PodopJujWn, 
^nx  vomica  are 
in  a  crude  form, 
comes  from  the 
be  supplied  with 


ith  the  liver,  is 
st  by  pain  in  the 
ct  the  liver  will 
ised  by  running, 
(rill  answer. 


times  disastrous ; 
arations  of  white 
ty  to  give  them  a 
jmployed  in  anti- 
la,  or  Colocynth. 
next,  and  so  on, 
vater.     Olive  oil, 


auaed  by  conges- 
come  so  swollen 
ding  tumors  are 
seediugly  painful, 
most  unportance. 
luch  remedies  as 
vomica,  taken  at 
mors  are  painflil, 
r  Bleeding  Piles, 
excessively  bum- 
ium,  or  Muriatic 
liquid  form,  and 
i  of  water  every 
tie  remedy,  and 
>•    To  designate 


an  appropriate  diet  ioT  one  afflicted  with  Piles  requires  a  little  care.  Salt 
provisions  mustgtiit  ;ally  be  avoided.  The  free  use  of  stimulating  drinks 
IS  pernicious.  Bic.:i-bread  and  fruits  are  commendable.  Meats,  not 
allowable,  and  most  kinds  of  vegetables. 


highly  seasoned,  an 

Itching  of  the  Vins, 

and  sometimes  of 
in  the  latter  with 
morning. 


which  sometimes  is  a  concomitant  of  Piles 
rms,  is  cured  in  the  first  instance  with  Sulphur,  and 
'ina.     The  usual  dose  should  be  given   night  and 


DISEAisES  OF  THE  RESPIRATORY  ORGANS. 


The  organs  of  respiration  embrace  the  nose,  larynx,  trachea,  bronchia, 
lungs,  pleura,  heart,  and  their  appendages.  We  will  therefore  consider 
the  diseases  that  aftect  them  in  their  order. 


Ooryza,  Gold  in  the  Headi 


/ 


When,  from  exposure  to  cold,  the  nose  becomes  stopped,  and  there  is 
an  inclination  to  sneeze,  and  the  eyes  become  more  or  less  affected,  the 
following  remedies,  as  indicated,  will  prove  useful :  Nux  vomica  at  night, 
should  the  Coryza  be  more  apparent  in  the  afternoon  or  evening,  and 
particularly  if  it  is  attended  with  cold  affecting  the  entire  system.  Sti- 
bium, or  Tart,  em.,  is  a  good  remedy  to  lubricate  the  stoppage  of  the 
nasal  passages ;  Hepar  sulphur,  also,  when  this  stoppage  is  painfully'dis- 
agreeable  ;  Arsenicum,  or  Euphrasia,  when  there  i-s  a  thin,  acrid  dis- 
charge from  the  nose.  Pulsatilla  is  ])est  for  children  and  ladies,  when 
'iiffering  from  Nasal  CataiTh.  Coryza  is  synonymous  >vith  acute  Ca- 
tarrh, as  both  affect  the  mucous  membrane  that  lines  the  cavities  of 
the  nose. 

Clironio  Catarrh  is  much  like  the  Acute,  only  all  the  symptoms  have 
bi'come  persistent.  Acute  Catarrh  is  often  cured  in  a  few  days  by  Mer- 
curius,  Nux  vomica.  Belladonna,  Pulsatilla,  Tart,  em.,  Hepar  sulphur, 
aiul  Sulphur  ;  Mercurius,  tor  stupefying  headache  with  catarrh  ;  Nvx  vom- 
i  a,  when  the  catarrh  occasions  nausea ;  Belladonna,  when  there  accom- 
panies the  difficulty  pain  over  anil  in  the  eyes;  Pulsatilla,  when  there  is 
depression  of  spirits;  Tart,  em.,  Hepar  sulphur,  and  Sulphur,  to  remove 
(iltstructions  in  the  nasal  ducts,  and  to  subdue  irritation  and  soreness  of  the 
external  orifices  of  the  ducts.    Doses  as  usual,  repeated  three  times  a  da}'. 

In  the  treatment  of  Chronic  CataiTh,  other  remedies  are  called  into 
requisition.  Aurum  metaUicum,  if  there  is  a  heavy  yellow  discharge  from 
the  nose,  or  crusts  form  at  night;  Mercurius  iodatus,  in  scrofulous 
persons ;  Aurum.  muriaticum,  if  there  is  any  affection  of  the  vomer, 
or  partition  of  the  nose  ;  /Sulphur  and  Hepar  stdphur  uro  both  vali;- 
ablo  remedies,  as  are  Arsenicum  and  Lachesis,  when  the  peculiar 
symptoms  are  such  as  to  indicate  their  affiliation.  The  remedies  for 
the  chronic  form  need  not  be  repeated  so  often ;  once  in  twenty-four 
hours,  in  the  usual  dose,  is  sufficient.  


624 


DISEASES  OF  THE  BESPIBATOBT  OBQANS. 


ft| 


K>  .  ■ 


Inflammation  of  the  Larynx. 

The  upper  part  of  the  windpipe,  or  trachea,  is  termed  the  "  Larynx ; " 
and,  when  inflamed,  it  is  said  to  be  affected  with  Laryngitis :  and  this  may 
be-acute  or  chronic. 

Acute  Laiyn^tls,  or  luflflmmation  of  the  Lajrynx.  —  Tiiis  trouble  is 
denoted  by  cough,  hoarseness,  and  sore  tin-oat,  affecting  the  voice,  and 
rendering  respiration  somewhat  difficult,  and  conversation  fatiguing  or 
painful.  It  comes  on  from  a  cold,  and  may  be  the  continuation  of  a 
nasal  catarrh.  With  the  cough  there  is  usually  some  expectoration,  or 
else  dry,  uncomfortable  sensation,  and  inclination  to  be  clearing  the  throat. 
If  the  pulse  is  febril  or  full,  give  Aconite  in  the  firet  stage ;  und,  if  there 
is  painful  soreness  of  the  larynx,  give  Belladonna.  Aconite  will  remove 
the  fever,  and  Belladonna  the  congestion  of  the  capillary  vessels  of  tht 
mucous  membrane,  which  causes  the  soreness,  mercurius  viv.  often 
follows  Belladonna  well.  K,  after  the  employment  of  these  remedies, 
expectoration  of  mucus  occurs  from  coughing,  give  Phosphorus  or 
Sanguinaria.  If  the  cough  is  tight,  as  if  the  larynx  was  closing  up, 
give  Sambucus.  The  remedies,  in  the  usual  doses,  may  be  re- 
peated every  two  hours.     The  diet  should  be  simple,  but  nutritious. 

Cbruuio  Laiyuffitis,  or  Inflammation  of  the  Larynx.  —  The  symp- 
toms of  this  form  of  the  disease  are  similar  to  those  of  the  acute  variety, 
only  the  cough  and  irritation  are  constant,  and  the  expectoration  some- 
times great.  The  disease  becomes  chronic  from  the  weakening  of  the  organ 
afler  one  or  more  acute  attacks  of  the  disease.  It  sometimes  mitigates 
in  warm  weather,  and  returns  again  in  winter.  Argentum  metallicum 
is  a  good  remedy  for  the  chronic  form,  when  characterised  by  soreness  of 
the  throat.  Belladonna  is  always  useful  when  the  difficulty  is  aggravated 
by  a  cold  ;  Phosphorus^  when  there  is  considerable  collection  of  mucus, 
and  Hepar  sulphur  when  there  are  excessive  dryness  and  hoarseness. 
Causticum  is  particularly  useful  when  the  inflammation  is  persistent,  and 
the  cough  constantly  excited,  and  when  it  resembles  a  croupy  cough,  and 
comes  on  spasmodically  or  in  paroxysms.  When  Chronic  Laryngitis  is 
not  kept  in  check  or  cured,  it  soon  runs  into  that  formidable  disease 
known  aa  Laryngeal  Consumption,  or  becomes  attended  with  hectic  fever. 
In  such  a  case,  give  Stannum,  or  perhaps  Sulphur  ;  but  in  no  case  more 
than  one  dose  a  day.  The  patient  should  be  warmly  clothed,  and  shou'd 
always  provide  for  tempering  cold  air  before  it  is  inhaled  into  the  lun~s. 
The  diet  must  be  nutritious,  and  strictly  non-medicinal.' 


Oroup. 

Croup  is  of  two  kinds,  spasmodic  and  membranous.  The  spasmodic  is 
the  result  of  a  cold ;  and  it  comes  on  with  a  hoarse,  rough  cough,  which  is 
often  spasmodic  and  ouffocating.  The  catarrhal  or  membranous  comes 
on  like  a  cold,  and  then  supervenes  a  crowing  cough  and  copious  collec< 
tion  of  mucus ;  and  sometimes  an  exudation  of  a  membranous  character 
Alls  the  larynx  and  upper  portion  of  the  trachea.  For  spasmodic  croup, 
Tartar  emetia  is  undoubtedly  the  best  remedy ;  Aconite,  when  there  is 


he  "  Larynx ; " 
:  and  this  may 

riiis  trouble  ia 
tlie  voice,  and 
in  fatiguing  or 
itinuation  of  a 
pectoration,  or 
■ing  the  throat, 
and,  if  thero 
ite  will  remove 
vessels  of  tlu 
rius  vtv.  often 
lese  remedies, 
^^hosphoruH  or 
a&  closing  u|), 
,   may  he  ro- 
ut nutritious. 

—  The  symp- 
5  acute  variety, 
toration  aome- 
ing  of  the  organ 


times  mitigates 
um  metallicum 
by  soreness  of 
y  is  aggravated 
tion  of  mucus, 
nd  hoarseness, 
persistent,  and 
ipy  cough,  and 
!  Laryngitis  is 
nidable  disease 
th  hectic  fever. 
1  no  case  moi-u 
ed,  and  shou'd 
ito  the  lun~s. 


e  spasmodic  is 
ough,  which  is 
•ranous  comes 
copious  coUec- 
lous  charact«itr 
jmodic  croup, 
vhen  there  is 


DISEASES   OF   THE   RESPIRATOItr   ORGANS. 


525 


fever :  Belladonna,  if  the  throat  is  sore  ;  Ipecac. ,  if  the  breathing  is  asth- 
matic. In  membranous  croup,  a  resort  must  be  had  to  Aconite  at  first,  to 
induce  perspiration  ;  if  this  fails,  give  Bryonia,  and  then  Spongia,  Iodine, 
Bromine,  and  Eepar  sulph.,  in  the  order  mentioned.  The  usual  doses 
may  be  given  every  fifteen  or  twentj'  minutes  when  the  symptoms  are 
alprming.  Croup  goes  under  the  technical  natne  of  Cyoanche  Trachealis, 
because  it  implicates  both  the  larynx  and  windpipe. 

Inflammation  of  the  Windpipei  —  Tracheitia.  ' 

There  is  some  resemblance  of  this  disease  to  croup ;  and  yet  it  may 
occur,  and  not  manifest  that  peculiar  character.  It  is  denoted  by  cough, 
soniotimes  exceedingly  tight,  at  others  looser,  greater  or  less  obstruction 
of  the  breathing,  and  some  pain  and  soreness  of  the  throat  above,  and  a 
tickling,  raw  feeling  below,  towards  the  bronchial  tubes.  Aconite  is 
essential  in  the  treatment  of  this  difficulty,  and  also  Belladonna,  Bryonia, 
Phosphorus,  Causticum,  Hepar,  SanguiTiaria,  and  Spongia.  It  is  to  be 
observed,  however,  that  only  one  of  these  remedies  must  be  given  at  a 
time  ;  five  drops  in  half  a  tumbler  of  water,  and  a  teaspoonM  every  thirty 
minutes.    Diet  simple  and  non-medicinal. 


Aoute  Bronchial  Inflammationi  —  Bronchitis. 


J 


As  the  names  implies,  the  bronchial  tubes  becomes  highly  inflamed  in 
this  disease,  or,  rather,  the  mucous  membrane  that  lines  them.  There 
is  much  cough  and  expectoration.  This  disease  is  called  Catarrhal 
Fever  in  its  acute  form ;  and,  when  the  substance  of  the  lungs  becomes 
affected,  it  amounts  to  Pneumonia.  Acute  Bronchitis  requires,  for  the 
reduction  of  fever,  Aconite  or  Bryonia;  Belladonna  may  follow ;  and, 
ivhen  copious  expectoration  commences,  give  Phosphnrua;  and,  some 
time  aft^*",  give  Hyoscyamus,  especially  for  the  cough  at  night,  and 
also  Calcarea  carb.  for  the  soreness  and  cough  that  may  be  created. 
Repeat  the  medicines,  in  the  usual  doses,  three  times  a  day.  Diet  as  in 
all  febrile  diseases.  Barley  or  flaxseed  tea  for  drink,  and  a  light  diet  of 
toasty  is  best, 

Ohronio  Inflammation  of  the  Bronchia. 

Like  the  acute  form  of  the  disease,  it  has  its  scat  in  the  mucous  mem- 
brane that  lines  the  bronchial  tubes,  and  is  believed  to  be  the  sequel 
of  Acute  Bronchitis.  It  is  always  accompanied  by  a  cough,  and  more 
or  less  expectoration ;  now  and  then  a  paroxysm  of  fever.  It  is  a 
tedious  and  troublesome  disease ;  and,  when  not  cured,  is  always  better 
in  warm  weather,  and  much  aggravated  in  cold ;  and  this  would  point 
to  a  perpetual  warm  climate  as  its  cure.  When  there  are  paroxysms 
of  fever,  give  Aconite ;  if  there  is  pain  in  the  chest,  Bialladonna; 
profVise  expectoration,  Phospliorus,  or  Lycopod.;  hectic  fever,  8tan- 
num;  when  the  throat  is  sore,  give  Causticum,  Great  care  must  be 
taken  in  the  treatment  of  this  malady,  if  a  cure  is  expected,  or  other- 
wise it  will  terminate  in  a  lingering  consumption.  The  most  generous 
living  the  patient's  appetite  will  admit  of  must  be  supplied,  but  free 
Qx>m  medicinal  condiments. 


526 


DISEASES  OF  THE  RESPIRATORY  ORGANS. 


Lung  TevQT,  —  Pneumonia. 

Lung  fever  is  indicated  by  pain  in  the  chest,  cough,  flushed  face,  quick 

f»ulse,  rusty  expectoration,  headache,  loss  of  appetite,  and  oppressed 
)reathing.  Aconite  or  Bryonia  may  be  given,  in  the  usual  dose,  every 
hour  until  the  skin  becomes  moist ;  Belladonna^  if  the  pain  continues 
in  the  chest,  every  hour  until  relief,  or  a  change  is  necessary  ;  Jinj 
onia  may  follow  Belladonna,  if  heat  in  the  chest  is  a  promincMit  symp- 
tom ;  and  Phosphoms  may  foUovir  Bryonia,  provided  the  expectoration 
has  changed,  and  a  more  plentiful  secretion  of  mucus  is  thrown 
off.     Each  medicine  may  be  given  in  hourly  doses  when  called  for 

This  disease  becomes  Typhoid  Pneumonia  when  the  fever  accompany- 
ing the  inflammation  is  typhoid  ;  in  which  event  Bryonia  may  be  given 
in  the  first  8ta,'^e,  and  Belladonna  if  there  is  a  manifest  inclination  to 
sleep.  When  the  patient  begins  to  cough  up  mucus  tinged  with  blood, 
give  Phosphorus  ;  and,  if  very  much  prostrated,  give  Rhus  tax.  As  to  diet 
in  Pneumonia,  give  the  patient  any  light,  nourishing,  and  soothing  dnnks, 
as  jelly-water,  barley-water,  rice-water,  &c.  Application  of  warm  com- 
presses to  the  chest  is  recommended.  '   - 

Whooping  Oough.  —  I'Mseia /i^a«modica.  '" 

This  disease  often  comes  on  like  an  ordinary  cold,  and  the  victims  are 
observed  to  have  frequent  coughing  fits  ;  and  when  there  is  no  fever  or 
loss  of  appetite,  and  the  fits  of  coughing  continue  to  be  repeated,  it  may 
fairly  be  inferred  that  whooping  cough  is  progressing.  Soon  the  child  or 
patient  will  begin  to  whoop,  and  to  experience  frequent  paroxysms,  and 
draw  in  a  long  breath,  or  whoop,  which  is  followed  by  numerous  short 
expirations.  Droaera  will  mitigate  the  severity  of  the  paroxysms,  and 
so  will  Hyoscyamxis,  Corallia  rubra,  Sanguinaria,  and  Oausticum  : 
Qhelidonium,  if  there  are  symptoms  of  pulmonary  congestion ;  but 
there  is  no  remedy  known  that  will  break  it  up  at  once.  Give  a 
dose  of  the  selected  remedy  immediately  after  each  paroxysm. 

Pleuritis.  —  P^ewmy. 

Inflammation  of  the  pleura  is  denoted  by  sharp,  shooting  pains  in  the 
sides  of  the  chest,  that  interfere  with  respiration ;  quick  pulse,  flushed  face 
great  heat  over  the  chest,  &c.  Aconite,  in  the  usual  dose,  may  be  given 
every  twenty  minutes,  and  a  cloth  compress  of  warm  water  may  bo 
applied  to  the  region  of  the  pain.  Aconite  may  be  followed  witli 
Phosphorus,  given  every  hour  until  relieved.     Bryonia  is  good. 

Asthma. 

Difficult  and  laborious  breathing  may  be  hereditary,  or  be  brought  on 
by  a  cold,  over-exertion-,  or  exposure  of  some  kind.  It  comes  on  in 
paroxysms  that  kiome<,Imes  interfere  with  the  respiration  to  do  great  a 
degree  as  to  oblige  the  patient  to  sit  or  stand  in  order  to  get  breath. 
Many  cases  are  entirely  curable  with  Ipecac,  Arsenicum,  Apis  mellifica, 
Apocynum,  JLobelia,  and  Tart.  emeUo.  When  one  remedy  fails,  try  the 
next,*^until  a  fair  warfare  with  the  disease  has  been  eucountered. 


DISEASES  OF  THE  RESPOUTOBY  OBUANS. 


627 


ihed  face,  quick 

and    oppressed 
ual  dose,  every 
pain  continues 
pessary;    Ihy 
)minont  syinp- 

oxpectoratioii 
uiis  is  thrown 

n  called  for 
'er  acconipany- 

may  be  given 

inclination  to 

jed  with  blood, 

tox.    As  to  diet 

oothingdnnks, 

of  wariu  com- 


a.  .  ^ 

the  victims  are 
is  no  fever  or 
peated,  it  may 
on  the  child  or 
paroxysms,  and 
numerous  short 
paroxysms,  and 
id  Oausticum  ; 
)nge8tion ;  but 
ance.  Give  a 
roxysm. 


5  pains  in  the 
se,  flushed  (iue 
,  may  be  given 
water  may  ])o 
followed  with 
a  is  good. 


be  brought  on 
comes  on  in 
to  do  great  a 

•  to  get  breath. 

Apia  meUiJica, 

y  fails,  try  the 

tered. 


BleediDg  from  the  Langs, 

This  trouble  is  occasioned  by  the  rupture  of  some  of  the  blood-vesseli 
in  the  bronchial  tube,  caused  either  by  mechanical  injury  or  tubercles. 
If  from  the  former,  Arnica  is  the  remedy  ;  if  from  the  latter,  Hamame- 
lis.  In  case  of  pain  and  inflammation,  give  Phosphorus  ;  and  if  motion 
aggravates,  give  Bryonia.  Let  the  patient  sit  up,  if  able,  in  an  easy- 
chair,  until  the  bleeding  ceases.  If  fever  and  excitement  of  the  cir- 
culation exist,  give  Aconite  often. 

Consumption. 

This  formidable  disease  may  be  hereditary,  or  result  from  accidental 
causes.  When  hereditary,  it  may  not  develop  itself  until  adult  age ;  and 
one  of  the  first  signs  is  extreme  sensitiveness  to  cold,  a  plight  cough,  defec- 
tive nutrition,  and  extreme  emaciation  ;  night-sweats  come  on  subsequent- 
ly, with  hectic  fever;  and,  at  a  later  stage,  there  maybe  diarrhoea,  which 
resists  remedial  measures,  and  exhausts  the  life  of  the  patient.  That  kind 
brought  on  as  the  sequel  of  primary  affections  usually  supervenes  upon 
bronchitis  or  some  oth.er  exhaustive  disease  that  proves  destructive  to  nu- 
trition. In  the  first  stage,  or  when  chilliness,  debility,  and  loss  of  flesli 
become  ajiparent,  much  benefit  can  be  obtained  from  the  use  of  good  old 
Bourbon  or  rye  wliisUey :  from  a  half  to  a  whole  wine-glassful  may  be  taki-n 
twice  a  day.  The  introduction  of  carbon  into  the  system  in  this  wn y 
has  often  proved  of  great  service.  When  there  is  deep-seated  pain  in  the 
lungs,  especially  in  the  upper  portion,  iT/copocimm;  the  usual  dose  maybe 
given  every  day,  and  continued  as  long  as  any  benefit  is  perceived.  Ly- 
copodium  may  be  followed  by  Stannum  or  Sulph.,  provided  there  is 
any  hectic  fever ;  by  Garho  animalia  when  there  are  night-sweats.  If 
the  cough  becomes  troublesome,  and  the  expectoration  muco-purulent, 
Phosphorus  in  the  usual  dose  may  be  given  twice  a  day.  If  occasional 
hemorrhage.  Belladonna  may  be  given,  if  there  is  pain  ;  Ipecac,  if 
there  is  asthmatic  breathing ;  and  Hamamelisvir.,  if  there  is  bleed- 
ing from  the  lungs  Avithout  much  pain.  For  the  first  stage  of  bron- 
chial consumption,  see  the  treatment  directed  for  Bronchitis.  After 
tubercles  become  manifest,  the  same  remedies  may  be  indicated  as 
for  the  hereditary  disease.  The  diet  for  consumptives  should  bo  fish, 
game,  beef,  mutton,  and  vegetables  such  as  potatoes,  beans,  and  egg- 
plant ;  butter  and  cream,  with  toast,  are  also  allowable.  Let  the  diet 
be  as  generous  as  the  patient  can  take.  , 


For  the  conolnston  ot  Homceopauiio  remeoies,  see  pages  785  to  878. 


/  V    ' 


PROCESSES   OP  fHE  HYDROPATHIC  TREATMENT. 


For  the  description  of  the  hydropathic  appliances  contained  in  the 
following  pages,  I  am  indebted,  in  substance,  to  the  "  Hydropathic 
Family  Physician,"  by  Joel  Shew,  M.  D.,  author  of  several  popular 
works  upon  the  principles  and  practice  of  hydropathy.  I  have  not 
uniformly  adopted  his  exact  language,  which  is  not  always  the  best 
he  might  have  chosen  to  express  his  thoughts. 

Priessnitz  is  admitted  to  have  been  the  originator  of  the  hydro- 
pathic modes  of  treating  diseases.  He  was  an  unlearned  man,  though 
he  had  original  powers  of  mind;  and,  imperfect  as  the  treatment  is, 
he  benefited  his  race  by  conferring  it  upon  the  world. 

At  first,  and  for  some  time,  baths  were  made  too  cold,  and  were 
continued  too  long;  the  result  was,  much  injury  to  the  patient  in 
many  cases.  Time  and  experience  have  brought  a  better  adaptation 
of  the  temperature  and  continuance  of  the  water  appliances  to  the 
symptoms,  constitution,  and  temperament  of  each  patient.  Formerly, 
weak,  exhausted,  and  nervous  persons,  not  less  than  the  fulUbiooded 
and  strong,  were  put  into  the  wet-sheet  pack,  and  reduced  near  to 
death's  door ;  and  there  is  reason  to  believe  that  in  some  cases  where 
the  practice  is  in  ignorant  hands,  this  barbarity  is  not  wholly  discon- 
tinued. The  practice,  however,  is  now  mainly  in  better  hands ;  and 
although  I  by  no  means  admit  its  sufficiency  as  a  system  of  remedial 
agencies,  I  am  persuaded  it  is  doing  some  good.  Used  in  connection 
with  the  ancient  system  of  regular  medicine,  which  is  the  joint  pro- 
duct of  time,  science,  and  experience,  the  water  treatment,  moulded 
and  modified  to  the  circumstances  and  strength  of  the  patient,  is  an 
auxiliary  of  no  mean  power.  As  such,  I  accept  it.  As  such,  it  is  re- 
ceived by  hundreds  and  thousands  of  regular  practitioners  throughout 
the  world.  Further  than  this,  it  never  can  or  will  be  generally  re- 
ceived. By  pushing  it  beyond  this,  its  rightful  and  honored  sphere^ 
its  friends  only  limit  its  progress,  and  injure  its  influence. 

The  following  ia  the  substance  of  Dr.  Shew's  description  of  hydro- 
pathic appliance. 

The  Wet-Sheet  Pack. 

In  this  process  a  coarse  linen  or  cotton  sheet  is  used,  long  enough 
to  reach  from  the  patient's  head  to  the  soles  of  his  feet,  and  about 
two  yards  in  width.     The  bed  is  stripped  of  all  its  covering,  one  or 


\TMENT. 


ontained  in  the 

"  Hydropathic 

leverai  popular 

I  have  not 

ilways  the  beat 

of  the  hydro- 
id  man,  though 
e  treatment  is, 

cold,  and  were 

the  patient  in 
itter  adaptation 
pliaiices  to  the 

nt.  F<»rinerly, 
;he  fuU-biooded 
educed  near  to 
me  cases  where 

wholly  discon- 
ter  hands ;  and 
em  of  remedial 
d  in  connectiott 
I  the  joint  pro- 
ment,  moulded 
i  patient,  is  aa 
Ls  such,  it  is  re- 
lers  throughout 
)e  generally  re- 
tonored  sphere^ 
ce. 
ption  of  hydro- 


d,  long  enough 
feet,  and  about 
overing,  one  or 


PROCESSES  OF  THK  HYDROPATHIC  TREATMENT, 


529 


ria.  ITS. 


two  pillows  only  being  left  for  the  head.  One  or  two  comforters  are 
then  spread  upon  it,  and  over  these  the  same  number  of  woollen 
blankets,  whicn  are  less  injured  by  wet  than  cotton  comfortables. 
The  sheet  having  been  pretty  well  wrung  out  of  cold  water, —  always 
pure  and  soft,  if  such  can  be  had, — is  then  spread  out  smoothly  upon 
the  blanket.  The  patient,  being  undressed,  lays  himself  upon  the 
sheet,  and,  his  arms  being  held  up,  an  assistant  laps  one  side  of  it 
over  the  body  and  lower  limbs ;  when,  the  arms  being  dropped  at  the 
side,  the  other  part  of  the  sheet  is,  in  like  manner,  lapped  over.  The 
blankets  are  then,  one  by  one,  brought  over 
the  person  in  the  same  way,  and  tucked 
under  from  head  to  foot.  Comfortables 
may  be  added,  if  necessary.     (Fig.  178.) 

It  is  always  best  to  place  a  wet  towel, 
covered  with  a  dry  one,  on  the  patient's 
head  while  he  is  packed.  If  too  much 
chill  is  not  produced,  the  dry  one  may  be 
left  off. 

This  is  the  ordinary  way  of  taking  a  pack 
in  chronic  disease. 

The  wet  sheet  is  one  of  the  most  soothing  and  agreeable  of  all  the 
water  appliances.  Hence  it  is  that  it  is  so  often  misused.  It  is  so 
delightful,  and  tends  so  much  to  produce  slumber,  that  the  patient 
never  feels  ready  to  get  out  of  it  But  this  slumber,  —  so  \  -ofound  and 
sweet  as  it  often  is,  —  he  should  remember,  may  be  only  an  apoplectic 
stupor,  which  leaves  him  with  a  swimming  head,  attended  with  faint- 
ness,  perhaps,  and  ending  in  a  severe  headache  ;  giving  him,  in  short, 
a  congestion  of  the  brain.  All  this  happens  in  consequence  of  robbing 
the  skin  too  long  of  the  air  it  should  breathe. 

There  has  been  a  notion  at  some  of  the  establishments  that  the 
wet  sheet  is  to  be  used  for  sweating ;  and  to  this  end,  the  patient  has 
been  literally  stewed  hour  after  hour,  in  some  cases,  even  four,  five, 
and  six  hours  in  succession,  with  the  view  of  sweating  him.  All 
such  practice  is  hurtful.  If  the  patient  gets  better  under  it,  it  is  in 
consequence  of  the  good  effects  of  water  used  in  other  ways,  coupled 
with  the  ever-important  adjuncts,  air,  exercise,  and  diet.  In  later 
times,  Priessnitz  never  sweat  patients  at  all,  much  less  in  wet  sheets. 
If  a  man  must  sweat,  leave  off  the  wet  sheet  assuredly,  as  that  only 
hinders  the  operation.     Use  the  blanket  pack,  or  the  vapor  bath. 


How  Long  shall  the  Pack  Continue? — Here,  too,  there  has  been, 
and  still  is,  much  error  in  hy<lropathic  practice.  "  Btay  in  the  pack 
till  you  get  warm,"  has  been  the  old  doctrine.  But  some  get  warm 
at  first,  and  afterward  get  cold  ;  —  so  at  least  they  feel.  What  is  to 
be  done  ? 

One  of  Priessnitz's  improvements  was,  to  give  short  packs.  "  Re- 
main enveloped  for  fifteen  or  twenty  minutes  only,"  he  said.  "  If  you 
are  not  able  to  bear  the  pack  in  that  way,  take  the  rubbing  wet  sheet 
and  the  lighter  processes  until  you  are."  In  some  cases  he  gave  two 
or  three  of  these  short  packs  in  succession,  the  patient  rising  between 


W' 


'Wtmt 


530 


TROCKSSES  OF  THE  HYDKOI'ATIIIC  TKEATMKNT. 


I'  ' 


each  to  take  an  airing,  a  rubbing  wet  Bhcct,  or  other  bath,  and  then 
returning  to  the  pack. 

Thus  far  the  wet  sheet  has  been  spoken  of  as  used  in  chronic  dis> 
eases.  In  acute  attacks  it  is  nanaged  differently,  according  to  tlio 
case.  If  the  object  be  to  abstract  caloric  from  the  body,  we  cover  the 
sheet  but  little,  —  with  a  single  dry  sheet,  or  a  blanket  or  two,  or,  per- 
haps, with  none  of  these. 

We  know  that  if  we  keep  a  towel  about  a  keg  of  water  in  a  hot 
day,  the  water  will  be  made  cooler  by  evaporation.  In  the  same  way, 
when  a  patient  is  hot  and  feverish,  we  keep  one,  or,  still  better,  two 
wet  sheets  around  him,  without  other  covering,  and  thus  bring  down 
the  heat  and  circulation  to  any  desirable  degree.  We  sprinkle  water 
upon  the  sheets,  or  rewet  them  as  often  as  is  necessary,  —  in  some 
extreme  cases  of  fever  continuing  them  a  whole  week  or  more.  Ex- 
perience teaches  that  the  continuous  application  of  the  wet  linen  is, 
in  such  cases,  a  most  serviceable  application,  and  one  that  tends  most 
powerfully  to  induce  in  the  dermoid  structure  its  natural  and  health- 
ful state. 

Tlie  Wet  Sheet  Acts  by  Absorption.  —  It  draws  morbific  matter  out 
of  the  bodjj^  as  any  one  may  see  who  applies  the  sheet  for  a  short 
time,  and  then  washes  it.  Observe,  too,  what  an  odor  comes  from 
the  sheet  when  a  diseased  patient  has  been  packed.  At  the  same 
time,  it  absorbs  the  pure  water  into  its  finest  tissues  on  a  large  scale, 
thus  supplying  that  Huid  which  of  all  substances  the  system,  under 
such  circumstances,  most  needs.  This  moist  warmth  of  the  sheet 
also  acts  as  a  must  soothing  poultice. 


The  Wet  Dress. 

A  MODIFICATION  of  the  wet  sheet,  and  in  some  respects  an  improve- 
ment, is  the  "  wet  dres8,"80  called. 

A  coarse  linen  or  cotton  dress  is  made  with  large  arms,  so  that  one 
may  take  the  application  without  help.  The  dress  being  wet  and  ap- 
plied, the  patient  lays  himself  upon  blankets,  in  which  he  wraps  himself 
just  sufficiently  to  become  comfortable.  Or,  he  may  have  dry  flannel 
dresses  to  put  on  over  the  wet  one,  and  then  lie  in  a  common  bed. 
In  this  application,  the  air  is  net  excluded  from  the  surface  to  any- 
thing like  the  same  extent  as  in  the  common  tight  pack.  Hence,  a 
patient  may  remain  in  it  a  half,  or  the  whole  of  the  night,  if  he 
chooses,  —  being  careful  to  become  neither  too  warm  nor  too  cold, 
Rewetting  once  or  twice  in  the  night  will  be  of  service.  Often  in  a 
single  night  \  bad  cold  may  be  thrown  off  in  this  simple  way. 


The  Half  Pack.    "^ 

Many  patients  have  so  little  reactive  energy,  that  while  they  can 
bear  a  half  pack,  so  called,  the  entire  sheet  would  abstract  so  much 
caloric  from  the  body  as  to  injure  them.  In  such  cases,  the  sheet  is 
to  be  applied  so  as  to  extend  only  from  the  arm-pits,  or  at  most,  frorc 


IKNT. 


bath,  and  then 

ill  chronic  dis- 
ccording  to  the 
ly,  we  cover  the 

or  two,  or,  per- 

water  in  a  hot 
1  the  same  way, 

still  better,  two 
lus  bring  down 
e  sprinkle  water 
jary,  —  in  some 
c  or  more.  Ex- 
the  wet  linen  is, 
that  tends  most 
iral  and  health- 


rbific  matter  out 
leet  for  a  short 
Jor  comes  from 
At  the  same 
on  a  large  scale, 
e  system,  under 
th  of  the  sheet 


jcts  an  improve- 

rms,  so  that  one 
dng  wet  and  ap- 
le  wraps  himself 
have  dry  flannel 

a  common  bed. 

surface  to  any- 
pack.  Hence,  a 
the  night,  if  he 
m  nor  too  cold, 
ice.  Often  in  a 
pie  way. 


t  while  they  can 
bstract  so  much 
ases,  the  sheet  is 
or  at  most,  ftoTt* 


ritOCESSES  OF  THE  HYDUol'.^TIIIC  TREATMENT. 


5;ii 


the  neck  to  the  hips,  leaving  the  lower  extremities,  as  it  were,  in  the 
dry  pack.  Sometimes  the  sheet  is  allowed  to  extend  to  the  ankles, 
not  including  the  feet.  Packing  the  trunk  of  the  body  in  wet  towels, 
acts  upon  the  same  principle  as  the  partial  ur  half  pack,  and  is,  in 
many  cases  a  valuable  preliminary  measure.  It  is  well  to  take  these 
preparatory  ps  when  a  patient  who  has  suffered  long  from  chronic 
disease,  is  bc^.nnitig  with  the  envelopment. 

The  Folded  Wet  Sheet. 

In  domestic  practice,  a  modification  of  the  wet  sheet  may  be  had 
()y  folding  four-double  a  common  coarse  sheet,  for  enclosing  th€ 
trunk  from  the  armpits  down.  Two  thicknesses  of  this  are  wet  in 
cold  water,  to  come  next  the  body. 

This  is  a  valuable  application  in  a  host  of  ailments,  as  pleurisy, 
iiillaiiimation  of  the  lungs,  inflammation  of  the  bowels,  colic,  cholera, 
cholera  morbus,  rheumatism,  painful  menstruation,  after  pains,  etc. 
This  remedy,  which  can  be  applied  in  five  minutes,  will  often  soothe 
a  patient  quietly  to  sleep,  whose  lot,  without  it,  would  be  a  night  of 
agony.  One  advantage  of  this  application  is,  that  if  a  patient  is  too 
weak  to  rise,  the  sheet  may  be  opf»ned  in  front,  so  that  fresh  water 
may,  when  needed,  be  sprinkled  u  ">n  it,  and  wet  towels  may  be 
added  under  it,  upon  the  abdomen,  if  necessary. 

In  all  the  methods  of  applying  the  wet  sheet,  there  can  be  no  pos« 
Bible  objection  to  using  warm  bricks,  bottles,  etc.,  for  the  feet  when 
cold. 

Bath  after  the  Pack.  —  It  is  the  practice  generally  to  take  some 
form  of  the  bath  after  the  pack.  If  the  patient  is  too  feeble  to  rise, 
an  ablution  is  performed  while  he  is  in  bed.  In  other  cases,  a  wet- 
sheet  rubbing,  shallow,  plunge,  towel,  or  other  bath  is  resorted  to,  but 
not  strictly  of  necessity.  It  is  better,  however,  as  a  rule,  to  make  the 
process  a  compound  one,  that  is,  to  take  some  form  of  bath  after  the 
pack.  This  should  also  be  followed  by  exercise  in  the  open  air,  if  it 
can  possibly  be  taken.  A  pack,  followed  by  a  faithful  turn  at  work, 
or  by  exercise  in  the  open  air,  is  always  worth  much  more  than  when 
followed  by  rest  within  doors. 

The  Rubbing  Wet  Sheet. 

The  rubbing  wet  sheet,  too  little  appreciated,  and  too  seldom  used 
is  one  of  the  most  valuable  of  all  the  hydropathic  resources.  There 
is  probably  no  other  single  application  of  water,  in  all  the  multiform 
modes  of  hydropathic  medication,  that  can  be  made,  on  the  whole,  as 
useful  as  this.  It  is  a  tonic,  a  stimulant  a  sedative,  an  antispasmodic, 
a  derivative,  or  a  febrifuge,  according  to  the  circumstances  under 
which  it  is  applied. 

We  take  a  coarse  linen  sheet, —  although  cotton  answers  a  very 
good  purpose,  —  large  enough  to  throw  around  the  body  like  an  In- 
dian's blankei     It  is  wrung  more  or  less,  according  to  the  demands 


fi32 


PROCESSUS  OF  THE  HYDROPATHIC  TREATMENT. 


Fia.  17«. 


of  the  cane.     Thereupon,  it  is  thrown  quickly  around  the  patient's 

body,  who,  if  strong  enough,  is  in  the  stunding  pottture ;  and  thetv 

both  patient  and  assistant  set  vigorously  to 

ASHirk,  rubbing  over  the  sheet,  not  toilh  it, 

ns  some  do,  three,  four,  or  more  minutes, 

until  the  surface  becomes  thoroughly  warm 

(Fig.  179). 

If  there  is  fever,  less  friction  is  required. 
After  the  wet  sheet,  comes  a  dry  one,  to 
be  used  in  the  same  manner.  Those  who 
have  sutRcient  reactive  energy,  —  and  most 
have,  —  may  dry  the  body  simply  by  fan- 
ning it  with  the  dry  sheet,  the  windows  at 
the  same  time  being  open.  This  sort  of 
nir-bath  exerts  a  highly  pleasurable  effect 
upon  the  skin.     Instead  of  giving  one  a  >    i    i    \       .   . 

told,  it  helps  greatly  to  ward  it  oil     This  method  of  drying  the  body 
WHS  one  of  Priessnitz's  later  improvements. 

The  rubbing  wet  sheet,  it  should  be  remembered,  is  not  a  sing^le 
application,  capable  of  producing  only  one  effect.  It  is  used  in  three 
ditierent  gradations,  and  to  produce  very  different  results.  It  is  well 
wrung,  or  only  moderately  wrung,  or  left  quite  wet  and  dripping.  If 
a  person  ia  fatigued,  or  has  a  low  degree  of  reactive  energy,  the  first 
form  is  the  one  to  adopt ;  if  there  is  not  much  fatigue,  and  good  re- 


active energy,  the  second ;  and  if  the  patient  is  feverish,  and  the 
object  is  to  abstract  heat  simply,  we  use  the  sheet  quite  wet  and  drip- 
ping; and  we  repeit  it  as  many  times  in  succession  as  the  case  may 
need.  One  great  advantage  is,  that  we  give  it  before  or  after  a  wet 
pack,  when  no  bath  is  at  hand ;  we  also  give  it  in  connection  with 
any  other  bath  we  may  choose. 

See  how  admirable  a  remedy  the  rubbing  wet  sheet  is,  when  prop- 
erly understood!  A  patient,  —  a  child,  perliapi',  —  is  so  feeble  in  the 
reactive  power,  that  almost  any  form  of  bath  we  can  give  it  sends  the 
biood  from  the  surface,  making  the  lips  and  nails  pale  or  blue,  and 
the  extremities  cold,  showing  congestion  of  the  internal  organs. 
When  a  bath  produces  such  effects,  it  is  very  apt,  to  say  the  least,  to 
do  more  harm  than  good.  But  we  can  apply  the  rnbbini^  wet  sheet 
in  !<uc-h  a  way  as  to  cause  none  of  these  ill  oll'ects ;  bot<idos,  it  may 
be  repeated  many  times  in  the  day,  so  as  to  give  tiie  patient  the  ad- 
vantage of  a  strong  treatment;  for  a  li'^/it  treatment,  which  can  bo 
easily  borne,  Is  made  a  strong-  one  by  the  fretiuoiuy  of  its  repetition. 

A  wet  sheet,  well  wrung,  liolds  perhaps  a  pint  of  water;  or,  at 
most,  a  quart.  Now,  it  must  appear  plain,  lliat  a  |)int  or  quart  of 
cold  water,  spread  over  so  large  a  surface  as  tlie  whole  hkiii,  must  be- 
come very  easily  warmed  by  the  body's  heat.  Besides,  if  there  is 
g-reat  delicacy  of  constitution,  we  may  wring  the  sheet  out  of  water 
at  seventy,  eighty,  or  even  ninety  degrees,  gradually  lowering  it  as 
the  patient  can  bear  it. 

The  domestic  availability  of  this  application  is  also  to  be  spoken  of. 
In  ev  y  dwelling,  however  humble,  there  is  the  coarse  sheet,  and  the 


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PK0CE8SES  OF  THE  HYDROPATHIC  TREATMENT. 


533 


bucket  of  water.  How  useful,  therefore,  as  a  resort,  in  home  prac- 
tice ! 

The  rubbing  wet  sheet  appears  a  trifling  application,  —  one  which 
is  not  capable  of  producing  any  great  result  But  when  we  remem- 
ber the  myriads  of  nerves  of  animal  life,  spread  over  the  skin,  and 
derived  from  the  brain  and  spinal  cord,  it  need  not  surprize  us  that 
its  application  should  so  invigorate  the  body,  take  off  bodily  and 
mental  depression,  remove  languor  and  fatigue,  expel  flatus  from  the 
bowels,  remove  thirst,  give  appetite,  and  cause  a  feeling  of  calmness 
and  relief  which  can  be  appreciated  only  by  those  who  experience  it. 
A  minister,  for  example,  preaches  three  times  on  a  Sunday,  and  gets 
liis  brain  so  excited  that  he  cannot  sleep.  A  cold  bath  would  be  too 
powerful,  and  opiates  would  only  act  as  stimulants,  making  the  mat- 
ter worse.  Two  or  three  successful  applications  of  the  rubbing  wet 
sheet,  with  powerful  friction,  bring  the  blood  so  much  to  the  surface, 
that  his  brain  becomes  relieved,  and  he  very  soon  falls  into  a  sound 
and  refreshing  sleep.  So,  too,  when  a  man  has  been  long  wet  and 
drenched  on  a  rainy  day,  and  comes  home,  with  the  surface  and  ex- 
tremities cold,  and  the  blood  pressing  hard  upon  the  brain  and  other 
internal  organs,  —  the  well-wrung  rubbing  sheet  is  applied,  with  plen- 
tiful friction,  and  at  once  the  oppressed  organs  are  set  free. 

In  using  the  rubbing  wet  sheet,  as  in  all  other  forms  of  general 
bath,  it  is  well  to  wash  the  hands  and  face  in  cold  water,  both  before 
and  after  it.  There  is  no  need  of  throwing  it  over  the  head,  as  some 
have  thought  it  necessary  to  do.  A  patient  needs  to  breathe  freely 
when  he  takes  a  bath. 

This  application  is  not  always  the  most  pleasant  one.  It  does,  in 
fact,  require  a  good  degree  of  moral  courage  to  enable  one  to  endure 
the  first  shock.  The  sensations  produced  by  it  are  worse,  if  possible, 
than  those  from  a  plunge  into  cold  water ;  ]  mean  the  first  touch  of 
the  sheet  to  the  body.  Nervous  ladies  sometimes  tell  us  they  cannot 
take  the  rubbing  wet  sheet,  when,  at  the  same  time,  they  take  the 
cold  plunge,  which  is  far  more  powerful,  and  perhaps  too  powerful  for 
their  case.  This  unpleasant  feeling  does  no  harm,  for  it  vs^nishes  in  a 
moment  or  two  after  the  sheet  touches  the  body. 

The  Douche  Bath. 

This  is  the  most  powerful,  but  not  the  most  useful,  of  all  the  hydro- 
pathic appliances.  A  common  douche  consists  of  a  stream  of  water 
from  one  to  two  inches  in  diameter,  with  a  fall  of  ten,  fifteen,  or 
twenty  feet  But  douckes  may  be  a<rranged  of  any  desirable  size  and 
height     (Fjg.  180.) 

This  remedy  is  useful  in  paralysis,  stiff  joints,  gout,  rheumatism, 
tumors,  and  old  swellings  of  various  kinds.  Those  who  have  weak 
lungs,  stomach,  or  other  abdominal  organs,  should  not  resort  to  the 
douche  without  khe  be<«^    "  medical  advice. 


■-i''  !l 


m 


!:[ 


m 


534 


PROCESSES  OF  THE  HYDROPATUIC  TREATMENT. 


The  Shower  Bath. 

This  is  also  one  of  the  more  powerful  of  the  hydropathic  appli- 
ances,  and  needs  judgment  in  its  use.  It  consists,  in  fact,  of  a  vast 
number  of  small  streams  or  douches,  and  hence  is  a  powerful  refrig- 
erant, as  well  as  excitant,  to  the  system.  It  is  useful  to  commence 
this  bath,  for  a  time  at  first,  only  upon  the  limbs. 

The  Cataract  Bath. 

This  also  is  one  of  the  more  powerful  of  the  hydropathic  processes, 
and  is  to  be  classed  with  the  two  preceding  baths.  Like  them  it  may 
be  said  to  be  stimulant,  tonic,  and  alterative,  while  it  is  also  highly 
sedative  as  far  as  animal  heat  is  concerned. 

The  Hose  Bath. 

Through  the  modern  improvements  in  India-rubber,  gutta  percha, 
leather,  etc.,  it  is  easy,  whenever  there  is  a  small  fall  or  head  of  water, 
to  arrange  what  is  called  a  hose-bath.  It  is  in  principle  a  douche, 
with  the  additional  advantage  that  it  can  be  made  to  act  upon  any 
part  of  the  body,  and  from  whatever  direction  we  choose.  Rightly 
applied,  the  hose  bath  is  a  valuable  remedy.     (Fig.  181.) 


Fis.  180. 


Fio.  181. 


The  Pail  Douche. 

The  process  which  passes  under  this  name  is  taken  thus :  The 
patient  seats  himself  in  an  empty,  shallow,  or  other  bathing  tub,  and 
crosses  his  hands  over  his  chest.  As  many  pails  of  water  as  are  or- 
dered are  then  dashed  over  him  suddenly,  one  after  another,  before 
and  behind  alternately,  —  not  poured,  but  thrown  with  some  force,  by 
first  a  backward  and  then  a  forward  motion  of  the  pail. 

A  better  method  of  using  it  is,  for  the  patient  to  stand  in  an  empty 


A 


INT. 


ropathic  applU 
fact,  of  a  vast 

owerful  refrig- 
to  commenoo 


ithic  processes, 

v8  them  it  may 

is  also  highly 


r,  gutta  percha, 
ht^ad  of  water, 

cipie  a  douche, 
act  upon  any 

loose.     Rightly 

!•) 

.181. 


iken  thus :  The 
jathing  tub,  and 
i^ater  as  are  or- 
another,  before 
ti  some  force,  by 
.11. 
md  in  an  empty 


PROCESSKS  OF  THE  HYDROPATHIC  TREATMENT. 


535 


bathing  tub,  while  an  assistant  takes  two  pails  of  water,  one  ton  de- 
grees warmer  than  the  other,  and  empties  the  warmer  half  upon  the 
clicst  and  half  upon  the  back,  and  then  bestows  the  colder  pailful  in 
the  same  manner ;  then  dries  with  friction. 

The  Wave  or  Sluice  Bath. 

This  is  taken  at  the  sluice-way  of  an  undershot  mill-wheel,  or  in 
any  similar  place.  The  patient  takes  hold  of  a  rope,  or  something  by 
which  he  can  maintain  his  position,  and  then,  lying  down,  subjects 
his  body  to  the  action  of  the  water.  This  is,  on  the  whole,  a  pleasant 
and  agrr  able  bath,  and  in  its  effects  somewhat  resembles  the  douche^ 
being,  however,  milder  and  safer. 

The  Half  Bath. 

This  bath  may  be  used  as  one  of  the  mildest  of  the  water-cure 
processes,  or  as  one  of  the  most  powerful.  An  ordinary  bathing  tub  is 
a  very  good  apparatus  for  the  purpose.  A  good  sized  washing  tub 
will  answer  very  well,  if  there  is  nothing  else  at  hand.  The  water 
should  generally  be  quite  shallow  in  this  bath,  —  from  three  to  six 
inches.  Priessnitz's  half-baths  were  made  of  wood,  four  or  five  feet 
Jong,  about  two  and  a  half  feet  wide,  and  twenty  inches  deep.  This 
simple  contrivance  is  one  of  his  most  powerful  remedial  means, — 
that  by  which  some  of  his  highest  triumphs  are  achieved. 

The  water  is  generally  used  of  moderate  temperature,  at  sixty  to 
seventy  degrees  Fahr.,  and,  when  long  continued,  is  changed,  as  it 
becomes  warm  from  the  heat  of  the  body. 

This  bath  may  be  used. 

First,  as  a  means  of  cooling  the  mass  of  the  circulation  in  the  hot 
stages  of  fever,  and  in  inflammatory  attacks  of  every  kind ; 

Secondly,  as  a  revulsive,  or  means  of  drawing  blood  in  congestions 
or  inflammations  of  the  nobler  organs,  the  brain,  lungs,  stomach, 
liver,  etc. 

Thirdly,  as  a  means  of  resuscitation  in  the  shock  of  serious  acci- 
dents, sun-stroke,  and  before,  during,  or  after  apoplectic  and  other  fit& 
In  drunkenness  and  delirium  tremens,  the  half  bath  is  a  sovereign 
remedy ; 

Fourthly,  as  a  niiddle  means,  and  preparatory  to  the  general  bath 
in  weak  constitutions. 

In  the  latter  of  these  indications,  the  bath  is  generally  used  but  for 
a  few  minutes  after  the  wet  sheet,  or  at  other  times,  as  may  be  de- 
sired. In  the  former,  much  practical  knowledge  is  necessary  in  order 
to  proceed  always  with  safety,  and  to  obtain  the  best  results.  Thus, 
six,  or  even  nine  hours  may  be  required,  with  the  greatest  persever- 
ance, the  patient  being  thoroughly  rubbed  over  the  whole  surface,  and 
this  to  be  kept  up  constantly  by  relays  of  assistants,  the  patient's  head 
and  shoulders,  meanwhile,  being  supported. 


,    V 


\: 


536 


PROCESSES  OF  THE  HYDROPATHIC  TREATMENT. 


The  Plunge  Bath. 

In  sea,  river,  and  lake,  as  well  as  by  artificial  means,  and  as  a 
matter  of  luxury,  religious  observance,  purification,  and  the  preven- 
tion and  cure  of  disease,  the  plunge  bath  has,  in  all  periods  of  time, 
and  in  all  parts  of  the  world,  been  a  favorite  resort.  So  efficacious, 
indeed,  has  this  simple  means  proved  in  healing  the  sick,  that  not  a 
little  superstition  has  been  mir.gled  with  it.  Springs  and  wells  have 
often  been  supposed  to  possess  some  mysterious  power,  and  for  that 
reason  been  named  after  3oms  patron  saint.  In  this  respect,  the 
world  has  loved  mystery  and  marvellousness  rather  than  the  pure  and 
simple  truth. 

In  hydropathic  practice,  the  plunge  is  much  used ;  but  many  pa- 
tients are  not  able  to  bear  it.  Those  who  are  not  sufficiently  strong 
for  it  at  first,  should  practise  the  rubbing  wet  sheet,  the  half-bath, 
drinking,  exercise,  etc.,  until  the  plunge  can  be  borne.  It  is  a  favorite 
remedy  at  all  the  establishments,  to  be  taken  directly  on  coming  from 
the  wet  sheet  pack. 

The  Head  Bath. 

From  time  immemorial,  cooling  applications  to  the  head  have  been 
much  depended  upon  in  that  violent  and  dangerous  disease,  inflam- 
mation of  the  brain.  All  other  known  means  failing,  certain  obsti- 
nate affections  of  the  head  have  been  known  to  give  way  to  affusion 
of  cold  water  upon  the  part.  In  headache,  drunkenness,  delirium 
tremens,  the  delirium  of  fever,  epilepsy,  rheumatism  of  the  head,  dis- 
eases of  the  eye,  earache,  deafness,  loss  of  smell  and  taste,  and  in 
nose-bleed,  this  highly  energetic  remedy  is  brought  to  bear.  In  taking 
it,  the  patient  lies  down,  placing  the  back  of  his  head  in  a  shallow 
dish,  filled  only  an  inch  or  two  with  water.     (Fig.  182.) 


rio. 183. 


Fis.  18? 


The  Leg  Bath. 

This  is  useful  in  cases  of  ulceiB,  swellings,  emptions,  gont,  rhea- 
matism,  sprains,  wounds,  etc.,  of  the  leg  or  thigh.     The  relief  and 


and  as  a 
le  preven- 
la  of  time, 
;fficaciou9, 
that  not  a 
ivells  have 
[id  for  that 
jspect,  the 
e  pure  and 

many  pa- 
rtly strong 

half-bath, 
I  a  favorite 
ming  from 


have  been 

186,  inflam- 

rtain  obsti- 

to  affusion 

delirium 

head,  dis- 

ite,  and  in 

In  taking 

a  shallow 


gont,  rhea* 
relief  and 


J 


PnOCKSSES  OF  THE  HYDROPATHIC  TREATMENT. 


537 


strength  obtained,  often  by  a  single  application  of  this  remedV)  is  truly 
wonderful.  A  variety  of  apparatus  may  be  contrived  for  administer^ 
ing  the  leg  bath.  A  common  wooden  tub,  contrived  for  the  purpose, 
)ike  that  represented  in  Fig.  183,  answers  a  good  purpose.  In  sucb  a 
vessel,  he  covers  the  ii  flamed  limb  introduced,  and  cools  the  blood 
flowing  to  it 

The  Sitz-Bath. 

Convenient  tubs,  wooden  or  metallic,  are  constructed  for  this  bath^ 
but  an  ordinary  wash-tub  answers  very  well.  The  vessel  should  be 
large  enough  to  permit  the  motion  of  the  arms  in  rubbing  the  abdo- 
men, sides,  and  hips,  first  with  one  hand,  and  then  with  the  other 
Water  enough  should  generally  be  used  to  pretty  nearly  cover  the 
belly.  The  more  movement  and  friction  while  in  this  bath,  the  better. 
It  is  more  conveniently  administered  when  the  tub  is  elevated  two  or 
three  inches  from  the  floor.  Some  undress  the  patient  completely, 
and  place  a  blanket  or  sheet  over  the  upper  part  of  the  body ;  but 
oftener,  only  those  parts  are  uncovered  which  are  to  be  exposed  to 
the  water.     (Fig.  184.) 

In  a  variety  of  ailments,  this  bath  is  highly  valuable.  It  may  be 
made  one  of  the  most  powerful  of  all  the  hydropathic  modes.  Like 
all  other  powerful  applications,  it  should  be  taken  only  when  diges- 
tion is  nearly  or  quite  completed. 

As  a  tonic  to  the  stomach,  liver,  bowels,  womb,  spine,  etc.,  this 
bath  is  highly  useful.  In  constipation,  and  other  irregularities,  it  ia 
famous.  Those  of  sedentary  habits  will  find  its  use  of  rare  service. 
For  the  tonic  effect,  ten,  twenty,  twenty-five,  or  thirty  minutes,  If 
continued  for  some  length  of  time,  the  water  is  to  be  changed  once 
or  more,  as  it  would  otherwise  become  too  warm. 


Fio.  184. 


Fis.186. 


The  Waih-Tab  Bftth. 

Under  a  great  variety  of  circunMtances,  the  wash-tnb  bath  it  as 
iaviUuable  remedy.     For  example,  a  patient  is  feverish;  by  setting 


A 


( 


M 


'•^\ 


538 


PROCESSES  OF  TUE  HYDROPATHIC  TREATMENT. 


him  in  a  wash-tub  half  filled  with  water,  and,  at  the  same  time,  if  we 
choose,  putting  his  feet  in  a  pail  of  water,  cold  or  warm,  according  to 
the  case,  we  may  give  him  any  desirable  amount  of  cooling.  We 
cannot,  indeed,  too  highly  prize  this  simple  contrivance  for  using 
water,  —  a  means  which  every  family  possesses.     (Fig.  185.) 

The  water,  as  a  general  rule,  should  be  tepid,  ranging  from  72"  to 
90°,  and  may  be  prolonged  from  two  to  fifteen  minutes,  according  to 
the  strength  of  the  patient.  It  should  never  be  carried  to  the  extent 
of  producing  blueness  of  the  nails.  The  patient  should  be  dried  with 
towels,  or  the  dry  rubbing  sheet. 

This  bath  is  useful  in  the  treatment  of  eruptive  fevers,  bilious  le- 
mittents,  the  hot  stage  of  intermittents,  and  in  hectic  and  typhoid 
fevers.  It  is  often  used  after  the  wet  sheet  pack,  in  chronic  aft'ec- 
tions,  and  may  then  have  a  little  cooler  temperature,  or  else  be  fol- 
lowed by  pouring  a  pail  of  cooler  water  over  the  shoulders,  to  tone 
up  the  skin. 

The  Affusion. 

The  patient  stands  in  a  wash-tub,  bathing-tub,  or  other  convenient 
place,  when,  by  means  of  a  pail,  pitcher,  or  basin,  the  assistant  pours 
water  upon  the  head,  neck,  etc.,  either  upon  the  whole  of  the  body  or 
only  upon  a  part.  The  water  is  used  in  quantity  and  temperature 
according  to  the  necessities  of  the  case.  The  afiusion  is  one  of  the 
best  of  hydropathic  modes. 

Fifty  years  ago.  Dr.  Currie,  of  England,  performed  great  cures  in 
fever  by  the  affusion,  sometimes  tepid,  at  others  cold,  according  to  the 
strength  and  heat  of  the  patient.  If  there  was  great  heat,  the  water 
was  used  cold ;  if  not,  the  reverse.  In  a  variety  of  febrile  diseases, 
such  as  typhus  fever,  scarlet  fever,  small-pox,  measles,  tetanus,  con- 
vulsions, etc.,  he  used  this  remedy  with  remarkable  success. 

Towel  and  Sponge  Bath. 

With  one  or  two  coarse  towels  and  a  quart  or  two  of  water  we 
may  take  a  very  good  bath  almost  anywhere,  even  in  a  carpeted 
loom,  at  a  hotel,  or  wherever  we  may  be,  without  spilling  a  drop  of 
the  water.  After  a  person  becomes  accustomed  to  this  form  of  ablu- 
tion, none  but  the  most  indolent  will  be  willing  to  do  without  it, 
unless  they  can  have  some  other  form  of  bath.  A  daily  towel  ablu- 
tion, thoroughly  performed,  is  an  excellent  prevention  against  colds, 
helps  the  appetite  and  digestion,  and  is  a  good  means  of  preventing 
constipation. 

Some  are  in  the  habit  of  sitting  in  a  half-bath  or  a  sitz-tub,  and 
with  a  large  sponge  making  the  water  pass  freely  upon  the  head,  neck, 
shoulders,  and  other  parts  of  the  body.  At  the  same  time,  the  bather 
may  pour  water  from  a  cup,  basin,  or  pitcher,  upon  the  head,  neck, 
etc.  This  is  a  mild  affusion,  and  stronger  in  etiect  than  the  towel- 
bath. 


PROCESSES  OF  THE  IIYDROPATIIIC  TREATMENT. 


S3ii 


time,  if  we 
iccordiiig  to 
oling.  We 
o  for  using 
!5.) 

from  72"  to 
Lccording  to 
)  the  extent 
e  dried  with 

5,  bilious  re- 
and  typhoid 
iironic  aft'ec- 
else  be  fol- 
ders, to  tone 


r  convenient 

sistant  pours 

the  body  or 

temperature 

is  one  of  the 

eat  cures  in 
srding  to  the 
at,  the  water 
rile  diseases, 
tetanus,  con- 

3S. 


of  water  we 
1  a  carpeted 
ig  a  drop  of 
orm  of  ablu- 
1  without  it, 
<f  towel  ablu- 
gainst  colds, 
)f  preventing 

sitz-tub,  and 
le  head,  neck, 
le,  the  bather 
e  head,  neck, 
in  the  towel' 


Wash-Down. 

The  process  to  which  thi;*  name  if.  given  by  Dr.  Edward  Johnson, 
13  practised  as  follows :  "  The  pati^Mit  stands  in  an  empty  sitting  or 
wash  tub,  beside  which  stands  a  pail  of  cold  water  with  two  coarse 
towels  soaking  in  it.  The  bath  attendant,  taking  his  place  behind  the 
patient,  lifts  one  of  the  towels,  all  loaded  with  water,  a:y'  lays  it 
quickly  on  the  patient's  head.  The  patient  immediately  seizes  it, 
removes  it  from  his  head,  and  rubs  himself  rapidly  with  it, —  his  face, 
his  throat,  shoulders,  arms,  chest,  stomach,  bowels,  thighs,  and  legs. 
Having  gone  rapidly  over  the  whole  body  once,  he  drops  his  towel 
into  the  pail  again,  which  the  bath-man  presses  down  to  the  bottom 
of  the  water,  then  lifts  it  out,  and  places  it  on  his  head  again.  As 
before,  the  patient  seizes  it,  and  goes  all  over  the  same  ground  once 
more,  and  then  drops  it  into  the  water  again,  when  the  bath-man 
again  lifts  it  and  places  it  on  the  head  to  be  a  third  time  removed  by 
the  patient,  and  applied  as  before,  rapidly,  actively,  and  energetically, 
all  over  his  body  in  front.  The  bath-man  is  industriously  occupied 
all  the  time  behind  in  the  same  manner,  from  the  back  of  the  neck  to 
the  back  of  the  legs,  wetting  his  own  towel  as  often  as  he  wets  that 
used  by  the  patient,  viz.,  three  times.  This  is  called  a  wash-down  of 
three  towels.  The  patient  is  then  dried  in  a  dry  sheet.  It  is  a  '  ore 
powerful  bath  than  the  common  towel-bath,  but  not  in  all  respects  so 
convenient  to  take. 

The  Gold  Foot-Bath. 

One  of  the  first  things  people  who  are  troubled  with  cold  feet  do,  is 
to  plunge  them  into  cold  water.  Nor  is  the  assertion,  put  forth  in 
some  of  the  hydropathic  works,  that  the  cold  foot-bath  was  prescribed 
by  Priessnitz  for  the  same  purpose  that  the  faculty  order  warm  ones, 
correct.  When  the  feet  are  already  cold,  neither  Priessnitz  nor  any 
one  in  his  sober  reason  would  prescribe  cold  water,  which  can  only 
make  the  parts  colder.  To  obtain  the  good  effect  of  the  cold  foot- 
bath, so  far  as  the  feet  are  concerned,  they  should  be  warm  whenever 
it  is  taken.  For  a  tendency  to  coldness  of  the  feet,  —  a  very  common 
symptom  in  these  days  of  so-called  luxury  and  refinement,  and  one 
that  indicates  a  state  of  things  in  the  system  incomparably  more  to 
be  dreaded  than  the  mere  coldness  of  the  feet,  —  this  is  the  remedy. 
It  may  be  taken  at  any  convenient  time :  just  before  the  morning 
walk  is  a  very  suitable  occasion,  the  parts  being  usually  warm  early 
in  the  day. 

At  other  times,  if  cold,  they  should,  if  at  all  practicable,  be  warmed 
by  exercise  nd  friction,  before  subjecting  them  to  the  action  of  cold 
wat«r.  But  in  cases  of  old  age,  great  debility,  etc.,  the  warm  foot- 
bath, and  other  warm  applications  may  be  resorted  to  before  the  cold. 
Thus  with  cold,  exercise,  and  friction,  accustoming  the  feet  daily  and 
frequently  to  cold  water,  will  beget  in  them  a  habit  of  remaining 
Warm.     In  a  great  variety  of  ailments,  such  as  toothache,  rush  of 


h 


RSM 


v/ 


540 


PROCESSES  OF  THE  nYDROPATHIC  TREATMENT 


blood  to  the  head,  headache,  earache,  inflammation  of  the  eyes,  gout, 
rheumatic rn,  hemorrhages,  etc.,  the  cold  foot-bath  is  a  valuable  remedy. 
It  is  ordcn-d  deep  or  shallow,  and  of  duration  according  to  the  nature 
of  the  case. 

Wading  Foot-Baths. 

I  HAVE  often  directed  patients  to  wade  in  water  in  some  con  'enient 
place,  as  a  means  of  hardening  the  system  and  of  giving  tone  xo  the 
nerves.  Delicate  ladies  who  were  not  able,  as  they  supposed,  to  en- 
dure cold  water  applied  to  the  feet,  have  by  degrees,  wetting  the  feet 
but  little  at  first,  become  so  accustomed  to  the  coldest  water,  that  in  a 
few  weeks  they  could  bear  as  much  as  any  one  would  desire.  Caution 
and  perseverance  should  be  the  rule. 

It  is  partly  by  sympathy  and  partly  by  the  abstraction  of  heat,  that 
foot-baths  and  wetting  the  feet  act  in  so  beneficial  or  deleterious  a 
manner  as  we  know  them  to  do.  The  principle  of  sympathy  is  an  old 
one  in  the  medical  art,  but  none  the  worse  for  that. 

The  Warm  Foot-Bath. — Pediluvium. 

I  AM  aware  that  some  who  consider  themselves  genuinely  hydro- 
pathic,  object  to  the  use  of  this  remedy.  Having  truth  for  my  object, 
howeve/,  I  care  not  for  such  objections  so  far  as  myself  am  concerned, 
and  without  stopping  here  to  argue  the  question,  I  simply  remark  that 
warmth  under  some  circumstances  is  as  natural  an  application  for  the 
living  body,  as  cold  under  other  circumstances.  I  have  already  re- 
marked, under  the  head  of  the  cold  foot-bath,  that  putting  the  feet  into 
warm  water  is  often  a  good  preparatory  process  to  that  bath.  It  is 
good  also,  now  and  then,  for  soothing  divers  aches  and  pains,  and  also 
for  warming  the  feet  of  old  and  weakly  people,  v/ho  cannot  exercise 
sufficiently. 

The  Nose-Bath. 

In  a  variety  of  nasal  ailments,  catarrh,  colds  in  the  head,  inflamma- 
tion and  ulceration  of  the  nasal  passages,  nose-bleed,  etc.,  the  nose- 
bath  is  a  salutary  remedy.  The  water  is  used  either  tepid  or  cold, 
according  to  the  case.  It  should  be  drawn  back  if  possible,  so  that  it 
is  ejected  by  the  mouth.  Those  who  have  injured  the  nasal  cavities 
by  much  snuff-taking,  will  f5nd  advantage  from  sniffing  water  freely 
into  the  nostrils.  If  one  is  determined  to  leave  off  soun,  as  every  one 
addicted  to  it,  if  he  regards  either  health  or  bodily  comfort,  ought, 
he  will  find  it  useful  often  to  take  cold  water,  instead  of  the  abomina" 
ble  weed. 

The  Eye  &nd  Ear  Bath. 

Varioub  oontrivancei  may  be  brought  to  bear  in  applyin^^  water  to 
the  eye  and  ear.     Ijight,  ascending  douches  and  showers  are  useful  in 


/ 


FROCESSES  OF  THE  HYDROPATHIC  TREATMENT. 


641 


eyes,  gout, 

ble  remedy. 

the  nature 


con  'enient 
tone  lo  the 
osed,  to  en- 
ng  the  feet 
er,  that  in  a 
?.    Caution 

f  heat,  that 
eleterious  a 
hy  is  an  old 


nely  hydro- 
•  my  object, 
» concerned, 
remark  that 
ition  for  the 
already  re- 
;he  feet  into 
bath.  It  is 
ns,  and  also 
not  exercise 


,  inflamma- 
c,  the  nose- 
3id  or  cold, 
e,  so  that  it 
sal  cavities 
vater  freely 
18  every  one 
ifort,  ought, 
le  abomina- 


n|^  water  to 
ire  useful  in 


various  diseases  of  the  parts.  There  should  not  be  much  force  used 
in  this  way.  Immersing  them  also  in  water  is  often  useful.  The 
water  shuuld  not,  in  general,  be  very  cold,  tepid  or  warm  being  often 
the  best 

Month,  or  Oral  Bath. 

For  inflammation  of  the  gums,  mouth,  throat,  and  palate,  in  slimy 
secretions  from  the  throat  and  stomach,  in  toothache,  catarrh,  colds, 
and  chronic  hoarseness,  garglings  and  baths  for  the  mouth  are  of  great 
service.  Pauley,  a  merchant  of  Vienna,  has  been  thought  singular 
for  his  zeal  in  recommending  this  bath.  Clergymen  and  others  who 
eurt'er  hoarseness  by  niu<;h  speaking,  will  find  that  holding  very  cold 
water  in  the  mouth  until  it  begins  to  grow  warm,  and  then  ejecting  it, 
and  by  frequently  repeating  the  process,  much  benefit  will  be  obtained. 
Coughs  and  tightness  of  the  chest  may  often  be  essentially  relieved 
by  this  bath.  In  mucous  secretions  from  the  throat  and  stomach,  by 
ejecting  the  water  a  number  of  times,  it  will  surprise  those  who  have 
not  witnessed  the  remedy  to  see  the  amount  of  slimy  secretion  thrown 
oft 

Division  of  Baths. 

On  no  one  subject  connected  with  hydropathy  has  there  been  more 
"confusion  of  tongues,"  than  concernmg  the  temperature  of  baths. 
Both  in  books  and  in  popular  language,  among  physicians  as  well  as 
laymen,  have  words  been  used,  sometimes  confusedly,  and  at  other 
times  without  a.ny  meaning  whatever.  '  Orthodox  medical  works,  as 
well  as  the  miormo^ox,  come  under  the  same  category  of  error.  A 
few  simple  explanations  on  this  head,  properly  made,  will  be  sufficient 
for  all  practical  as  well  as  scientific  purposes. 

The  simplest  and  most  natural  division  of  baths  is  into  coW,  tepid, 
warm,  and  hot.  These  are  all  terms  of  evcry-day  life,  and  are  fully 
sufficient  to  guide  us  in  the  selection  of  any  and  all  the  multiform 
uses  of  water  which  hydropathy  teaches.  I  admit,  however,  that 
when  we  wish  to  be  especially  explicit,  the  actual  therinometrical 
temperature  should  be  mentioned.  Hot  baths,  I  maintain,  have  no 
|)roper  place  in  hydropathic  practice.  He  who  resorts  to  them  either 
(lot's  not  at  all  understand  the  true  principles  of  the  Water-Cure, 
or  is  guided  merely  by  the  whims  or  caprices  of  those  who  employ 
him. 

But  whatever  words  we  use  to  designate  the  different  baths,  there 
is  one  objection,  which  is,  that  ail  such  terms  are,  necessarily  arbitrary 
in  a  greater  or  less  degree.  What  appears  to  one  person  cold,  may 
to  nnother  appear  tepid,  or  wEtrm,  or  even  hot.  Thus  it  is  said  that 
on  a  road  over  the  Andes,  at  aboul  half  way  between  the  foot  and 
the  summit,  there  is  a  cottage  in  which  the  ascending  and  descending 
travellers  meet.  The  former,  who  have  just  quitted  the  sultry  valleys 
at  the  base,  are  so  relaxed,  that  the  sudden  diminution  of  temperature 
produces  in  them  a  feeling  of  intense  cold  ;  while  the  latter,  who  left 


542 


PROCESSES  OF  THE  HYDROPATHIC  TREATMENT. 


the  frozen  summit  of  the  mountain,  are  overcome  by  distressing  sen- 
sationH  of  extreme  heat  If  on  a  cold  winter's  morning  we  go  from  a 
warm  bed  to  a  bath  of  sixty  to  seventy  degrees  Fahr.,  the  water  ap- 
pcart.  cold.  If  we  then  plunge  immediately  into  water  which  is  at 
about  the  freezing  point,  and  then  return  again  to  the  water  at  sixty 
to  seventy  degrees  Fahr.,  it  appears  warm.  When  the  temperature 
of  the  atmosphere  is  at  fifty-five  degrees  Fahr.,  in  November  or  Octo- 
ber, in  this  latitude,  and  the  body  of  a  comfortable  degree  of  warmth, 
and  we  take  three  basins  of  water  at  sixty,  seventy,  and  eighty  de- 
grees Fahr.,  placing  one  hand  in  the  water  at  sixty  degrees,  the  other 
in  that  at  eighty  degrees,  letting  them  remain  thirty  seconds  in  each, 
and  then  immerse  them  both  in  the  water  at  seventy  degrees,  it  ap- 
pears to  one  cold^  to  the  other  warm. 

But  we  can  arrive  at  rules  which  approximate  so  nearly  to  the  ac- 
tual truth,  that  they  will  serve  us,  as  before  remarked,  for  guides  in 
all  practical  and  scientific  purposes. 

The  Cold-Biithi  —  With  a  majority  of  persons,  and  at  most  seasons 
of  the  year,  water  at  from  seventy  to  eighty  degrees  Fahr.  downward, 
gives,  when  immersed  in  it,  a  sensation  of  coldness.  The  spring  \\  ater 
of  all  countries  furnishes  what  may  therefore  be  called  a  cold-balh, 
although  there  will  be  a  range  of  many  degrees  variation  in  what  we 
term  cold. 

Tlie  Tepid-Bath.  —  The  word  ttpid  is  from  the  Latin  tepeo,  to  be 
warm.  The  true  English  meaning  of  the  term  however  is,  according 
to  Mr.  Webster,  vwderately  warm,  or  lukeivarm. ;  in  other  words,  water 
which,  when  a  person  is  immersed  in  it,  gives  a  kind  of  indefinable 
sensation,  one  which,  coming  properly  under  the  neither  cold  nor  vmrm, 
is  said  to  be  tepid.  This  temperature  will  be  found  to  range  at  from 
eighty  to  ninety-two  degrees  Fahr. 

The  Warm-Biith.  —  The  term  warm,  is  generally  well  understood. 
It  means  that  temperature  of  water  which  is  peculiarly  agreeable  to 
the  sensations.  Fresh-drawn  milk  or  blood  we  say  are  warm.  The 
temperature  of  water  which  will  cause  this  sensation,  varies  from 
ninety-two  to  ninety-eight  degrees  Fahr. 

The  Vapor-Bath.  —  The  temperature  of  the  vapor  of  simple  wad^er 
varies  from  about  ninety  degrees  Fahr.  upward,  according  to  the  heat 
of  the  water,  and  the  space  through  which  the  vapor  passes. 

The  Hot-Bath. — The  term  hot  is  also  expressive  of  its  proper  mean» 
ing.  If  the  body  is  immersed  in  water  above  blood-heat,  it  causes  an 
uncomfortable  sensation,  which  we  desigiiate  as  hot.  Hot  water  is  a 
disturber  of  the  vital  functions,  particularly  if  the  whole  body  is  im- 
mersed in  it.  Hot-baths,  therefore,  should  be  used,  if  ever,  oniy  in  a 
most  urgent  necessity.  Hot  water,  in  no  form  whatever,  entered  into 
any  part  of  Priessnitz's  treatment 

Having  thus  explained  the  temperatures  of  the  diflferent  divisions 
of  the  bath,  it  is  proper  to  state  them  in  a  tabular  form,  the  better  to 
aid  the  memory.     They  are  as  follows  : 


_:i  --:^in. 


IkMl 


PROCESSES  OP  THE  HYDROPATHIC  TREATMENT. 


543 


Cold-bath  from  iVeezing  point,        .        .  82  to  86°  F. 

Topid  " 80  to  92° 

Warm" 92  10  98° 

Vapor " 90°  and  iipward. 

Hot     •' above  98'' 

I  now  propose  to  explain  somewhat  minutely,  and  ut  the  same  time 
with  a  due  regard  to  the  needs  of  the  non-professional  reader,  the 
physiological  effects  of  each  of  the  several  kinds  of  bi\th,  and  I  here 
respectfully  premise  that  any  one  who  attempts  to  practise  the  water 
treatment  without  having  in  his  mind  clear  notions  upon  this  subject 
is,  to  say  the  lc:\st,  as  much  a  "  gropcr  in  the  dark"  as  he  who  attempts 
the  practice  of  drugs  of  which  he  knows  nothing,  upon  the  living  body 
of  which  he  knows  less.  How  can  a  ni^^n  b''.  trusted  in  water  treat- 
ment if  he  cannot  tell  beforehand  what  effect  a  bath  is  to  have ;  and 
this  he  cannot,  il  he  does  not  fully  understand  the  meaning  of  the 
terms  which  I  have  here  explained. 

EfTecte  of  the  rold-Biitli.  —  The  effects  of  the  cold-bath  are  properly 
spoken  of  under  two  heads,  the  primari/  and  the  secondary.  The 
terms  a.e  sutlieienlly  expressive  of  their  meaning.  The  first  avi' 
those  which  take  jilace  at  the  time  of  the  immersion  ;  the  second, 
those  that  occur  later,  constituting  what  we  understand  by  the  term 
reaction. 

Immediately  i  immersion  in  cold  water,  the  bather  experience;* 
some  acceleration  of  respiration  and  the  heart's  action,  although  the 
pulse  becomes  at  the  same  time  smaller  and  weaker.  Verj  soon, 
however,  the  pantitig.,  if  I  may  so  call  it,  passes  off;  the  temp'"rature 
of  the  body  is  found  diminished,  the  surface  paler  than  natural,  the 
skin  taking  on  that  form  of  appearance  known  as  "goose-flesh." 

The  first  effect  of  cold  water  applied  to  the  body,  generally,  is  to 
abstract  a  certain  amour  jf  heat  from  the  surface,  to  constringe  the 
capillary  vessels,  and  to  force  the  blood  inward.  Now,  as  the  living 
body  possesses  the  remarkable  property  of  maintaining  its  tempera- 
ture at  very  nearly  the  same  point,  whether  it  is  in  a  colder  or  hotter 
medium  than  itself,  the  vitals  at  once  set  to  work  in  restoring  the 
caloric  abstracted  by  the  contact  of  the  water ;  and  as  the  functions 
of  circulation  and  calorification  go  necessarily  together,  the  vital 
power,  acting  through  the  heart  and  blood-vessels,  attempts  a  return 
of  the  blood  that  had  been  forced  inward  by  the  coldness  of  the 
water. 

This  is  what  we  call  reaction.  If  the  individual  is  sufficiently 
•trong  and  well  stocked  with  vitality,  the  blood  is  quickly  returned 
to  the  surface  and  to  the  extremities  (which  are  always  most  liable 
to  become  cold,  being  farthest  from  the  heart),  constituting  what  ia 
termed  gcod,  or  vigorous  reaction.  But  if  the  surface  and  extremities 
continue  to  remain  un warmed  by  this  return  of  the  blood  to  them,  as 
happens  in  t^  case  of  feeble  persons,  there  is  said  to  be  poor,  or  tn- 
sujficient  ret     -jn. 

Effects  of  the  Tepid-Bath.  —  The  tepid-bath,  which  we  have  seen 
ranges  from  eighty  to  ninety-two  degrees  Fahr.,  produces  effects  anal- 


#.; 


I 


I 


544 


PROCESSES  OF  THE  UYDROPATUIC  TREATMENT. 


ogous  to  those  of  the  cold-bath,  only  not  so  lasting  and  pennanent. 
It  is  especially  useful  in  the  treatment  of  infants  and  children,  and  in 
all  cases  where  the  reactive  energy  is  feeble.  If  in  any  case  we  are 
in  doubt  as  to  whether  the  cold  bath  is  admissible,  the  tepid  form  will 
be  a  milder  measure,  and  at  the  same  time  serve  as  a  test  in  ventur- 
ing upon  the  cold.  The  tepid  bath  may  be  continued  longer  at  a 
time,  which  in  i^ome  cases  will  be  found  an  advantage. 

llffects  of  the  Warm-Bath.  —  There  is  among  hydropathic  physi* 
cians,  if  I  am  not  mistaken,  too  great  a  fear  of  warm  applications  on 
the  part  of  some,  while  others  go  to  the  opposite  extreme.  Mark,  I 
speak  of  warm  applications.  Hot^  as  before  remarked,  have  no  proper 
place  in  hydropathy,  —  a  rule  to  which  the  exceptions  are  few. 

The  warm-bath,  as  before  remarked,  ranges  from  ninety-two  to 
ninety-eight  degrees  Fahr.  It  is  not  the  mosl  useful  of  the  hydro- 
pathic resources,  but  one  of  the  most  useful,  as  I  shall  endeavor  here- 
after to  show. 

Among  the  ancient  Romans  the  warm-bath  was  not  considered  as  a 
means  of  luxurious  indulgence  that  tended  to  weaken  the  vital  powers, 
but  a  means  of  refreshment  for  the  wearied  traveller,  and  of  prepar- 
ing him  for  the  repast  and  the  enjoyment  of  other  rites  of  hospitality. 
The  effect  of  the  warm-bath  is  not  one  of  debility,  as  many  suppose, 
but,  on  *he  contrary,  it  is  a  sedative,  lowering  the  heart's  action  and 
the  circulation,  and  tending  to  repose  rather  than  excitement. 

Effects  of  tlie  Hot-Bath.  —  The  hot-bath,  before  remarked,  is  one 
which  is  above  the  temperature  of  the  blood,  ninety -eight  degrees 
Fahr.  It  was  laid  down  as  a  precept  by  Hippocrates,  that  a  bath  en- 
feebles when  the  heat  exceeds  that  of  the  body  immersed  in  it.  The 
truth  of  this  precept  has  often  been  verified  in  practice. 

1  do  not  wish  to  be  understood  as  affirming  that  hot  applications 
can  never  be  made  with  benefit  to  the  body ;  on  the  contrary,  heat 
applied  to  a  part  locally  may  be  of  service,  although  I  am  inclined  to 
believe  that  even  in  those  cases  where  heat  acts  in  a  beneficial  way, 
some  other  form  of  hydropathic  appliance  can  be  used  more  benefi- 
cially. I  make,  it  will  be  remembered,  a  broad  distinction  between 
the  terms  hot  and  warm. 


Sea-Bathing. 

As  regards  temperature,  sea-bathing  comes  under  the  general  head 
of  cold-baths.  Sea  water,  however,  at  those  seasons  of  the  year  when 
sea-bathiiig  is  resorted  to,  is  of  but  a  moderate  degree  of  coldness, 
varying  in  this  latitude  not  much  from  seventy  degrees  Fahr. 

In  order  to  appreciate  fully  the  effects  of  sea-bathing  upon  the  sys- 
tem, a  number  of  things  are  to  be  considered. 

Sea  water  differs  in  its  effects  from  common  water  by  its  possessing 
greater  density.  This  circumstance,  however,  is  not  of  so  great  im- 
portance as  that  of  the  stimulating  nature  of  the  mineral  it  contains. 
The  saline  ingredient  is  a  powerful  stimulant  and  even  irritant  of  the 
skin.    On  account  of  this  property,  it  is  found  that  an  exposure  to  the 


I 


ermanent; 
:n,  and  in 
se  we  are 
form  will 
in  ventur- 
nger  at  a 

liic  phyai- 

nations  on 

Mark,  I 

no  proper 

!W. 

ity-two  to 
he  hydro- 
iavor  here- 

idered  as  a 
:al  powers, 
of  prepar- 
lospitality. 
y  suppose, 
action  and 
It. 

ed,  is  one 
[it  degrees 
a  bath  en- 
n  it.     The 

pplications 
trary,  heat 
inclined  to 
ficial  way, 
ore  benen- 
n  between 


neral  head 
year  when 
f  coldness, 

on  the  sys- 

possessing 
3  great  im- 
it  contains, 
tant  of  the 

ure  to  the 


PROCESSES    OF   THE   HYDROPATHIC   TREATMliNT. 


545 


action  of  salt-water  is  not  so  liable  to  cause  ill  effects  as  that  to  fresh. 
The  salt  causing  a  degree  of  heat  upon  the  surface  somewhat  higher 
than  that  of  tho  natural  state,  the  system  is  for  the  time  shielded  from 
the  action  of  cold.  It  does  not  follow  from  this,  however,  that  a 
person  could  live  longer  irauiersed  in  sea  than  in  common  water,  any 
more  than  it  follows  that  because  alcohol  for  a  time  increases  the  ani- 
mal temperature,  life  can,  under  circumstances  of  great  exposure  to 
cold,  bo  the  longer  preserved.  This  it  is  now  well  known  ia  not  the 
case. 

An  advantage  of  sea-bathing  in  the  hot  season  is,  that  the  air  at 
the  sea-shore  is  cooler  than  on  land.  That  our  climate  in  summer  is 
too  hot  for  the  most  favorable  development  of  health  is  proved  by 
the  great  increase  of  mortality,  not  only  in  our  cities,  but  in  oth«t' 
parts,  during  the  hot  season.  The  European  cities,  with  all  their 
luimbers  of  inhabitants,  dampness,  narrow  streets,  intempei'ance, 
pauperism,  etc.,  would  naturally  be  expected  to  show  a  higher  range 
of  mortality  than  our  American  cities,  but  such  is  not  the  fact.  Even 
New  York,  with  all  its  natural  advantages,  is  as  sickly,  probably,  as 
any  of  the  British  or  European  cities.  This,  it  is  agreed  on  all 
hands,  must  be  owing  in  great  part  to  the  great  heat  of  our  summer 
months. 

The  manner  ot  taking  the  salt-water  bath  has  some  peculiarities 
which  are  favorable  to  health.  It  is,  in  the  first  place,  in  the  open 
air,  which,  if  the  weather  is  favorable,  that  is,  neither  too  hot  not 
cold,  is  always  a  great  advantage.  Other  things  being  equal,  a  bath 
in  tho  open  air  is  always  attended  with  a  better  reaction  and  a  greater 
degree  of  invigoration  than  one  within  doors. 

In  the  second  place,  sea-bathing  is  usually  and  almost  necessarily 
connected  with  exercise  both  before  and  after  the  bath,  circumstances 
which  are  always  highly  favorable  to  the  action  of  cold  water.  So 
beneficial,  indeed,  is  exercise  taken  in  this  way,  that  it  would  be  dif- 
ficult to  determine  which  of  the  two  —  the  exercise  or  the  bathing 
—  is  the  more  beneficial.  In  connection,  the  two  act  reciprocally 
upon  each  other,  each  rendering  the  other  doubly  beneficial. 

Injections. 

The  term  injection  implies  the  act  of  throwing  a  fluid  into  some 
cavity  of  the  body. 

In  ^/Vater-Cure  we  inject  water  more  frequently  into  the  bowels 
than  any  other  cavity.  This  kind  of  injection  is  also  called  enema, 
or  clyster. 

Most  people  have  so  little  confidence  in  simple  water,  that  if  a 
clyster  is  administered  to  them,  they  have  no  idea  that  it  can  operate 
in  so  effectual  a  way  as  it  usually  does.  Years  ago,  when  the  water 
treatment  was  much  less  known  than  at  the  present  time,  I  have  been 
suspected  of  having  secretly  put  some  cathartic  substance  in  the 
water,  "  for,"  said  the  patients,  •'  how  is  it  possible  for  water  to  act 
in  this  way  ?  " 

A  great  variety  of  injection-instruments  have  been  invented.  Some 
(J9 


f 


m 


"1!    .m "    V 


546 


PROCESSES   OF   TUB   HYDUOPATHIO   TREATMENT. 


':'X 


K 


of  these  are  very  convenient  and  useful ;  others  are  got  up  on  mere 
speculation,  and  are  but  little  worth.  Every  family,  at  least,  ought 
to  have  a  good  force-pump  injection-instrument,  if  they  can  obtain 
such  a  one.  A  lady's  toilet  is  never  complete  without  it.  A  good 
article  is  either  manufactured  or  sold  by  most  surgical-instrument 
makers,  and  druggists  often  have  a  good  article.  But  beware  of  im- 
poi<ilion.  It  is  better  to  get  along  with  a  common  bladder  and  goose- 
quill,  as  we  may  in  aa  emergency,  than  to  pay  for  a  good-for-nothing 
syringe.  ^ 

Modus   Operandi  of  Water. 

It  is  often  objected  to  hydropathy  that  water,  being  but  one  agent, 
cannot  bo  made  useful  in  all  diseases.  I  propose  here  to  make  some 
remarks  on  the  modus  operandi  of  tvatei',  in  which  I  shall  endeavor  to 
explain,  not  only  to  the  scientific  scholar,  but  to  the  ordinary  reader, 
that  water  is  capable  of  being  made  available  as  a  remedy,  —  and 
that  powerfully  too,  —  in  a  great  variety  of  ways.     It  then  acts  : 

1.  By  its  Presence. — Water,  as  we  have  seen  elsewhere,  com- 
poses the  larger  part  of  the  living  body ,  and  that  without  its  pres- 
ence in  a  large  proportion  in  the  living  system,  the  vital  processes 
cannot  for  a  moment  go  on. 

2.  By  Us  Coldness. —  Cold,  within  proper  limits,  preserves  and 
augments  life,  while  heat  tends  to  debility  and  decay.  In  proportion 
as  the  animal  heat  is  diminished  in  the  different  classes  of  animals, 
the  less  is  the  want  of  air  felt.  If  in  a  puppy  the  eighth  pair  of 
nerves  bo  divided,  producing  a  closure  of  the  glottis  so  that  no  air 
can  enter  its  lungs,  the  animal  dies  in  half  an  hour,  if  kept  at  an  or- 
dinary temperature.  But  if  the  animal  is  benumbed  with  cold  it 
survives  the  operation  for  a  whole  day.  Frogs,  in  the  summer,  when 
the  temperature  of  water  is  elevated,  are  obliged  to  come  often  to 
the  surface  for  air.  But  in  winter,  when  the  water  is  colder,  they 
live  ahnos*",  entirely  under  its  surface.  A  cholera  patient  in  collapse, 
a  person  who  has  been  stitied  by  foul  gases,  one  in  the  sinking  stage 
of  a  fever,  or  fainting  from  loss  of  blood,  or  in  any  way  asphyxiated, 
desires  always  coldness  rather  than  heat.  It  may  not  be  possible  in 
the  present  state  of  science  to  explain  these  phenomena  ;  but  unde- 
niably wo  have  the  facts. 

3.  By  Endosmose  and  Exosmose.  —  Animal  membranes  havo  the 
power  of  absorbing  liquids,  —  called  endosmose,  or  imbibition,  and  of 
throwing  them  out,  exosmose,  or  transudation. 

If  we  take  a  portion  of  the  intestine  of  a  chicken,  tie  one  end, 
nearly  fill  it  with  milk,  then  tie  the  other  end,  and  lastly  immerse  it 
in  a  tumbler  or  other  vessel  of  pure  water,  we  find  that  in  a  short 
time  the  milk  passes  out  of  the  mtestine  into  the  water,  and  the 
water  inwardly  mingling  with  the  milk.  This  process  goes  on  till 
the  fluid  within  and  without  the  intestine  becomes  one  and  the  same. 
This  is  a  familiar  illustration  of  the  principle  in  question. 


on  mere 
st,  ought 
n  obtain 
A  good 
striinaent 
re  of  im- 
;id  goose- 
r-uothiug 


ne  agent, 
ake  some 
deavor  to 
■y  reader, 
y,  — and 
acts : 

sre,  com- 
t  its  pres- 
processes 

srves  and 
)roportion 
f  animals, 
1  pair  of 
lat  no  air 
at  an  or- 
;h  cold  it 
ner,  when 
9  often  to 
der,  they 
I  collapse, 
cing  stage 
ihyxiated, 
)ossible  in 
but  unde- 


bave  the 
on,  and  of 

one  end, 
mmerse  it 
in  a  short 
,  and  the 
oes  on  till 
the  same. 


PROCESSES    OF    THE    HYDROPATHIC    TREATMENT. 


547 


4.  By  Dilution.  —  Water  is  the  greatest  diluent  in  nature.  There 
is  no  substance  which  is  at  all  comparable  to  it  for  penetrating  the 
myriads  upon  myriads  of  capillaries  that  exist  in  all  parts  of  the 
living  structure.  When  the  fluids  become  thick,  viscid,  and  filled 
with  impure  matters,  as  is  usually  the  case  to  a  greater  or  less  extent, 
ill  disease,  it  is  an  important  object  to  dilute  these  matters.  For  this 
purpose  water  is  the  only  available  remedy. 

5.  By  its  Tonic  Effect — Water  is  the  greatest  of  all  tonics,  and 
possesses  *'  -^  valuable  property,  not  of  wearing  out,  but  of  increas- 
ing in  its  gv.v»d  effects. 

6.  By  if 8  Excitant  or  Electrical  Power.  —  A  man  feels  dull  aad 
stupid  from  excessive  bodily  or  mental  labor,  from  excessive  alimen- 
tation, or  spirit,  or  tea  and  coffee-drinking,  with  the  blood  all  crowd- 
ing up  into  his  head.  We  apply  the  well-wrung  rubbing  wet  sheet 
one,  two,  or  three  times,  to  his  surface,  according  as  he  may  need, 
and  he  at  once  perceives  a  most  wonderful  change  for  the  better.  Or 
a  man  feels  of  a  morning  dull  and  stupid,  with  his  muscles  sore  ;  he 
has  the  rubbing  wet  sheet,  the  plunge,  shower,  or  douche,  and  in- 
stantly his  troubles  banish.  Or  he  may  have  a  lumbar  abscess,  which 
has  run  him  down  so  low  that  when  he  wakes  in  the  morning  he  findsi 
be  cannot  walk.  Two  or  three  gallons  of  cold  water  are  poured  over 
him,  upon  which  he  walks  leadily.  Now  these  effects  of  water,  re- 
markable as  they  are,  arise  simjily  from  its  excitant  or  electrical 
povv  er. 

7.  By  Its  Temperatnre.  —  In  acute  disease,  in  all  fevers  and  in- 
flammations, of  whatever  name  or  grade,  the  great  power  of  water  to 
regulate  the  temperature  of  the  body  is  one  of  the  most  striking  of 
all  the  phenomena  cognizable  by  man.  By  tiie  use  of  cold  water  wo 
can  always  vary  the  heat  of  the  body  and  the  velocity  of  the  heart's 
action  to  any  desirable  extent. 

8.  By  Purifying  tlie  Blood.  —  Water  accomplishes  one  thing  which 
no  drug,  no  other  substance  in  nature  can.  I( purifies  the  blood.  It 
•ioes  this  because  it  penetrates  every  lane  and  alley  of  the  system, 
however  minute.  No  capillary  is  so  delicate  that  it  does  not  pene- 
trate its  smallest  possiI)le  part.  It  purifies  the  blood,  because  as  long 
as  the  vital  principle  lasts,  the  tendency  of  nature  is  to  preserve  the 
vital  fluid  in  a  healthy  state ;  and  penetrating  every  tissue  of  the 
body  as  water  does,  it  assists  nature  in  the  purifying  process  as  no 
other  substance  can. 

9.  By  Augmenting;  the  Tital  Force,  —  No  fact  in  science  is  better 
established  than  that  water  possesses  the  power  of  actually  increas- 
ing the  amount  of  vitality  in  the  system.  This  is,  in  fact,  the  prime 
effect  of  water.  It  aids  the  system  in  throwing  off  disease  in  the 
same  way  that  increasing  a  merchant's  capital  aids'  him  in  throwing 
off  debt. 

The  foregoing  propositions  are  submitted  as  elucidating  son  jf 
the  leading  principles  concerned  in  the  action  of  water  upon  the  liv- 


I 


s 


r^'.s 


PROCESSES    OF    THE    HrDROPATIIIO    TREATMENT. 


iui^body.     I  do  not  claim,  however,  that  the  whole  of  the  philoso- 


phy of  the  effects  of  water  is  yet  understood  by  any  one. 
those  who  know  most  about  it  have  yet  much  to  learn. 


Doubtless 


Bules  for   Using  "Water. 

The  Time  of  Day.  —  In  general,  the  more  powerful  applications 
should  be  made  in  the  early  part  of  the  day.  At  this  time  the  calor- 
ilic  powers  and  the  circulation  are  more  vijrorous,  and,  consequently, 
tha  body  more  able  to  resist  powerful  applications  of  whatever  kind. 

The  Meals.  —  Ordinarily,  no  powerful  bath  should  bo  taken  within 
three  to  four  hours  after  a  meal.  A  full  stomach  and  cold  water  do 
not  at  all  agree.  But  in  certain  diseased  conditions,  as  feverishness, 
iiiflaniniatiou,  colic,  cramp  in  the  stomach,  cholera  morbus,  and  other 
sudden  attacks,  water  appliances  are  to  be  commenced  without  refer- 
ence to  hours  or  meals.     The  symptoms  then  are  our  only  guide. 

The  Li8;hter  Batlis.  —  If  there  is  doubt  as  to  which  application  to 
make,  the  well-wrung  rubbing  wet  sheet,  the  tepid  shallow-bath,  or  a 
warm-bath  should  first  be  taken. 

Reaction.  —  Within  a  reasonable  time  after  a  bath,  the  body  in  all 
its  piirts  should  become  naturally  warm.  If  the  feet  and  hands  re- 
niaiu  cold,  and  the  nails  and  lips  blue,  the  bath  has,  to  say  the  least, 
done  no  p  od.  In  some  cases  of  fevers  and  other  inflammatory  dis- 
eases, it  i.-  better  to  keep  the  body  chilly  than  to  allow  it  to  become 
too  warm. 

Illceration.  —  If  any  part  of  the  body,  as  the  extremities,  lungs, 
bowels,  etc.,  is  undergoing  any  considerable  ulceration,  very  cold 
baths  are  inadmissible. 

Nerrousness.  —  With  some  persons  who  are  highly  nervous,  and 
particularly  with  nervous  females,  much  cold  bathing,  although  it  ap- 
pears to  agree  well,  and  to  be  the  best  for  a  time,  is  in  the  end  harm- 
<'ul,  rendering  the  nervousness  and  general  debility  worse. 

Exercise.  —  For  the  douche,  plunge,  cold  sitz,  and  foot  baths,  and 
all  others  that  abstract  a  large  amount  of  caloric  from  the  system,  the 
body  should  be  fully  warm,  and  the  circulation  somewhat  accelerated 
by  exercise.  Exercise  should  also  be  taken  after  the  bath,  until 
the  heat  and  circulation  are  fully  restored.  But  if  exercise  is  im- 
l)racticable  either  before  or  after  the  bath,  friction  should  be  made  to 
take  its  place. 

Increased  Heat.  —  Elevation  of  temperature  constitutes  no  objec- 
tion to  bathing,  provided  the  body  is  not  excessively  fatigued.  The 
reason  why  overheated  persons  sometimes  lose  their  lives  by  plunging 
into  or  drinking  largely  of  cold  water,  is,  that  the  vital  force  has 
been  too  much  exhausted.     Mere  heat  is  an  advantage. 

Perspiration.  —  Neither  does  this  constitute  an  objection  to  bath» 
ing  or  water-drinking,  if  the  foregoing  rules  are  observed. 


he  philoso- 
Doubtles3 


applications 
10  the  calor- 
msequeutly, 
itevor  kind. 

aken  within 
)ld  water  do 
everishness, 
s,  and  other 
ithout  refer- 
y  guide. 

aplicatiou  to 
w-bath,  or  a 


body  in  all 
1  hands  re- 
lay the  least, 
nmatory  dis- 
it  to  become 

lities,  lungs, 
»n,  very  cold 

nervous,  and 
though  it  ap- 
he  end  harm' 

?e. 

ot  baths,  and 
e  system,  the 
it  accelerated 
e  bath,  until 
sercise  is  im- 
id  be  made  to 


tes  no  objec- 
tigued.  The 
s  by  plunging 
ital  force  has 

ction  to  bath" 
^ed. 


PROCESSES  OF  THE  HYDROPATHIC  TREATMENT. 


549 


The  Air.  —  Bathing  in  the  open  air  is  always  preferable  to  in-doors, 
provitled  the  extremes  of  heat  and  cokl  are  avoided. 

The  Head.  —  It  is  well  alv/ays  to  wet  the  head  with  cold  water, 
both  before  and  after  a  bath.  Douches  and  the  shower  should  never 
be  takiMi  on  this  part.  Sinijile  pouring  or  affusion  is  the  only  mechan- 
ical force  of  water  that  should  be  allowed  on  the  head.  ' 

Pregnancy.  —  This,  as  abundant  experience  proves,  forms  no  ob- 
jection to  bathing,  or  any  form  of  properly  regulated  water  treat- 
ment. Cold  bathing  and  water-drinking  are  of  the  greatest  service 
during  this  period. 

The  Season.  —  If  the  lungs  are  not  extensively  diseased,  and  if 
there  is  no  considerable  ulceration  going  on  in  any  part  of  the  sys- 
tem, the  cool  and  cold  seasons  are  preferable  for  a  course  of  bathing. 
With  right  management,  a  patient  gains  two  or  three  times  as  much 
in  a  given  time  during  the  cold  months  as  he  does  in  the  hot. 

Days  of  Rest.  —  One  day  in  seven  water  treatment  should  be  dis- 
continued, with  the  exception  of  a  simple  ablution  in  the  morning. 
Six  days'  treatment  in  the  week  is  worth  more  than  seven,  because  it 
is  a  law  of  nature  that,  if  a  remedy  is  continued  steadily  and  with- 
out change,  it  loses  much  of  its  good  effect.  This  is  as  true  of  water 
as  of  any  other  agent.  Those  who  do  wisely  will  omit  the  treat- 
ment on  Sunday,  whatever  their  religious  convictions  may  be. 

Internal  Use  of  Water.  —  The  same  general  rules  apply  here  as  in 
the  external  applications.  Thirst  should  for  the  most  part  be  grati- 
fied whenever  it  is  experienced.  As  a  rule,  the  less  water  drank  at 
meals  the  better.  For  the  ionic  effect,  it  is  to  be  taken  while  the 
stomach  is  empty,  and  it  is  better  that  exercise  should  accompany  it. 
From  six  to  twelve  tumblers  per  diem  is  a  fair  allowance  for  average 
patients. 

([nality  of  Water. — For  all  remedial  as  well  as  hygienic  purposes 
water  should  be  as  pure  and  soft  as  can  be  obtained.  "With  proper 
care  and  ingenuity  in  the  construction  of  cisterns,  filters,  etc.,  this 
desirable  end  can  be  everywhere  accomplished.  Lead,  and  lead 
pipes,  should  be  avoided,  except  where  the  water  runs  freely  and 
constantly. 

The  Sweating  Piocess.  —  Formerly  it  was  much  in  vogue  to  sweat 
patients  in  the  blanket  pack,  but  latterly  the  practice  has  quite  gone 
into  disrepute.  For  several  years  of  the  latter  part  of  Pricssnitz's 
career  he  was  very  averse  to  using  the  process.  It  was  a  remark  of 
his,  that  the  cures  by  sweating  were  not  permanent. 

Wet  Bandages  and  Compresses,   etc. 

These,  as  we  have  already  seen  under  the  head  of  wounds  and  in- 
juries, are  of  great  value  in  water  treatment.     They  are  used  of  any 
desirable  size,  upon  any  part  of  the  body,  and  produce  different  effects 
-cordingly  as  they  are  used.     Cooling  wet  compresses  are  such  as 


•',f| 


m 


i 

H 


are  changed  or  revvct  frequently,  and  for  the  most  are  left  uncovered. 
The  xmrmhuf  or  fitiwuladii;/  are  covered  and  left  upon  the  part  until 
it  becomes  as  warm  or  warmer  than  natural.  Warm  fomentations 
are  useful  in  certain  cases,  but  the  //o<  should,  as  a  rule,  be  discarded. 

The  wet  yirdle  is  one  of  tlie  most  useful  of  all  medical  appliances. 
Two  and  a  half  or  three  yards  of  good  toweling,  with  tapes  arranged 
at  one  end,  the  corners  of  which  have  been  turned  over  and  sewed  so 
a«  to  form  a  point,  forms  a  good  girdle.  It  should  puss  usually  three 
times  about  the  body,  one  half  having  been  wet.  This  brings  two 
thicknesses  of  wet  on  the  abdomen  and  one  upon  the  back.  At 
Graefenberg  this  appplication  was  worn  by  every  patient,  and,  as  u 
rule,  all  of  the  time.  It  is  useful  in  a  great  variety  of  ailments,  both 
acute  and  chronic.  The  same  form  of  application  is  also  useful  for 
the  arms,  legs,  etc.,  the  tapes  being  used  in  preference  to  pins. 

The  wet  jacket,  or  cheat  wrapper,  is  also  a  valuable  resort  in  dis- 
eases of  the  chest.  Oiled  silk  and  other  similar  articles,  as  I  have 
elsewhere  observed,  are  not  to  l)e  used  upon  these  local  applicatioDS. 


■V 


■iv.«- 


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"?. 


f  V 


■(^     . 


iiicovercd. 
I  part  until 
iiciitations 
diHcarded. 
ppliaucea. 
3  arranged 
I  sowed  80 
lally  three 
)rings  two 
back.     At 

and,  as  u 
ents,  both 

useful  for 

pins. 

ort  in  dis- 

as  I  have 
plications. 


DOMESTIC  MiiNAGEMENT  OF  THE  SICK-ROOM/ 


Choice  of  the   Sick-Boom,   etc. 

Sleeping^  Apartment.  —  In  every  case  of  disease,  however  slight  its 
nature,  the  sleeping  upiirtmcnt  of  the  sick  should  be  airy  and  well 
ventilated  ;  but,  when  Providence  visits  any  member  of  a  family  with 
disease  of  a  serious  and  protracted  description,  all  other  considera- 
tions giving  way  to  the  necessity  of  the  case,  an  apartment  should  be 
chosen  and  arranged  in  a  special  manner  for  the  reception  of  tae  in- 
valid. It  should  be  one  calculated  to  administer  to  his  temporary 
comfort,  as  well  as  to  aid  his  recovery.  It  is  not  time,  when  the 
alarm  is  sounded  and  the  danger  is  already  urgent,  to  think  of  such 
arrangements ;  forethought  must  be  put  in  requisition ;  every  want 
anticipated ;  and  whatever  is  likely  to  be  required  should  not  only 
be  provided,  but  so  arranged  that  it  can  be  instantly  found  when  it  is 
needed. 

The  sick-room  should  be  large,  lofty,  and,  if  possible,  with  a  north- 
em  aspect,  in  order  to  avoid  the  heat  of  the  mid-day,  or  the  afternoon 
sun ;  the  windows  should  be  capable  of  being  opened  by  drawing 
down  the  uppermost  sash ;  an  advantage,  however,  which  caimot 
always  be  obtained,  as  this  mode  of  opening  windows  is  too  gener- 
ally neglected  in  the  construction  of  modern  houses.  No  room;  how- 
ever large,  should  be  used  as  a  sick-room,  unless  it  has  a  chimney  ; 
but  neither  the  chimney-board  nor  the  soot-board  of  the  apartment 
should  be  put  up,  even  in  summer.  No  article  of  unnecessary  furni- 
ture should  be  permitted  to  remain  in  the  room  ;  and  that  which  is 
left  in  it  should  be  of  a  description  fitted  to  administer  to  the  conven- 
ience of  the  invalid. 

Two  tables  are  sufficient.  One  of  them  may  be  small,  to  stand 
near  the  bed,  for  the  immediate  use  of  the  patient :  namely,  to  hold 
his  jug  of  barley-water,  or  toast-water,  or  other  I)everage  ;  —  a  small 
tea-pot,  or,  what  is  preferable,  a  half-covered  cup  with  a  Sj)out,  to 
enable  fluids  to  be  administered  without  raisinfr  the  sufl'erer  iu  bed  ;  — 
his  medicines  for  the  day;  —  and  any  other  thing  which  he  may  fre- 
quently require. 

The  other  table  should  be  large,  for  the  accommodation  of  medi- 
cines not  in  immediate  use,  and  also  for  spare  glasses,  jugs,  cups, 

•  Thompson,  On  the  Management  of  the  SicP       'om. 


'  ■If 


Ml 


I 


t 
j 

i  '■■ 


^  ^^^ii^:1K•;■'ui^«;:Jfi'!>  ..-iafefc/^zy.t- 


fv 


552 


DOMESXrO    MANAOEMRNT    OF    THE    SICK-ROOM. 


spoons,  both  largo  nii'l  omall,  and  other  necessftry  articles.  This 
table  should  have  one  drawer,  at  least,  Avhich  ought  to  bo  furnished 
with  the  following  articled  r  hro'id  and  narrow  tape ;  two  or  three 
half-worn  ril)boPs  ;  a  bundle  of  olu,  soft  linen  ;  a  sponge  ;  a  few  ounces 
of  lint ;  scissors,  large  and  small ;  a  bone  spatula  for  spreading  oint- 
ment ;  a  couple  of  rolls  of  muslin,  and  the  same  quantity  of  flannel 
bandage  two  inches  broad;  a  pin-cushion  well  supplied  with  pins; 
needles  and  thread  ;  and  about  half  a  yard  of  simple  adhesive  plaster. 

A  Sofa  or  Reclining^  Chair.  —  A  sofa,  if  the  apartment  be  sufli- 
ciently  large  to  admit  of  it,  is  a  very  important  piece  of  furniture  iu 
tlie  sick-room ;  the  erect  or  the  sitting  posture  being  injurious  in 
many  diseases ;  and,  when  the  sick-bed  requires  to  be  made,  a  sofa 
aflfords  the  means  of  removing  the  patient  from  the  bed  with  as  little 
inconvenience  to  him  as  possible. 

If  there  is  not  space  for  a  sofa,  there  should  bo  an  invalid  or  re- 
clining chair;  and,  when  circumstances  will  permit,  it  should  be  of 
that  kind  which  is  susceptible  of  a  variety  of  changes,  so  as  to  vaiy, 
at  pleasure,  the  position  of  the  patient.  There  should  not  be  more 
than  two  other  chairs  in  the  room.  If  there  is  a  looking-glass  in  the 
apartment,  in  a  situation  which  admits  of  the  patient  seeing  himself 
in  it  as  he  lies  in  bed,  its  place  should  changed,  or  it  should  be  alto- 
gether removed  from  the  room.  A  chest  of  drawers  is  essential ;  but 
none  of  the  drawers  should  be  appropriated  for  the  reception  of  dirty 
linen,  which  ought  never  to  be  allowed  to  remain  a  moment  in  the 
sick-room.  One  drawer  should  be  specially  allotted  for  towels,  of 
which  an  ample  supply  is,  in  every  case,  necessary.  The  washing- 
stand  will  require  two  additional  basins  ;  an  additional  water  bottle 
and  a  tumbler ;  and  a  large,  s;ipernumerary  water  jug,  under  the  ta- 
ble, always  full  of  water. 

Ko  Cooking  in  Sick-room.  —  There  should  be  no  kettle,  nor  any 
implement  of  cooking,  in  the  sick-room  ;  even  in  winter,  and  when  a 
fire  is  required.  In  general,  afire  in  the  sick-room  is  only  necessary 
for  the  comfort  of  the  attendants;  but  nurses  too  frequently  take  ad- 
vantage of  it  to  boil  the  water  for  their  own  tea,  and  to  prepare  the 
slops  for  the  invalid ;  a  custom  which  cannot  be  too  severely  repro- 
bated. The  lump  termed  a  Might-nurse,  consisting  of  a  water-bath 
placed  over  a  lamp  in  a  wire-worked  cylinder ;  a  small  tin  kettle 
which  enters  the  top  of  the  cylinder ;  and  a  covered  earthen-ware 
vessel  which  fits  it  into  the  water-bath ;  are  useful  for  keeping  fluids 
warm,  and  at  the  same  time  for  preserving  a  light  in  the  room,  when 
an  unshaded  lamp  or  a  candle  would  be  hurtful. 

In  continued  fevers,  the  sense  of  hearing  is  often  so  morbidly  acute, 
that  ordinary  sounds  become  causes  of  pain.  In  this  case,  if  the  floor 
of  the  sick-room  be  not  wholly  carpeted,  every  iirecaution  to  lessen 
the  intensity  of  sound  should  be  taken.  One  of  the  most  efiectual  is 
to  have  a  couple  or  more  pairs  of  large  list  shoes  outside  the  door, 
into  which  the  feet,  even  of  the  doctors,  may  be  advantageously 
thrust,  when  their  shoes  make  a  creaking  noise,  or  when  a  visitor  or 
nurse  treads  with  a  heavy  foot.     On  the  same  account,  when  more 


DOMESTIC   MANAGEMENT   OF   TIIJ5    8ICK-KOOM. 


553 


of 


than  Olio  nurse  or  nttcndnnt  is  rcqnirod  to  ho  in  tlio  room  nt  the  uarao 
time,  no  conversation,  c.lthougli  it  may  bo  carried  on  in  u  whiaper, 
should  bo  pormittod.  AVliisporing,  indeed,  is  apt  to  excito  delirium, 
and  to  augment  it  when  it  is  already  present. 

Beds  and  Beddiiijp.  —  The  French  beds,  without  curtains,  are  those 
best  adapted  for  tho  sick-room.  When  four-posted  bedsteads,  sur- 
rounded by  curt'iins,  were  more  in  uso  tlmu  at  the  present  timo,  the 
mischief  arising  from  excluding  tho  free  air,  by  drawing  the  curtains 
close  around  the  bed,  was  frequent  and  serioi;  .  In  every  case  of 
disease,  indeed,  especially  when  it  is  attended  by  fever,  the  [)ationt 
eliould  be  kepi  cool,  and  the  most  perfect  freedom  bo  given  to  the 
breathing;  tho  mattress  should  be  placed  over  the  feather  bed,  and 
tlio  pillows  be  firm  and  elastic.  The  Marseilles  coverlets,  which  are 
spread  upon  beds  during  the  day,  and  often  retained  at  niglit,  are 
heavy,  and  calculated  rather  to  increase  than  to  subdue  fever  ;  conse- 
quently they  should  be  wholly  discarded  from  the  sick-bed.  In  Joed, 
when  tho  disease  k  fever,  and  when  it  is  accompanied  with  pjrcat  rest- 
lessness owing  to  the  evening  exacerbation,  if  tho  bed-rc.a  be  suffi- 
ciently large,  two  beds  should  be  placed  in  it;  oi  if  two  adjoining 
bed-cliarabers  can  bo  obtained,  a  bed  ought  to  be  put  in  each,  so  that 
the  patient  can  be  moved  from  one  bed  to  tho  other  every  morning 
and  evening.  This  both  aids  sleep,  and  it  also  tends  greatly  to  insure 
the  personal  cleanliness  of  the  patient.  The  bed-clothes  of  the  bed 
from  which  the  patient  is  moved,  should,  on  his  removal,  bo  immedi- 
ately turned  down  and  fully  exposed  to  tlie  air ;  a  precaution  which 
will  set  aside  the  necessity  of  so  frequent  a  change  of  linen,  as  would 
be,  otherwise,  required.  When  there  is  only  one  bed,  and  when  tho 
disease  is  fever  (unless  the  patient  is  too  ill  to  permit  his  being 
moved),  the  sheets  which  have  been  used  at  night  should  be  replaced 
by  others  in  the  morning,  and  hung  up  in  tho  free  air  during  the  day, 
to  be  again  used  at  night.  But,  when  it  can  conveniently  bo  done, 
in  every  case  of  continued  fever,  especially  of  an  infectious  kind,  tho 
sheets  should  be  changed  once  in  twenty-fou  hours  ;  a  practice  which 
is  likely  to  prevent  the  fumes  of  infection  Irom  being  communicated 
to  the  blankets  or  to  any  of  the  furniture  of  the  room. 

Yentilat [on  is  always  of  primary  importance;  and  that  period, 
happily,  is  gone  by,  in  which  air  was  carefully  excluded  from  tho 
chambers  of  the  sick,  even  when  they  were  suffering  under  febrile 
disease. 

Ventilation  is  particularly  demanded  in  those  fevers  in  which  mil- 
iary eruptions  display  themselves ;  under  no  circuinstances  is  it  so 
essential  as  in  febrile  diseases  of  an  infectious  kind.  It  may,  how- 
ever, be  consolatory  to  those  whose  duty  it  is  to  attend  such  cases,  to 
know  that  infection,  communicated  through  the  air,  rarely  extends 
above  a  few  feet  from  the  body  of  the  patient ;  and  even  in  the  most 
malignant  diseases,  with  the  exception  of  contlueiit  small  pox,  and 
malignant  scarlet  fever  of  the  worst  kind,  its  influence  does  not  ex- 
ceed a  few  yards,  if  the  room  be  well-ventilated.  On  tho  contrary, 
if  ventilation  be  neglected,  the  power  of  infection  becomes  greatly 


'IM 

'■III 


M 


554 


DOMESTIC   MAXAOK^nCNT   OF   THR   SICK-ROOM. 


augmented  from  its  conccntrutioii  in  c<)n6nod  and  qiiioHccnt  air ;  it 
evon  settles  upon  tlie  ciotlies  of  the  nttondants,  iind  on  tiio  furniluiv 
of  tlie  room  ;  and  tii<'He  iml)ibo  it  most  readily  whun  tlusir  texture  is 
wool,  fur,  or  cotton,  or  any  loose  or  downy  substauco  ca|)al)le  of  re- 
ceiving and  readily  r«!t!iiuiug  the  air.  Smooth  and  polished  surfaces 
do  not  easily  receive  or  retain  infectious  matter ;  consequently  the 
nurses  and  attendants,  in  cases  of  infectious  diseases,  should  have 
glazed  gowns,  and  aprons  of  oiled  silk. 

In  no  infectious  diseases  are  these  rules  more  essentially  necessary 
than  in  small  pox  and  scarlet  fever.  It  is  well  known  that,  if  the  bed- 
clothes of  a  patient  laboring  under  either  scarlet  fever  or  small  pox 
be  closely  folded  up,  they  will  retain  the  infectious  matter,  and  com- 
municate the  disease  at  a  great  distance  of  tim't ;  but  the  influence  of 
free  ventilation  is  so  great,  that  medical  practitioners  who  are  attend- 
ing small  pox  patients,  and  who  go  from  them  into  the  open  air,  do 
not  spread  the  disease.  Indeed,  all  infection  is  weakened  by  dilution 
with  air.  The  danger  of  infection  is  augmented,  if,  along  with  bad 
ventilation,  the  atmosphere  of  the  room  be  moist  from  ahy  cause. 

It  is  further  consolatory  to  know  that  the  infectious  matter,  even 
of  the  most  virulent  description,  is  not  poisonous  to  every  one  who 
is  placed  within  the  sphere  of  its  influence.  A  predisposition  of  the 
body  to  receive  the  infection  must  exist  before  it  can  be  communi- 
cated ;  a  condition  which  is  augmented  by  fatigue  and  watching,  de- 
fective nourishment,  mental  depression,  or  anything  which  can  lower 
the  vital  powers.  The  necessity,  therefore,  of  maintaining  these 
powers  by  attention  to  rest,  a  sufficient  quantity  of  good  and  gener- 
ous diet,  and  cheerfulness  of  mind,  need  not  bo  insisted  upon. 

In  every  case  of  infectious  disease,  the  attendants,  even  in  the  best 
ventilated  rooms,  should  stand  on  the  windward,  or  on  that  side  of 
the  sick-bed  from  which  the  current  of  air  comes  ;  as,  by  neglect  of 
this  rule,  and  by  standing  in  the  current  which  has  passed  over  the 
patient,  the  infectious  exhalations  are  blown  upon  them  in  a  direct 
stream  from  the  body  of  the  patient.  The  attendants  should  never 
lean  over  the  sick,  nor  should  they  receive  their  breath.  The  health 
also  of  the  nurses  should  always  be  supported  by  nutritious  and  gen- 
erous diet ;  but  not  by  brandy,  nor  any  other  ardent  spirit. 

The  term  infection,  in  its  most  extensive  signification,  implies  some 
deleterious  matter,  originating  from  any  source,  and  transmitted 
through  the  air,  which  is  capable  of  causing  diseases  in  the  human 
body.  When  this  matter  is  emanated  from  the  diseased  bodies  of 
men.  the  term  is  frequently  regarded  as  synonymous  with  contagion; 
but,  in  strictness  of  language,  the  latter  refers  only  to  the  communi- 
cation of  disease  by  contact.  Whatever  may  bo  tlio  matter  of  infec- 
tion, it  may  enter  the  body  through  the  medium  of  the  lungs,  which 
is  the  most  ready  inlet,  or  by  the  saliva,  or  even  through  the  surface, 
if  the  skin  be  abraded,  or  if  any  ulceration  be  present.  The  influ- 
ence of  infectious  matter  is  evidently  exerted  on  the  nervous  system, 
displaying  itself  by  debility,  inertness,  dislike  to  motion,  great  sus- 
ceptibility of  cold,  irrital)ility  and  despondency  of  mind,  and  by  the 
production  of  a  disease  similar  to  that  of  the  person  from  whom  the 


out  nir ;  it 
0  fiiniiliiro 
'  textiiro  U 
iil)lo  of  ro- 
m\  surfaces 
iieiiily  tlio 
loiild  have 

•  necessary 
if  til 0  hod- 

small  pox 
,  niul  coin- 
ifluoiico  of 
are  attend- 
pen  air,  do 
by  dilution 
y  with  bad 
''  cause, 
atter,  even 
■y  one  who 
tion  of  the 

communi- 
tching,  de- 
i  can  lower 
ling  these 
and  gener- 
pon. 

in  the  best 
hat  side  of 

neglect  of 
d  over  the 

in  a  direct 
ould  never 
The  health 


13  and  gen- 
t. 

iplies  some 
ransmitted 
the  human 
I  bodies  of 
contagion ; 
I  commiini- 
sr  of  infec- 
ngs,  which 
ho  surface, 
The  influ- 
)U8  system, 
,  great  sus- 
uiid  by  the 
\  whom  the 


DOMESTIC   MAVAOEMENT  OF  THE   SICK-ROOM. 


.^55 


Infectious  matter  has  proceeded.  The  infection  may  bo  suppoHoU  to 
have  taken  effect,  aiul  t(»  have  produced  the  actual  disease,  when  the 
person  who  has  been  exposed  to  its  intlueiieo  is  attacked  with  giddi- 
ness, pain  of  the  head,  irregular  licat  and  chills,  nausea,  and,  if  tho 
infectious  diseaso  be  siuull  pox,  con .'ulsions.  These  symptoms  are 
sufficient  to  denote  the  necessity  for  immediate  medical  advice. 

'rniiperiitun*.  —  Next  to  ventilation  nothing  is  of  more  importance 
than  the  regulation  of  tiio  tempeniture  of  tho  sick-room,  avoiding 
both  extremes  of  elevation  or  of  de|)ression  ;  but  much  depends  on 
tho  nature  of  the  disease. 

The  best  general  temperature  of  a  sick-room  is  60°  (Fahr.)  ;  and 
it  is  preferable  to  regulate  this  rather  by  the  thermometer  than  by  the 
sensations  of  the  patient  or  tho  attendants.  Under  some  circum- 
stances, however,  the  feelings  of  the  patient,  and  his  susceptibility  of 
impressions  upon  tho  skin,  should  not  be  overlooked.  Thus  if  the 
temperature  be  a  little  al)()Vo  that  of  summer,  and  tho  patient,  never- 
theless, feel  chilly,  it  should  be  raised  five  or  six  degrees.  This  chil- 
liness is  very  apt  to  be  felt  in  a  dyspeptic  state  of  the  habit,  and 
more  especially  when  it  is  accompanied  with  hypochondriasis.  It 
differs  from  that  more  severe  but  transient  coldness  which  accompa- 
nies intermittent  fevers,  and  some  other  periodical  affections  ;  and  it 
requires  an  elevated  temperature  of  the  air  for  its  removal,  whilst  the 
cold  stage  of  intermittent  diseases  is  best  relieved  by  the  warm  bath, 
either  general  or  local. 

So  important  is  the  regulation  of  temperature,  especially  in  fevers, 
Ahat  it  often  does  more  good  than  any  other  remedial  measure.  I 
have  seen  patients,  laboring  under  high  delirium  in  a  close,  ill-venti- 
lated room,  become  rapidly  quite  collected  by  merely  lowering  the 
heat  of  the  apartment  twelve  or  fifteen  degrees. 

lu  convalescence,  "s  the  air  of  the  sick-chamber  should  be  fre- 
quently renewed,  the  temperature  in  spring  and  autumn  ought  to  be 
maintained  as  near  as  possible  at  55°  to  60°  (Fahr.)  ;  and  it  should 
be  very  gradually  lowered  as  the  invalid  acquires  strength,  so  aato 
enable  him  to  bear  with  impunity  the  varying  temiierature  of  these 
seasons  in  the  open  air.  Even  then,  if  the  previous  disease  has  been 
pulmonary,  the  air  admitted  to  the  lungs  should  be  tempered  by  the 
use  of  the  Respirator,  or  a  muslin  handkerchief  tied  around  tho 
mouth.  When  the  invalid  first  ventures  out  of  doors,  nothing,  in- 
<leed,  is  so  essential,  in  a  prophylactic  point  of  view,  as  avoiding 
extremes  and  sudden  transitions  of  temperature. 

Cleanliness.  —  Although  cleanliness  in  the  sick-room  is  essential, 
yet  it  may  be  carried  so  far  as  to  become  an  annoyance  to  tho  inva- 
lid, and  consequently  to  prove  injurious.  It  is  not  requisite  to  sweep 
the  room  daily,  nor  to  dust  and  arrange  the  furniture  every  morning, 
provided  oirler  be  preserved  in  the  room,  and  notliing  but  what  is 
i'mmediately  necessary  for  the  comfort  and  convcnicnco  of  tho  invalid 
be  permitted  to  remain  in  it.  It  is  truly  distressing  to  observe  the 
confusion  which  prevails  in  some  sick-rooms ;  everything  being  out 
of  place,  and  to  be  searched  frr  when  it  is  wanted. 


!  I 
■I  I 


1 1 


-■MSpWfT^HWi^^'*'    ■ 


656 


DOMESTIC   MANACIRMRNT   OF   THE    SICK-HOOM. 


M- 


The  period  chosun  for  clHiuiiiig  aiiil  nrrniiging  tho  sick-room  hIiouM 
be  the  nioi-iiing  ;  na,  nt\cv  u  niglit'd  rest,  the  piitiont  is  more  ubio  to 
boar  tho  little  ik.mho  uikI  l)iiHtlu  which  it  always  inoru  or  lousoccaflioiis. 
I'ho  carpet  should  ho  Hpriiiklcd  wilh  moist  tca-leaven,  uiid  lightly 
swept ;  and  during  this  operation  the  curtains  of  tho  hod,  if  tlmre  ho 
any,  ohould  ho  drawn. 

It  is  scarcely  requisite  to  insist  on  the  nocossity  of  the  utmost 
attention  to  the  cloaulinoss  of  everything  in  tho  sick-room.  The 
moment  after  any  vessel  or  implement  is  used  hy  tho  invalid,  it 
should  ho  removed  from  the  apartment,  and  returned  as  soon  as  it  is 
cleaned.  Nothing  in  the  form  of  a  slop-basin  or  a  slop-pail  is  admis- 
sible ;  thoy  only  administer  to  the  laziness  of  nurses. 

The  necessity  of  cleanliness  in  tho  vessels  used  for  tho  food  of  in- 
valids is  jtrikingly  illustrated  in  tho  bad  effects  arising  from  the  neg- 
lect of  it  when  an  infant  is  brought  up  by  hand.  In  such  a  case,  if 
either  the  feeding-bottle,  or  tho  boat,  which  is  employed,  be  not  in- 
stantly cleanaed  after  the  meal  has  been  given,  the  small  portion  of 
the  pap  or  food  which  remains  in  the  vessel  becomes  sour,  and  taints 
tho  whole  of  the  fresh  food  mixed  with  it,  causing  colic  and  convul- 
sions in  the  infant.  The  same  risk  of  injury  occurs  in  the  sick-room, 
if  tho  vessels  used  for  administering  food  to  tho  invalid  be  not  in- 
stantly and  well  cleansed  after  every  time  they  are  used. 

It  is  too  common  also  to  use  one  glass  or  cup  for  administering 
medicines,  and  to  leave  it  unrinsod  from  time  to  time,  —  a  custom 
which  may  prove  as  deleterious  as  a  defect  of  cleanliness  in  vessels 
employed  for  food.  Some  medicines,  when  they  are  exposed  to  tho 
air,  rapidly  undergo  changes  which  alter  their  properties ;  and  this 
alteration  having  been  undergone  by  the  small  portion  which  is  ahvayg 
left  in  the  glass  or  cup,  communicutos  tho  disposition  to  bo  decom- 
posed to  that  which  may  bo  next  poured  into  the  cup.  An  active 
medicine  may  bo  thus  rendered  inert ;  or  ono  which  is  mild  in  its 
operation  may  be  so  changed  as  to  operate  with  hazardous  encrgv. 
The  same  precaution,  as  to  cleanliness,  is  also  requisite  as  to  the 
minim  measure,  when  the  medicines  arc  directed  to  be  administered 
iu  a  form  which  requires  its  employment. 

Darkeiiin;^  the  Sick-room.  —  It  is  a  common  error  to  imagine  that 
a  sick-room  should  always  be  either  partially  or  wholly  darkened,  in 
some  diseases,  as,  for  example,  fevers,  when  tho  eyes  are  acutely  sen- 
sible to  light,  so  that  they  remain  half  closed,  and  the  eyebrows  are 
contracted,  the  greatest  relief  is  experienced  from  darkening  the 
room.  When  delirium  is  present,  a  certi'.in  degree  of  darkening  is  in 
some  instances  serviceable ;  whilst  in  others,  especially  when  tho  de- 
lirium is  accompanied  with  visual  illusions,  nothing  so  readily  dispels 
these,  and  consequently  abat«,^a  the  delirium,  as  the  admisaion  of  the 
full  daylight  into  the  sick-room.  There  is  much  difficulty,  liowever, 
iu  determining  which  state  of  the  apartment  is  likely  to  bo  most  ser- 
viceable in  any  particular  case.  Observation  of  the  eflfects  of  light 
and  darkness,  in  the  indf^'idual  case,  must  be  our  guide. 

These  illusions  of  the  sight  are  generally  the  result  of  former  im- 


tr 


DOMKITIO  MANAOEMKNT  OF  TlIK  SICK-ROOM. 


557 


prosMioiiH,  ronowod  at  a  niomnnt  when  the  hriiiii  is  in  Hiich  n  diatiirlxid 
foiidilion  ai  to  Hot  asido  the  cxorciso  of  jiidginoiit.  In  this  condition 
of  llio  brain,  tlio  rcnowod  conceptions  aro  not  readily  corrected,  an  in 
health,  by  imprcHMious  received  from  tlio  external  world  ;  honco,  they 
become  more  vivid  in  the  mind  of  tlie  invalid  when  the  sick-room  is 
darkened,  and  all  visible  ol)jectsaro  shut  out.  Tluy  aro  isnally  dis- 
pelled by  now  impressions  on  the  organ  of  sense  chiefly  i:iiplicated  ; 
on  which  acconnt,  those  which  aro  coiuiectod  with  sight  seldom  occur 
during  the  day,  ■when  real  objects  aro  presented  to  the  eye,  unless  the 
brain  bo  so  over-excited  ns  to  bring  the  conceptivo  faculty  into  in- 
tense exercise,  suiHcient  to  awaken  thoso  false  pin'ceptions  which 
create  a  belief  of  the  ])resence  of  individuals  not  only  not  present, 
but  who  have  been  long  dead.  This  state  of  the  mental  organ  is 
similar  to  that  otJ  M'hich  depend  the  spectral  illusions  of  the  insane, 
but  difFering  from  it  in  its  transient  nature.  I  have  frequently  wit- 
nessed the  conversation  'vith  one  of  these  spectral  beings  instantly 
terminated,  and  the  whole  illusion  dispelled,  on  opening  the  window 
shutters  of  the  room;  whilst  the  invalid  has  thus  expressed  himself: 
"Bless  mo!  I  thought  I  wae  talking  with  Mr.  ,  just  now,  I 

must  have  been  dreaming  ;  for  now  I  recollect  he  has  been  dead  many 
years."  A  twilight  obscurity  in  the  sick-room  is  often  more  produc- 
tive of  those  illusions  than  darkness. 

The  Nuise.  —  When  all  the  arrangements  arc  completed  in  the 
sick-room,  little  benefit  can  be  anticipated  if  a  proper  nurse  be  not 
obtained  to  render  them  available  to  the  invalid.  Every  female,  who 
wisht.  ^o  act  as  a  sick- nurse,  shoidd  be  obliged  to  serve  a  certain 
time  as  an  assistant  nurse  in  one  of  the  public  hospitals,  and  to  re- 
ceive a  certificate  of  her  efficiency  before  she  leaves  the  establish- 
ment. The  advantages  which  the  public  would  derive  from  a  body 
of  nurses,  educated  in  this  manner,  must  be  obvious  to  every  one  who 
has  had  opportunities  of  observing  the  miserable  working  of  the 
present  system. 

In  hiring  a  sick-nurse,  the  qualifications  which  should  regulate  our 
choice,  refer  to  aye,  strength,  health,  temper,  dispontion,  J  abits,  and 
education. 

Age. — She  should  not  be  under  twenty-five,  nor  above  fifty-five 
years  of  age.  This  period  is  fixed  upon,  on  account  both  of  the 
physical  powers  and  the  moral  conduct  of  the  individual.  Under 
twenty-five,  the  strength  of  a  woman  has  not  reached  its  maturity, 
and  is  scarcely  adequate  for  lifting  patients  in  and  out  of  bed,  and 
for  many  other  duties  which  require  strength,  connected  with  the 
office  of  a  nurse  ;  but  the  strength  and  the  muscular  power  in  females 
begin  to  fail  after  fifty-five,  when  the  natural  transition  from  maturity 
to  decay  takes  place. 

Strength.  —  The  foregoing  remarks  respecting  age  render  i.-  almost 
unnecessary  to  say  that  a  woman  of  a  naturally  delicate  frame  of 
body  is  unfit  for  a  sick-nurse :  at  the  same  time,  a  coarse,  heavy, 
and  masculine  woman  is,  for  many  reasons,  objectionable.     Whilst 


■A 


558 


DOMESTIC  MANAGEMENT  OP  THE  8I0H.-ROOM. 


strength  is  requisite,  tho  frame  should  bo  such  as  to  indicate  activ- 
ity. 

Health.  —  None  of  the  quaI:5cations  of  a  sick-nurse  are  of  impor- 
tance more  than  health.  An  individual  who  herself  requires  atten- 
tion is  ill-calculated  to  attend  upon  others.  A  woman  who  is  asth- 
rx.itic,  or  has  any  difficulty  of  breathing,  or  an  habitual  cou<!jh ;  who 
is  rheumatic  or  gouty,  or  has  any  spasmodic  affection ;  who  is  af- 
flicted with  p.'ilpitation  ;  or  suflers  from  periodical  headache,  vertigo, 
or  a  tendency  to  paralysis  ;  or  who  is  consumptive,  or  scrofulous  ;  or 
has  defective  sight  or  hearing ;  or  anything  which  causes  decrepitude, 
is  disqualified  Tor  a  sick-nurse.  It  is  important,  also,  to  ascertain 
there  is  no  hypochondriacal  nor  hysterical  tendency,  nor  predisposi- 
tion to  mental  depression 

Temper  and  Disposition.  —  It  is  scarcely  requisite  to  say  that  an 
attendant  upon  the  sick  should  possess  a  happy,  cheerftd,  equal  flow 
of  spirits ;  a  temper  not  easily  ruffled ;  and  kind  and  sympathetic 
feelings ;  but,  at  the  same  time,  not  such  as  to  interfere  with  firm- 
ness of  character.  The  expression  of  the  countenance  should  be 
pen  and  winriing,  so  as  to  attract  the  good-will  and  confidence  of 
the  invalid  ;  a  pleasing  and  gentle  manner  being  more  likely  to  gain 
esteem,  and  insure  obedience  to  the  orders  of  the  physician,  than  the 
most  persuasive  arguments  which  can  be  addressed  to  the  under- 
stanling  of  tho  patient. 

A  collected,  cheerful  expression  of  the  countenance,  in  the  attend- 
ant on  the  sick,  is  likely  to  inspire  hope,  and  to  aid  the  efforts  of  the 
physician  for  the  recovery  of  his  patient. 

The  general  disposition  of  a  sick-nurse  should  be  obliging.  Every 
little  office,  which  the  invalid  may  require  to  be  done,  should  be  per- 
formed at  ouce,  and  without  the  smallest  apparent  reluctance,  even 
when  the  necessity  for  its  immediate  performance  is  not  absolute^ 
There  is  also  an  earnestness  of  manner,  which  should,  if  possible,  be 
obtained  or  acquiesced  in  by  the  sick-nurse,  as  it  impresses  the  idea 
that  she  feels  deeply  interested  in  the  case  ;  a  circumstance  which  is 
always  highly  appreciated  by  the  patient. 

Finally,  it  is  inmecessary  to  say  that  a  nurse  should  be  honest,  as 
no  description  of  servant  hiis  so  much  in  her  power.  But  tho  honesty 
of  tha  nurse  is  not  to  be  measured  by  her  respect  for  property  ;  she 
must  be  above  imposing  on  the  physician,  with  respect  either  to 
medicines  or  to  diet.  Her  religion,  also,  should  be  sincere,  but  not 
Pharisaical ;  and  although  she  may  occasionally  persuade  her  charge 
"  to  put  his  trust  in  God,  the  fountain  of  health,"  *  yet  she  must  rec- 
ollect that  preaching  is  not  her  province  ;  and,  when  mistimed,  even 
the  best  advice  may  prove  not  only  profitless,  but  injurious  ;  and  this 
is  especially  likely  to  be  the  result,  when  the  doctrines  which  she 
professes  are  of  a  controversial  kind. 

With  respect  to  gossiping,  it  is  a  detestable  habit  under  any  cir- 


•  FuUer. 


DOMESTIO   MANAGEHKNT   OF   THK   SICK-ROOM. 


559 


cnmstances ;  but,  in  a  nurse,  it  may  bo  productive  of  the  greatest 
danger,  produce  family  fciids,  and  a  thousand  other  evils. 

In  her  Habits,  a  sick-nurse  should  be  sober,  active,  orderly,  and 
clean,  and  neat  in  her  person. 

The  first  of  these  habits  —  namely,  s()br'",ty  —  is  so  essential  a 
qualification  in  every  attendant  in  the  sick-room,  that  it  requires  no 
comment.  Happily,  the  desire  for  ardent  spirits  is  now  less  frequent 
than  formerly,  when  women  were  seldom  employed  as  nurses  until 
they  were  nearly  superannuated,  and  until  their  habits,  good  or  bad, 
were  too  firmly  rooted  to  be  removed. 

The  Activity  essential  for  a  good  nurse  docs  not  imply  a  bustling  or 
fidgety  manner,  but  a  quiet,  steady  method  of  proceeding  in  the  per- 
formance of  her  duties,  equally  devoid  of  fluster,  turbulence,  or  noise. 
This  activity  is  generally  associated  with  orderly  habits  ;  a  most  valua- 
ble qualification,  and  without  which  the  sick-room  becomes  a  scene  of 
confusion  and  disgust.  Every  medical  man  must  have  witnessed  this 
state  of  disorder  with  regret,  when,  on  visiting  his  patient,  he  finds  no 
chair  to  sit  upon,  until  some  article  of  bedding,  or  of  clothing,  be  re- 
moved from  it,  and  the  seat  dusted  with  the  apron  of  the  nurse  ;  and 
when  a  former  prescription,  or  anything  else,  is  wanted,  he  must  wait 
until  the  nurse  rummages  out  half  a  dozen  of  drapers  in  search  of  it. 

Another  quality,  usually  conjoined  with  activity  and  orderly  habits 
in  a  nurse,  is  cleanliness  in  her  own  person,  and  in  that  of  her  charge, 
as  well  as  that  of  the  sick-room.  The  dress  of  a  nurse  should  be 
simple  and  neat,  without  trimmings.  Nothing  is  more  out  of  place 
than  a  fine  lady  attempting  to  perform  the  duties  of  a  nurse. 

Educatioil.  —  It  may  appear  a  refinement  to  talk  of  the  education  of 
a  nurse  ;  but  there  is*  not  a  greater  ditference  between  noon-day  and 
midnight  than  between  an  educated  and  an  ignorant  nurse.  The  for- 
mer is  often  an  aid  to  the  physician,  not  only  in  carrying  his  orders 
into  eflfect,  but  b"  observing  and  informing  him  of  symptoms  of  great 
importance  whici  have  occurred  during  his  absence  :  whereas  the  lat- 
ter is  a  source  o»"  constant  anxiety,  and  too  often  assumes  the  privi- 
lege of  acting  in  direct  contradiction  to  his  orders,  and  according  to 
her  own  opinion.  ,  - 

Unhired    Attendants. 

The  selection  of  a  good  nurse,  however  eminently  qualified  she 
may  be  for  her  duties,  does  not  supersede  the  attendance  of  a  rela- 
tive or  a  friend  in  the  sick-room ;  on  the  contrary,  I  can  conceive  no 
condition  so  deplorable  as  that  of  an  invalid  left  altogether  to  the  care 
and  management  of  a  hireling.  It  is,  nevertheless,  too  true  that  few 
ladies,  even  those  who  are  wives  and  mothers,  have  any  acquaintance 
with  the  arrangements  of  the  sick-room,  and  the  management  of  the 
invalid  ;  they  are,  consequently,  too  often  forced  to  be  guided  by,  and 
to  rely  for  instruction  on,  the  nurse,  instead  of  being  able  to  superiu- 


Wd 


r-\n 


-,i»  Yi:^-^.-^>*^'^^~;  t 


M'' 


560 


DOMESTIC  MANAGEMENT  OF  THE   SICK-ROOM. 


fc 


tend  her  conduct,  to  ascertain  that  she  lierfornis  her  duty,  and  to  cor- 
rect her  failings. 

The  degree  of  intelligence  which  is  demanded  in  a  nurse  is  very 
ditferent  to  that  which  is  requisite  for  a  wife  or  a  relative  in  the  sick- 
room. Tiie  intelligence  of  the  nurse  is  directed  to  supply  the  wants 
of  the  iuvalid,  to  administer  to  his  comforts,  and  to  obey  the  instruc- 
tions of  the  physician ;  that  of  the  friend  or  relative  involves  the 
power  of  discriminating  disposition  and  temper ;  of  watching  the 
progress  of  the  diseas«,  and  judging  of  the  propriety  of  not  pursuing 
certain  measures,  which,  although  indicated  by  the  s^'mptoins  at  the 
time  of  prescribing,  yet  may  require  to  be  altered,  and  consequently 
detailed  to  the  physician,  whose  presence  may  be  requisite  before  his 
next  intended  visit.  It  is  of  the  utmost  importance,  also,  that  rela- 
tives attending  in  the  sick-room  should  be  able  to  control  their  feel- 
ings in  the  presence  of  '^he  invalid. 

Nothing  is  more  essential,  in  the  domestic  manugement  of  diseases, 
than  a  knowledge  of  the  natural  disposition  and  temper  of  the  inva- 
lid. An  irritable  or  a  passionate  man  requires  a  very  different  man- 
agement from  that  which  is  proper  for  a  man  of  naturally  mild  and 
easy  disposition.  Disease  awakens,  in  an  augmented  degree,  the  irri- 
tability of  the  former ;  he  becomes  impatient  of  contradiction ;  and 
every  time  his  opinions  are  injudiciously  opposed,  the  turbulent  agi- 
tation of  the  nervous  system  which  follows  either  increases  the  dis- 
ease or  weakens  the  inliuence  of  the  remedial  agents.  On  the  other 
band,  a  mild  and  gentle  disposition  often  leads  to  extreme  sensitive- 
ness, when  ""isease  attacks  the  body  :  a  word,  a  look,  is  sufficient  to 
touch  some  bympathetic  cord  ;  to  unstring  the  whole  nervous  system  ; 
and  to  augment  the  morbid  susceptibility  already  present  in  the  habit 
to  a  degree  which  is  not  always  devoid  of  danger.  Much  discretion 
and  judgment,  therefore,  are  requisite  in  both  instances  :  in  the  one 
case,  to  prevent  ebullitions  of  temper ;  in  the  other,  to  refrain  from 
anything  that  might  be  construed  by  the  invalid  into  harshness  ;  and 
yet,  at  the  same  time,  in  each  case,  to  maintain  that  influence  over 
the  patient  which  the  treatment  of  every  disease  demands  in  an  at- 
tendant oc  the  sick. 

Prejudice  and  Antipatliles.  —  In  those  who  are  imperfectly  or  erro- 
neously educated,  the  judgment  is  apt  to  be  biassed  by  prejudice  and 
antijpathies ;  and,  under  the  influence  of  these,  it  is  misdirected  in  a 
manner  of  which  the  individual  is  often  wholly  unconscious  ;  thence 
the  necessity  of  freedom  from  prejudice  in  the  attendants  in  the  sick- 
room, and  the  farther  importance  of  the  friends  or  relatives  of  the 
sick  being  able  to  superintend  the  conduct  and  the  management  of 
hired  nurses.  On  the  other  hand,  the  judgment,  even  in  the  well- 
educated,  is  apt  to  be  misled  by  the  affections,  the  influence  of  which 
is  as  much  opposed  to  the  healthy  exercise  of  discrimination  as  the 
prejudices  of  the  ignorant.  Self-control,  therefoi-e,  is  also  an  essen- 
tial qualification  of  the  siok-room. 

It  is  only  from  knowing  that  the  attendants  of  the  sick  are  pos- 
sessed of  intelligence  and  self-control,  that  a  physician  can  rely  upon 


DOMESTIC   MANAGEMENT   OF   THE    SICK-UOOM. 


561 


liing   the 
pursuing 


having  his  orders  correctly  and  duly  executed  :  when  those  qualities 
are  absent,  he  has  to  dread,  on  the  one  hand,  the  presumption  of 
ignorant  prejudice  ;  and,  on  the  other,  the  improper  yielding  of  sen- 
sitive indulgence.  To  the  invalid,  also,  it  is  important  to  know  that 
the  directions  of  his  physician  are  fulfilled  by  an  intelligent  person  ; 
for,  even  in  the  most  severe  diseases,  as  long  as  the  mental  faculties 
remain  unaffected,  a  sick  man  is  capable  of  detecting  ignorance,  or 
the  effects  of  prejudice,  in  his  attendants  ;  and,  whcii  he  is  convinced 
of  the  existence  of  either,  all  the  influence  of  the  individual,  whether 
inirse,  or  friend,  or  relative,  is  at  an  end. 

Were  the  business  of  the  sick-room  (independent  of  the  wants  and 
comforts  (  C  >  invalid)  confined  to  the  mere  observation  and  collec- 
tion of  fa*.  -namely,  the  noting  of  the  symptoms  of  disease  —  and 
reporting  them  tr>  the  physician,  it  would  be  superfluous  to  urge  the 
necessity  of  superior  intelligence  in  its  superintendent ;  but  many  of 
its  duties  requii  i  not  only  a  well-regulated  understanding,  but  an 
equally  sound  condition  of  the  moral  feelings  and  the  benevolent 
afi'cctions,  with  a  recognition  of  the  authority  of  conscience  in  the 
whole  operations  of  life.  In  the  period  of  sickness,  under  the  direc- 
tion of  the  judicious  and  discreet,  an  invalid  may  be  led  to  the  inves- 
tigation of  his  moral  and  religious  condition,  and  to  review  his  past 
conduct,  with  the  determination  of  turning  the  result  to  his  future 
welfare,  should  he  happily  recover  and  re-enter  society.  Surely  such 
important  duties  as  these  cannot  be  intrusted  to  the  unqualified,  or 
the  ignorant,  or  the  hireling ;  nor  can  more  be  required  to  demon' 
strate  the  importance  of  adding  to  the  other  branches  of  female  edu- 
cation a  knowledge  of  the  various  important  duties  of  the  sick-rooin, 
which  females,  whether  as  mothers  or  daughters,  or  wives  or  friends, 
are  likely  to  be  called  upon  to  fulfil. 


Prognostics. 

In  every  disease  the  medical  attendant  is  naturally  called  upon  to 
deliver  his  opinion  of  the  degree  of  danger  which  hangs  over  the 
patient :  hence,  it  is  unnecessary  to  enter  into  any  minute  details  on  the 
subject  of  prognostics.  But,  as  in  many  diseases  changes  occur,  in 
the  absence  of  the  practitioner,  which  ought  instantly  to  bo  examined 
into,  in  order  that  the  danf  ^  likely  to  accrue  from  them  may  be 
averted,  it  is  important  that  the  friends  and  ordinary  attendants  of 
the  sick  should  be  aware  of  their  presence,  so  as  to  obtain  the  imme- 
diate assistance  of  the  medical  attendant.  Were  this  information, 
also,  more  generally  diffused,  many  unnecessary  visits  would  be  saved 
to  the  physician,  and  much  unfounded  suspicion  of  danger  prevented 
from  distressing  and  torturing  the  minds  of  the  friends  of  the  sick. 

In  Fevers  delirium  alone  should  excite  no  alarm,  unless  it  be  very 
high,  or  of  the  low,  muttering,  incoherent  kind.  In  jaundice,  and  in 
diseases  of  the  chest,  it  is  alarming ;  and  in  the  latter  stages  of 
pulmonary  consumption,  its  presence  always  indicates  the  approach 
of  death. 


I'l 


I  ■ 


562 


DOMESTIC   MANAGEMENT   OF   THE    8ICK-UOOM. 


Great  confusion  of  thought,  los/t  of  recollection  of  the  Hiost  recent 
occurrence,  u  restless,  wandering  eye,  and  a  correspondent  vacancy 
or  confusion  of  countenance,  are  always  to  be  dreaded  in  fevers  and 
in  diseases  of  the  brain.  An  expression  of  great  anxiety  is  equally 
alarming  in  all  acute  diseases ;  and  a  presentiment  of  death  is  still 
more  to  be  dreaded. 

Hoarseness,  with  constant  spitting,  occurring  at  an  early  period  in 
small-pox,  is  very  unfavorable. 

Squintinn^  in  affections  of  the  head  ought  to  be  particularly  noticed, 
nnd  mentioned  to  the  attending  practitioner ;  and  the  same  remark 
applies  to  a  greatly  contracted,  or  a  dilated,  or  an  immovable  condi- 
tion of  the  pupil  of  the  eye  ;  or  the  turning  up  of  the  pupils  under 
the  upper  eyelids. 

Deafness  is  not  an  luifavorable  occurrence  in  continued  fever ;  but 
a  sudden  attack  of  headache  in  pulmonary  diseases  ought  instantly 
to  be  mentioned  to  the  physician. 

The  Sn<iden  Disappearance  of  Pain  in  inflammatory  affections  of 
the  bowels  is  always  to  be  dreaded  ;  but  it  does  not  in  every  instance 
portend  the  existence  of  mortification. 

Con(^h,  depending  on  inflammation  of  the  bronchial  membrane,  sud- 
denly supervening  on  a  suppressed  eruption,  is  always  to  be  dreaded. 

In  Croup,  when  the  breathing  is  audible,  or  when  there  is  a  crow- 
ing sound  in  inspiration,  or  a  cooing  or  croaking  respiration,  danger 
is  present. 

In  Hooping-Congb,  when  the  paroxysms  suddenly  increase  in  vio- 
lence, and  the  face  becomes  livid,  and  the  thumbs  are  drawn  across 
into  the  palms  of  the  hands,  the  appearance  of  convulsions  may  be 
anticipated :  hence  immediate  notice  of  these  symptoms  should  be 
communicated  to  the  medical  attendant. 

Rig;ors  invariably  excite  alarm ;  but  they  are  only  dangerous  in 
chronic  internal  diseases,  in  which  they  often  indicate  the  formation 
of  pus,  or  the  existence  of  suppuration. 

Pallidness  of  the  countenance,  with  a  slight  degree  of  lividity,  are 
symptoms  of  hazard  in  the  inflammation  of  the  lungs. 

The  Position  of  the  Patient  as  he  lies  in  bed,  especially  in  fevers, 
is  of  much  importance.  Constantly  lying  on  his  back,  with  a  ten- 
dency to  sink  to  the  bottom  of  the  bed ;  a  propensity  to  keep  the 
arms  and  the  feet  out  of  bed,  and  to  uncover  the  trunk ;  or  to  pick 
the  bed-clothes  ;  tremors  ;  twitching  of  the  tendons  ;  grinding  of  the 
teeth,  and  sleeping  with  the  eyelids  half  open,  and  the  white  of  the 
eyes  only  seen  ;  are  all  justly  regarded  as  symptoms  of  great  danger. 

Fainting  (Syncope)  is  to  be  considered  alarming  in  diseases  of  the 
heart,  or  during  profuse  bleeding  from  the  nose,  or  from  any  other 


1X)MK8TIC   MAXAGKMKNT   OF  THE    8ICK-UOOM. 


563 


}st  recent 
t  vacancy 
"overs  and 
is  equally 
bh  is  still 


period  ia 


y  noticed, 
16  remark 
hie  condi- 
)il3  under 

fever ;  but 
instantly 

actions  of 
y  instance 

rane,  sud- 
5  dreaded. 

is  a  croto- 
>n,  danger 


ise  m  vio- 
,wn  across 
IS  may  be 
should  be 


igerous  m 
formation 


ndity,  are 

in  fevers, 
rith  a  ten- 
keep  the 
or  to  pick 
ling  of  the 
lite  of  the 
at  danger. 

isea  of  the 
any  other 


part :  deep  i^ighing ,  also,  under  such  circumstances,  is  most  unfavora- 
ble, and  often  indicates  rapid  dissolution. 

Hiccup,  in  the  advanced  stages  of  either  acute  or  chronic  diseases, 
is  invariably  alarming. 

Difficulty  of  Swallowing;,  also,  in  the  advanced  stages  of  fever, 
palsy,  and  affections  of  the  head,  always  indicates  extreme  danger ; 
vomiting,  on  tlie  contrary,  is  not  unfavorable,  unless  it  be  very 
severe  and  protracted  ;  but,  if  the  ejected  matters  be  putrid,  or  fecu- 
lent, then  the  vomiting  is  always  to  be  dreaded. 

Coma,  or  an  irresistible  propensity  to  sleep,  following  the  sudden 
suppression  of  gout,  or  the  cessation  of  periodical  bleeding  in  piles, 
or  the  healing  of  old  sores,  is  always  alarming,  and  requires  prompt 
medical  assistance.  , 

Convulsions  without  fever  or  any  affection  of  the  head  seldom 
prove  daiigerous ;  but  they  are  never  free  from  danger  when  they 
are  accompanied  with  stupor  or  coma.  They  are  also  dangerous 
when  inflammatory  fever  is  present.  They  are  less  dangerous  in 
women  than  in  men,  in  the  young  than  in  advanced  age.  In  infancy, 
corfvulsions  are  more  to  be  dreaded  in  the  robust  than  in  the  delicate 
and  irritable  child. 

Diarrhcea  is,  under  every  circumstance,  an  unfavorable  event,  when 
it  occurs  either  in  fevers,  or  in  the  termination  of  chronic  diseases ; 
and  the  passing  of  involuntary  stools,  when  scarcely  any  diarrhoea 
exists,  is  equally  to  be  dreaded. 

Retention  of  the  Urine,  as  well  as  its  involuntary  discharge,  is  al- 
ways an  unfavoi'able  symptom. 

Purple  Spots  appearing  on  the  skin,  livid  Upa  and  cheeks,  oozing 
of  blood,  sudden  Jiushlnys  followed  by  pallor,  are  unfavorable  symp- 
toms ;  and  the  appearance  of  cedematous  swellings  of  the  legs  and 
skin  in  the  last  stage  of  chronic  organic  diseases  always  indicate  ap- 
proaching death.  When  purple  spots,  also,  appear  in  small-pox, 
with  flattening  of  the  pustules  on  the  trunk  of  the  body,  and  a  white 
pasty  aspect  of  the  eruption  in  the  face  ;  and  if,  at  the  same  time,  the 
extremities  become  cold,  any  hope  of  recovery  can  scarcely  bo  enter- 
tained. 

Great  and  continued,  or  progressing  emaciation  in  chronic  diseases, 
and  what  is  termed  ihQ  fades  Hippocratica,  are  to  be  dreaded. 

Excoriations  on  the  parts  on  which  the  body  rests,  —  for  example, 
the  haunches,  or  the  lower  part  of  the  back,  —  especially  if  these 
become  livid  and  sloughy,  always  indicate  extreme  danger. 

Great  Difficulty  of  Breathinji;,  even  to  a  feeling  of  sufibcation,  is 
not  necessarily  hazardous  in  asthma;  for  although  few  diseases  are 
so  little  under  control  by  the  interference  of  the  physician,  yet 
asthma  seldom  proves  fatal,  unless  it  tends  to  the  production  of  other 
diseases. 


l^• 


my 


■-V 


V,'       "^     . 


111  Coosumptiou,  partial  sweating,  as  of  the  bead,  the  chest,  or  the 
liml)s,  are  always  uut'avoraljlo  ayinptoms. 

When  2}i'€f/nanci/  occurs  in  a  woman  laboring  under  consumption, 
the  disease  is  arrested,  until  after  delivery,  as  if  Providence  threw  a 
bbield  over  the  mother  for  the  safety  of  the  offspring. 

The  Siuideii  Disappenrunre  of  Swelling  of  the  Legs,  in  chronic  or- 
ganic  diseases,  is  indicative  of  approaching  death. 

When  a  child.  Instead  of  rallying  after  any  acute  disease,  becomes 
fmac/fl<erf,  and  the  belly  is  large  and  tympanitic,  there  is  always  much 
danger. 

Ov»rian  Disease,  or,  as  it  is  usually  termed,  ovarian  dropai/,  has 
hitlierto  proved  incurable  ;  but  it  is  relieved  by  tapping  ;  and,  if  the 
powers  of  life  be  sustained  by  proper  food,  and  carriage  exercise  in 
the  open  air ;  and  if  all  medicines  be  let  alone,  except  such  as  are 
required  to  regulate  the  bowels,  life  may  be  sustained  for  many  years. 

All  diseases  not  involving  organic  changes  are,  with  a  few  excep- 
tions, more  or  less  under  the  control  of  medicines,  and  are  conse- 
quL'utly  curable.  But  some  diseases,  in  which  no  organic  changes 
have  been  discovered,  are  nevertheless  incurable.  TIais  is  the  case 
.vith  spasmodic  asthma,  which  has  rarely  been  cured. 

It  is  true  that  functional  disturbances  are  not  unfrequcntly  associ- 
ated with  organic  diseases  ;  but,  under  such  circumstances,  it  is  the 
province  of  the  attending  physician  to  point  out  to  the  friends  of  the 
patient  the  greater  or  the  less  degree  of  danger  in  these  complications. 

Diet,   etc.,  in  Disease  and  Convalescence. 

In  numerous  instances,  much  hazard  often  exists  after  disease  has 
disappeared,  and  when  the  patient  is  declared  convalescent :  and  as 
this  period  iu  the  removal  of  diseases  is  left  to  the  management  either 
of  the  patient  himself  or  of  his  friends,  some  general  remarks  respect- 
ing it,  and  also  in  reference  to  particular  diseases,  are  requisite. 

In  every  recovery  from  sickness,  whether  external  or  internal,  be- 
fore the  salutary  advantages  obtained  from  the  treatment  be  confirmed, 
the  organ  or  part  which  has  suffered  must  be  either  left  at  rest  or  bo 
used,  according  to  the  nature  of  the  case.  Thus,  if  any  part  have 
suffered  from  inflammation,  it  must  not  be  used  for  some  time  after 
the  inflammation  is  subdued.  If  the  eyes  have  suffered,  the  person 
must  neither  read  nor  write,  nor  expose  the  eyes  to  the  heat  of  the 
fire,  nor  to  a  strong  light,  until  some  days  after  every  trace  of  the 
disease  has  disappeared.  If  the  arm  has  been  affected  it  must  be 
kept  at  rest ;  and  if  the  leg,  not  only  should  walking  be  refrained 
from,  but  the  limb  should  be  placed  rather  higher  than  the  trunk  of 
the  body.  If  the  previous  disease  has  affected  the  brain,  every  men- 
tal exertion  must  be  avoided  ;  and  so  on,  whatever  may  be  the  organ 
which  has  especially  suffered.  Even  when  the  exercise  of  the  organ 
is  resumed,  it  should  not  be  carried  to  fatigue,  nor,  on  any  accouLt, 
should  it  be  such  as  to  produce  excitement.     At  the  same  time,  it 


ist,  or  the 

nimption, 
3  threw  a 


ironic  or- 

,  becomes 
ays  much 

'opay,  has 
11(1,  if  the 
xercise  in 
ich  as  are 
my  years. 
3W  excep- 
,re  couse- 
0  changes 
i  the  case 

ly  associ- 
!,  it  is  the 
ids  of  the 
Dlications. 


nee. 

isease  has 
it :  and  as 
ent  either 
:s  respect- 
islte. 

erual,  be- 
sonfirmed, 
rest  or  bo 
pjirt  have 
time  after 
he  person 
eat  of  the 
ice  of  the 
t  must  be 
refrained 
5  trunk  of 
very  men- 
the  organ 
the  organ 
Y  accouLt, 
\Q  time,  it 


DOMESTIC  MANAGEMENT   OF   THE    SICK-ROOM. 


5fi5 


must  not  be  forgotten  that,  in  the  treatment  of  external  injuries,  when 
it  has  been  necessary  to  keep  the  limb  long  in  a  sling,  in  one  position, 
—  as,  for  instance,  in  fractures,  —  the  muscles  which  bend  the  arm 
acquire  from  the  habit  a  contraction  which  cannot  be  overcome  by 
the  antagonist  muscles,  owing  to  the  length  of  time  they  have  been 
on  the  stretch  weakening  their  contractile  power.  The  arm,  there- 
fore, should  be  frequently  taken  from  the  sling,  and,  being  rested  upon 
the  elbow,  a  moderate  weight  should  be  hold  in  the  hand,  and  friction 
with  oil  employed  upon  the  contracted  muscles.  It  is  true  that  sur- 
geons usually  give  directions  for  this  operation,  before  they  quit  the 
management  of  the  case ;  but  surgeons,  as  well  as  physicians,  are 
sometimes  dismissed  before  the  convalescence  is  complete  ;  on  which 
account,  arms  and  limbs  have  remained  contracted  for  life,  from  a  want 
of  the  knowledge  necessary  to  counteract  the  evil  at  an  early  stage. 

I  say  nothing  respecting  the  continuance  of  remedies  during  con- 
valescence from  many  diseases,  except  urging  the  necessity  of  regu- 
lating the  bowels. 

The  most  important  part  of  the  management  of  convalescence  cer- 
tainly refers  to  air,  exercise,  and  diet.  The  errors  daily  committed, 
in  all  these  matters,  exert  the  most  powerful  influence  in  retarding 
complete  restoration  to  health;  and  often,  indeed,  induce  evils  of  a 
more  formidable  kind  than  the  diseases  from  which  the  patients  have 
just  emerged. 

1.  Air.  In  every  convalescence,  whatever  may  have  been  the 
nature  of  the  disease,  if  it  has  been  so  severe  as  to  wear  down  the 
strength  of  the  invalid,  country  air  is  essential.  The  benevolent 
Author  of  our  existence  has  made  medicinal  the  hills,  the  vales,  the 
groves,  and  all  the  harmonies  of  nature  ;  and  in  the  repose  of  these 
man  finds  a  balm,  not  only  for  a  wounded  sprit,  but  for  his  stricken 
body. 

In  selecting  a  country  residence  for  a  convalescent,  care  must  be 
taken  to  ascertain  whether  any  source  of  malaria  exists  in  the  neigh- 
borhood ;  as,  in  that  case,  even  if  all  other  circumstances  be  favorable, 
the  place  is  exceptionable. 

2.  Exercise.  In  convalescence,  much  caution  is  requisite  in  appor- 
tioning the  exorcise  to  the  degree  of  returning  strength.  When  the 
convalescent  is  still  too  feeble  to  take  sufficient  exercise  on  foot,  the 
best  substitute  for  it  is  riding  horseback  ;  but,  as  soon  as  walking  can 
be  borne,  it  should  be  preferred  to  either  horse  or  carriage  exercise. 

3.  Diet.  In  health,  diet  may  be  left,  in  a  great  degree,  to  the  in- 
clination or  the  taste,  as  far  as  regards  the  quality  of  the  food  ;  and, 
although  diseases  occasionally  originate  from  repletion,  yet,  in  gen- 
eral, the  appetite  may  be  considered  as  the  best  regulator  of  quantity, 
when  the  food  is  simple,  and  the  appetite  is  not  pampered  by  high 
seasoning  and  rich  sauces.  In  disease,  however,  a  very  opposite  rule 
is  to  be  observed  ;  the  regulation  of  both  the  quantity  and  the  quality 
of  the  food  is  of  the  utmost  importance.  The  taste  is  often  so  per- 
verted as  to  desire  that  which  would  prove  injurious  ;  and  were  appe- 
tite to  be  the  guide  of  quantity,  diseases  would  frequently  not  only  be 
increased  in  severity,  but  life  itself  would  be  brought  into  jeopardy. 


\ 


56G 


nOMESTIO   MANAGEMENT'OF   TIIK   SICK-ItOOM. 


iK 


As  soon  118  solid  animal  food  can  bo  tnkon  with  impunity,  that 
which  is  most  (ligcstil)lo  should  bo  solcctod.  An  opinion  has  gener- 
ally prevailed  that  gelatinous  matters,  and  meats  which  readily  yield 
jelly,  — such,  for  example,  as  voal  and  lamb,  —  are  the  most  easily 
digested,  and  at  the  same  time,  are  also  the  most  nutritivo.  This  is 
a  mistake  ;  for,  with  the  exception  of  poultry,  the  flesh  of  young^ni- 
mals  is  stringy  and  of  a  lax  fibre,  and  is  even  loss  easily  digested  than 
that  of  too  old  animals,  which  presents  a  great  density  of  texture. 
The  middle-aged  animals  afl()rd  the  most  digestible  food. 

Nothing  tends  to  lessen  the  density  of  the  fibre  of  every  kind  of 
animal  food  so  much  as  keeping  it  for  a  certain  time  ])oforo  it  is 
cooked.  In  this  case,  the  tenderness  is  the  result  of  incipient  decom- 
position or  putrefaction ;  but  the  utmost  caution  is  requisite  to  pre- 
vent this  from  advancing  so  far  as  to  present  the  slightest  trace  of 
taint,  in  the  food  of  the  convalescent.  In  the  low  state  of  vitality  in 
convalescence,  the  change  which  commencing  deconiposition  (putre- 
faction) causes,  renders  animal  food,  in  that  condition,  a  source  likely 
to  occasion  either  a  relapse  into  the  disease  from  which  the  patient 
bas  recovered,  or  to  form  a  new  disease. 

In  examining  the  relative  vakw  of  other  articles  of  d  let  adapted  for  the 
sick  and  convalescent,  the  first  which  presents  itself  to  our  notice  is 

nUk.  —  As  milk  is  the  food  of  almost  all  young  animals,  its  diges- 
tibility appears  at  once  evident ;  and  there  can  bo  little  doubt  that  it 
isvery  digestible,  when  it  is  drunk  Iminodiately  after  it  is  drawn  from 
the  udder  of  the  cow,  or  that  of  the  ass,  or  the  goat,  before  its  com- 
ponents have  time  to  separate.  When  this  separation  is  effected, 
either  spontaneously  by  time,  or  by  moans  of  rennet  or  other  agents, 
its  properties  are  altered,  and  its  digestibility  is  lessened. 

Cream,  when  intimately  united  with  the  other  components  of  milk, 
—  namely,  the  curd,  or  the  caseous  part,  and  the  whey,  —  is  not  the 
same  substance  as  after  its  separation.  In  the  milk,  .  is  more  easily 
digested,  and  is  the  most  nutritive  part  of  the  milk.  But  in  its  sepa- 
rate state,  it  is  ill  adapted  either  for  the  sick  or  convalescent,  except 
in  the  form  of  butter,  which  is  not  unwholesome,  unless  it  be  eaten 
in  excess  or  be  melted.*  In  the  same  manner  the  separate  curd  is  in- 
digestible ;  and  whty  itself,  although  highly  nutritive,  yet  is  flatulent ; 
nevertheless,  it  is  an  excellent  demulcent  in  many  cases  of  disease. 
But  none  of  the  components  of  milk  are  equal  to  milk  itself.  It  is 
often  necessary,  in  convalescence,  to  dilute  it  in  water. 

E[f!ps.  —  It  is  not  uncommon  to  hear  that  the  yolk  of  a  raw  egg, 
boaten  up  with  water  and  sugar,  with  the  addition  of  a  small  quan- 
tity, of  white  wine,  is  a  light  and  nutritive  aliment  in  convalescence, 
and  even  in  some  states  of  disease  ;  but  erfffs  are  much  less  digestible 
Ml  this  form  than  when  they  are  lightly  boiled.  In  jaundice,  however, 
.'irising  from  viscid  mucus  obstructing  the  orifice  of  the  common  duct, 
the  yolk  of  a  raw  egg  beaten  up  with  cold  water  is  serviceable. 

*  [Althougli  cream  is  not  as  digestible  aa  milk,  yet  it  is  much  less  liable  to  turn  acid 
in  the  stomach ;  it  is  often  beneficial  to  dyspeptics,  either  alone  or  diluted  with  water.] 


'■S"-' 


DOMR8TIO   MANAQEMKNT   OF   TIIK    SICK-ROOM. 


567 


Fish,  at  loiist  tlio  wiiito  kind,  stimulates  much  loss  tlian  tho  flosh 
of  land  animals  ;  hcnco  it  ia  a  proper  food  for  tlioso  lahorinf^  unuer 
some  acute  diseases ;  and  also  for  convalescents,  when  a  sudden  re- 
turn to  moro  stimulating  food  would  prove  hurtful.  But  it  is  not 
adapted  for  convalescents,  when  tho  object  is  to  bring  up  rapidly  tho 
strength  of  debilitated  hal)its. 

Kaw  oyders  havo  been  erroneously  supposed  to  be  both  easy  of 
digestion  and  nutritive.  Tho  latter  opinion  is,  in  some  dogreo,  true  ; 
but  tho  former  is  erroneous.  Raw  oysters  are  less  digestible  than 
plainly  cooked  oysters.  Both  are  improper  for  tho  sick  and  for  early 
convalescents.  Lobsters,  crabs,  prawns,  cray-tish,  scallops,  and 
other  shell  fish,  are  still  more  objectionable. 

If  fish  of  any  kind  be  admissible,  it  should  bo  simply  boiled  :  fried 
fish  is  even  worse  for  invalids  than  the  outside  or  tho  brown  of  roasted 
meat. 

Vegetables.  —  In  reference  to  vegetable  diet,  it  is  only  tho  mildest 
description  of  esculent  roots  that  are  fitted  for  the  use  of  the  sick.  In 
preparing  all  of  them  for  the  sick-room,  they  should  be  well  boiled  in 
two  distinct  waters,  until  they  are  soft  and  very  soluble,  and  in  a  state 
not  to  leave  undissolved  anything  which  could  act  as  a  mechanical 
irritant  on  the  intestinal  canal.  When  properly  cooked,  they  are 
moderately  nutritive,  and  free  from  any  stimulant  properties ;  and 
they  are  well  adapted  for  the  stomach  of  the  sick,  unless  in  cases  in 
which  the  torpor  of  the  organ  is  such  as  to  permit  them  to  run  into 
acetous  fermentiition  and  to  prove  flatulent. 

Fniitg.  —  With  respect  to  fruits  they  produce  tho  most  diversified 
eflfccts;  and,  consequently,  are  more  or  less  proper  for  invalids,  ac- 
cording to  circumstances,  either  connected  with  themselves  or  with 
the  condition  of  the  patient  at  the  time.  The  stone  fruits,  with  the 
exception  of  the  ripe  peach,  or  the  nectarine,  are  to  be  rejected.  Tho 
apple  tribe,  except  very  soluble  pears,  are  still  less  admissible.  The 
apple,  however,  when  roasted,  and  when  the  seeds  and  the  hard  cen- 
tral parts,  as  well  as  the  skin,  are  removed,  is  less  o])jectionablo  ;  and, 
as  it  possesses  laxative  properties,  the  roasted  apple  is  well  adapted 
for  the  sick,  when  food  is  at  all  allowable,  and  when  the  bowels  are 
torpid.  The  orange,  if  fully  ripe,  is  grateful  and  wholesome  to  all 
invalids,  and  is  only  equalled  in  these  qualities  by  the  grape  ;  but  in 
using  tho  orange,  the  pulp  should  bo  rejected.  Care,  also,  should  be 
tiiken  not  to  swallow  either  the  skin  or  the  seeds  of  the  grape. 
Strawberries  are  a  little  stimulant,  of  easy  digestion,  and  more  cool- 
ing than  the  other  small  fruits ;  mulberries  are,  also,  uncxcei)tiona- 
ble ;  but  currants  and  gooseberries,  and  even  raspberries,  are  not 
free  from  objection  for  invalids  laboring  imder  aciito  diseases. 

With  the  exception  of  oat  and  wheaten  bread,  all  the  vaiioties of 
farinaceous  aliments  may  bo  regarded  as  modifications  of  starch,  con- 
taining little  nutritive  matter,  and  therefore  well  adai>ted  fi)r  tho  sick- 
room. It  has  been  supposed  that  arrow-root,  sago,  tai)ioca,  and 
similar  substances,  are  very  nutritive,  because  they  form  mucilages 
with  boiling  water :  but  this  is  not  the  fact ;  and  were  they  very 


i 


568 


DOMEflTIO  MANAGEMENT  OP  TIIR   RICK-ROOM. 


nutritive,  they  would  ho  ill  ndaptcd  for  invalids.  Rico  in  every  case 
Mrhere  tlio  stomacli  h  in  iin  a(;oHccnt  state,  is  preferable  to  the  other 
farinacere,  because  it  is  less  f(!rtnontahl6. 

The  farinaceous  food,  which  is  ordered  in  the  cciuvaloscenco  of 
children  from  acute  discuses,  is  often  made  of  broad  so  as  to  consti- 
tute jaa/j.  No  description  of  food  has  a  greater  tendenjy  than  this  to 
become  sour ;  a  quantity  only  sufficient  for  a  single  raoal,  therefore, 
should  bo  made  nt  a  time ;  for  what  remains  is  always  sour  before 
the  next  meal ;  and  even  if  the  quantity  bo  small,  and  it  be  mixed 
with  fresh  pap,  it  communicates  its  faculty  of  becoming  sour  to  the 
whole  mass. 

>  Fluid  Aliments. 

Water.  —  The  best  and  the  most  universal  beverage  for  the  sick  is 
water:  but  the  qualities  of  water  differ,  according  to  the  sources 
whence  it  is  procured.  The  fewer  foreign  in^edients  it  holds  in  so- 
lution the  greater  are  its  diluent  properties.  Distilled  water,  or  rain 
or  river  water  filtered,  and  that  of  soft  water  springs  which  filtrate 
through  silicious  strata,  are  the  only  kinds  proper  for  the  use  of  the 
sick-room.  Hard  water,  under  whatever  name  it  is  found,  whether 
as  spring  water,  or  pump  water,  or  well  water,  should  be  excluded. 
The  impurities  of  river  and  rain  water  are  merely  held  in  suspension  ; 
consequently,  they  are  readily  removed  by  filtration. 

Water  itself  is  aliment ;  many  individuals  under  certain  circum- 
stances have  lived  for  a  considerable  time  upon  it  alone.  Those  who 
live  chiefly  on  animal  food  require  more  drink  than  those  who  eat 
much  vegetable  matter. 

The  influc.ice  of  water  on  the  animal  economy  may  bo  regarded  ia 
two  points  of  view  : 

^  As  an  article  of  diet. 

As  a  medicinal  asfent. 


m 


As  an  article  of  diet,  in  health,  water  is  the  beverage  provided  by 
nature  for  all  animals,  man  not  excepted.  The  sensation  of  thirst  is 
the  natural  call  for  fluids,  either  to  assist  digestion,  or  to  allay  a  dry, 
hot  condition  of  the  mouth  and  the  gullet.  The  consequence  of  not 
satisfying  this  call  is  fever  of  a  nervous  kind  ;  and,  if  it  be  long  re- 
sisted, inflammation  of  the  air  passages.  On  the  other  hand,  too 
much  fluid  is  injurious;  for  although  the  vital  powers  of  the  stomach 
counteract  the  tendency  which  it  affords,  by  over-diluting  the  gastric 
fluir*.,  to  the  fermentation  of  the  aliment  in  the  stomach,  yet,  when  it 
is  in  excess,  those  vital  powers  languish ;  hence  spontaneous  chemi- 
cal changes  in  the  contents  of  the  stomach  take  place,  and  induce 
dyspepsia.  For  all  the  purposes  of  dilution,  in  health,  water  is  ade- 
quate, and  it  is  the  only  truly  wholesome  beverage. 

As  a  medicinal  agent,  water  is  demanded  in  every  disease  in  which 
a  dry  skin,  and  an  elevation  of  the  natural  heat  of  the  surface,  consti- 
tuting fever,  are  present.     In  this  case,  the  desire  is  for  cold  water,  or 


nOMESTTO  MANAGICMEKT  OF  THK   8TCK-ROOM. 


569 


cooling  fluids ;  and  it  should  always  bo  indulged.  Tho  dcgroo  of 
tcmpomturo,  however,  must  bo  regulated  by  tho  condition  of  the  in- 
valid ;  but  tho  best  medium  temperature  is  l)etwecn  50'^  and  60^  Fahr.  ; 
ftltbough  even  60°  is  too  low,  when  tiio  debility  of  the  frame  is  consid- 
erable. 

Tho  qualities  of  the  various  kinds  of  beverages  proper,  and  gener- 
ally employed  in  the  sick-room,  should  be  known. 

Toast-water,  when  properly  prepared,  which  it  seldom  is,  forms  a 
uscfui  beverage  in  the  sick-room.  It  is  slightly  nutritive,  owing  to  its 
containing  n  small  portion  of  gluten,  in  conjunction  with  fecula  and 
sugar.  It  is  one  of  the  oldest  and  one  of  the  best  diluent  demulcents  ; 
diluting  at  the  same  time  that  it  softens  the  acrimony  of  the  secreted 
juices  of  the  stomach,  in  febrile  diseases. 

Gru<^l,  whether  made  of  groats  or  of  oatmeal,  is  less  mild  and  de- 
mulcent: than  barley  water ;  and  it  is  more  likely  to  undergo  the  ace- 
tous fermentation  in  the  heat  of  tho  stomach  ;  a  circumstance  which 
is  greatly  iHvorod  by  the  sugar  and  butter  which  is  sometimes  added 
to  it.  Unlets  gruel  be  very  thin,  it  can  scarcely  be  regarded  as  dilu- 
ent ;  and  when  thick,  it  is  too  heating  an  aliment  for  patients  laboring 
under  febrile  symptoms. 

Tea,  in  the  form  in  which  it  is  usually  taken,  is  too  stimulant  and 
astrmgent  to  be  a  good  diluent ;  and,  when  it  is  strong,  the  narcotic 
property  which  it  possesses  renders  it  improper  for  most  invalids, 
whatever  may  be  the  nature  of  their  diseases.  As  it  is,  nevertheless, 
agreeable  to  most  palates,  and  very  refreshing,  it  may  be  taken  in 
moderate  quantity,  provided  it  be  not  strong,  without  any  hazard. 

Sage,  balm,  and  mint  teas,  are  often  substituted  for  common  tea. 
Each  of  them  undoubtedly  allays  the  irritability  of  the  stomach  in 
some  cases  ;  but,  as  general  boverngos  in  disease,  they  are  less  useful 
than  toast-water.  Raspberry  vinetjar,  lemonade,  tamarind  tea,  apple 
tea,  and  similar  compound  diluents,  should  never  be  administered 
without  the  conse  it  of  the  physicia;*  If  a  patient  be  taking  an  anti- 
monial,  they  w'il  excite  vomiting;  if  a  mercurial,  griping;  and  they 
are  equally  incompatible  with  many  other  medicines,  and  with  many 
conditions  of  the  stomach  in  disease.  They  are  a  description  of 
beverage  greatly  recommended  and  largely  distributed  by  the  Lady 
Bountifuls  in  the  country,  and  have  frequently  been  productive  of 
serious  mischief. 

Coffee  is  more  heating,  and,  consequently,  less  admissible  than  tea  ; 
it  may,  however,  be  taken,  if  it  be  largely  combined  with  milk.  Cocoa 
and  chocolate  are  still  more  objectionable  than  either  tea  or  coffee  in 
the  sick-room. 

With  respect  to  the  Kamber  of  Heals,  and  the  periods  best  adapted 
for  taking  them,  it  is  scarcely  requisite  to  remark,  that,  although  in 
health,  three  moderate  meaie,  at  proper  intervals,  are  customary,  and 
well  adapted  for  the  support  of  the  irame,  yet,  under  the  changed 


i 


,•570 


DOMKSTIO   MANAORMRNT  OK  THR    8ICK-UOOM. 


condition  of  tii«  Bystt'in  in  diHeiiflo,  it  would  ho  improix^r  to  tiil<«  niiy 
rcgnltir  iiu.nhcr  of  niualrt,  or  to  obHorvo  any  Hlatod  puriodd  for  tukiiig 
tbem  :  honio  no  po'iorul  rnlos  can  apply. 

Ah  a  f][on«Tiil  rnio,  in  tlio  dodino  of  discnsos,  nnd  on  thn  npproiu-li 
of  convaloHo«ncp,  wlicn  tlio  dosiro  of  talking  food  rctuni'',  tho  best  timo 
for  tho  principal  niual,  diniitr,  is  ahout  two  hours  after  noon.  If  tliu 
broakfaat  ho  taken  ut  nine  o'clock,  and  tho  evening  meal  at  seven,  tlio 
h  ur  of  two  in  tho  middle  period  of  thu  day  ;  so  that,  when  dinner  in 
taken  at  that  timo,  tho  intervals  between  breakfast  and  dinner,  and 
bctv/ocn  dinner  and  supper,  aro  not  only  equal,  but  neither  is  tix) 
short  to  limit  tho  complete  digestion  of  the  previous  meal ;  nor  too 
long  to  injure  the  powers  of  the  weakened  stomach  by  protracted 
fasting. 

All  acute  diseases  require  moro  or  less  abstioenoe,  especially  when 
tho  object  of  tho  treatment  is  to  lower  tho  system ;  and  in  some 
chronic  affections,  abstinence  is  almost  essential.  If  this  bo  true,  the 
necessity  of  tho  strictest  observance  of  the  directions  of  tho  physician 
on  this  subject  must  bo  obvious.  It  is  one,  however,  which  is  not 
only  neglected,  but  is  often  combated  both  by  nurses  and  friends ; 
and  indulgences,  which  are  supposed  to  bo  of  too  trivial  a  nature 
to  cause  any  injury  to  the  sick,  have  often  been  followed  by  fatal 
effects. 

But,  although  abstinence  be  requisite  during  the  existence  of  an 
acute  disease,  yet  it  is  injurious  when  it  is  too  rigidly  maintained 
after  convalescence  is  actually  established ;  it  often  induces  a  now 
train  of  symptoms,  not  very  unlike  those  for  which  it  was  properlj 
prescribed  and  the  removal  of  which  it  has  aided :  namely,  acceU 
oration  of  the  pulse,  increased  impetus  of  tho  heart,  headache,  and 
even  delirium. 

t  General  Diseases. 

Happily,  in  febrile  affections,  the  appetite  of  the  invalid  is  not  in 
a  condition  to  desire  food ;  and  no  stronger  demonstration  can  be 
required  of  tho  impropriety  of  forcing  it  upon  him  under  such  circum- 
stances. Simple  fluids,  such  as  diluents,  are  all  that  he  desires,  ali 
that  tiio  stomach  can  bear ;  and  such  alone  should  be  administered  in 
fever,  before  that  low  condition  of  the  system,  which  demands  the 
use  of  wine  or  other  stimulants,  supervenes.  In  these  cases,  who  i 
the  patient  desires  moro  nourishment  than  is  usual,  animal  tood  ought 
not  to  be  given,  unless  by  the  direct  recommendation  of  the  physi- 
cian. Indeed,  in  general,  the  inclination  of  tho  invalid  happily  re- 
volts from  animal  food,  as  much  as  experience  condemns  its  adminis- 
tration. 

While  febrile  symptoms  are  present,  farinaceous  matters,  little  nu 
tritious,  such  as  barley-water,  gruel,  arrow-root  mucilage,  or  sago, 
acidulated  with  lemon-juice,  and  sweetened  to  the  taste  of  the  patient, 
are  most  suitable  ;  but  even  these  should  Ix;  given  in  small  quantity, 
and  at  considerable  intervals.  Thii  bcvcra^o  generally  most  agreeable, 
«nd  also  most  salutary,  to  those  suffering  under  fever,  is  cold  water. 


to  tako  Hiiv 
li  for  taking 

hn  a|)proa<'h 
lio  Ix'st  timo 
)on.  Ifllio 
it  seven,  tlio 
icii  dinner  is 
(liiinor,  and 
itiier  is  too 
'ul  ;  nor  too 
protracted 

jcially  wlien 
lid  in  some 
bo  true, the 
le  pliysiciaa 
irbich  is  not 
md  frienda ; 
iai  a  nature 
ed  by  fatal 

tence  of  an 
maintained 
uces  a  new 
as  properly 
noly,  accelo 
ladacbe,  and 


lid  is  not  in 
tion  can  be 
iuch  circura- 
I  desires,  alt 
linistered  in 
lemnnds  the 
cases,  whc  i 
1  food  ought 
'  the  physi- 
happily  re- 
its  adminis- 

's,  little  nu 
^e,  or  siigo, 
tiic  patient, 
lil  quantity, 
it  agreeable, 
cold  water. 


DOMESTIC   MANAORMKNT   OF   TIIR   HICK-ItOOM. 


571 


In  the  decline  of  fevers  even,  as  I  have  already  remarked,  although 
the  Hevority  rcHpectiiig  diet  siioultl  bo  relaxed,  yet  nuich  danger  may 
result  from  miHtakeri  kindness  and  over-/.eal,  in  urging  uiiimal  and 
otimulaut  food  at  t<»o  early  a  perio  1  of  the  eonvaIeri(!enee.  Indeed, 
the  neccHsity  of  caution  at  this  time  is  greater  tlian  during  the  con- 
tiinianeo  of  the  fever;  and  the  more  acute  the  disease  has  been,  the 
greater  must  bo  tho  caution  in  the  convalesconee,  especially  if  the 
treatment  has  been  of  an  evacuatit  and  lowering  descpptiou. 

The  tirst  change  of  diet,  in  tho  decline  of  fevers,  should  be  t(>  an- 
other article  of  the  samo  kind  of  food  which  was  allowed  in  tho  dis- 
ease;  for  example,  frouj  simple  arrow-root mucilai/eioavroio-root and 
milk,  or  to  some  other  of  tho  farinaceous  compoui  '  ^ ;  whilst,  at  tho 
same  time,  axHen'  milk  may  bo  given,  in  small  qua  .ty  in  tho  morn- 
ing Rice,  one  of  the  farinaceie,  is  generally  supposed  to  bo  astrin- 
gent, but  this  is  a  mistake.  It  forms  an  excellent  diet  ia  all  casus  of 
early  but  decided  convalescence.  It  should  be  well-boiled,  and  mi*  d 
either  with  broth  and  beef-tea,  or  gravy  which  has  been  cooled,  a. 
tho  fat  taken  from  it.  In  the  transition  to  animal  food,  beef-tea, 
chicken-broth,  and  mnUon-broth,  and  other  liquid  animal  decoctions, 
should  be  tirst  resorted  to;  then  zo/u7e^*.s//,  simply  cooked  ;  for,  al- 
though iish  is  more  digestible  than  animal  food,  yet  it  affords  much 
loss  stimulant  nourishment ;  it  is  therefore  better  fitted  for  tho  early 
stage  of  couvaloscence.  When  convalescence  is  completed,  a  more 
generous  diet  is  admissible. 

With  respect  to  beverage,  water,  toa^'<t-water  or  lemnii-peel-water, 
is  sufficiei't,  until  the  medical  attendant  declares  that  a  little  wine  is 
requisite. 

In  convalescence  from^wer,  it  is  an  error  lO  permit  tho  patient  to 
get  up  too  soon.  He  ould  not  leave  bis  bed  until  [ns  strength  bo 
considerably  advanced.  No  danger  can  result  from  too  strict  an 
observance  of  this  rule ;  whereas  much  risk  may  bo  incurred  by  its 
oeglect. 

If  the  head  has  been  much  affected,  every  mental  exertion  should 
be  refrained  from  duruig  the  convalescence ;  and,  according  to  the 
degree  of  suffering  in  any  local  organ,  precautions  must  be  taken  to 
guard  that  part  of  the  frame  against  a  fresh  attack  of  disease. 

Eruptive  Fevers  require  more  precaution  in  convalescence  than  gen- 
<M'al  fevers,  both  as  regards  diet  aiid  exposure  to  sudden  alternations 
of  heat  and  cold.  This  is  more  especially  essential  after  measles  and 
scarlet  fever. 

Measles  are  often  followed  l)y  a  distressing  cough,  and  other  symp- 
toms of  pulmonary  inflammation  ;  or  by  a  harassing  diaiThcea,  which 
wears  down  the  strength  ;  or  by  inflamed  eyes,  catarrh,  or  obstinate 
toothache.  In  infants,  canker  of  the  mouth  occasionally  makes  its 
attack  and  proves  fatal.  All  these  affections,  after  measles,  might 
generally  be  prevented  by  taking  care  not  to  allow  too  soon  a  return 
to  the  use  of  animal  food,  or  too  early  an  exposure  to  cold  or  to  night 
air.  Even  in  summer,  flannel  should  be  worn  next  the  skin  for  sorae 
weeks  after  the  disease  has  disappeared. 


T 


% 


572 


DOMESTIC  MANAGEMENT   OF  THE   SICK-ROOM. 


Scarlatina  is  frequently  followed  by  dropsical  symptoms ;  which, 
however,  might  generally  be  avoided  by  the  same  attention  to  diet 
and  regimen  as  after  measles. 

Small-Pox,  when  severe,  and  especially  when  confluent,  is  very  apt 
to  awaken  into  activity  the  dormant  seeds  of  scrofula,  if  any  heredi- 
tary taint  exists  in  the  constitution ;  hence  abscesses,  ulcers,  and 
swelled  glands  make  their  appearance.  These  demand  the  aid  of 
the  physician  or  the  surgeon.  But  if  the  convalescent  be  properly 
dieted,  and  recourse  be  had  to  a  change  of  air  as  soon  as  his  strength 
will  permit,  these  evils  may  be  avoided. 

Erysipelas  not  unfrequently  attacks  convalescents  from  small-pox 
and  other  eruptive  fevers.  When  it  occurs,  independent  of  any  prior 
disease,  the  same  attention  to  diet  and  regimen  is  requisite  as  in  other 
eruptive  fevers. 

ConTUlsions,  it  is  well  kn(jwn,  are  not  unfrequently  the  result  of 
errors  in  diet,  in  individuals  with  an  irritable  condition  of  the  stom- 
ach and  bowels.  Advice  should  always  be  demanded  respecting  the 
diet  of  those  who  are  liable  to,  and  who  suffer  from,  convulsions  ;  but 
it  must  not  be  supposed  that  when  they  occur  in  children  and  have 
been  suMued,  a  system  of  starvation  is  necessary  to  prevent  their 
recurrence.  As  far  as  regards  convalescence  in  such  cases,  it  will 
be  proper  to  bear  in  recollection  the  following  rules  : 

1.  When  the  patient  is  of  Sifull  habit,  has  a  short  neck,  and  a  ten- 
dency to  diseases  of  the  head,  the  diet  should  be  spai*e.  The  use  of 
animal  food,  indeed,  in  such  a  habit,  should  be  wholly  prohibited  in 
childhood ,  and  very  sijaringly  employed  by  adults  ;  whilst  vegetables, 
farinaceous  matters,  milk  and  weak  broths,  may  be  allowed. 

2.  When  tho  habit  of  body  is  spare,  and  when  languor  and  chilli- 
ness are  present,  the  diet,  although  free  from  stimulus,  yet  should  be 
nourishing,  and  consist  of  the  lighter  kinds  of  animal  food;  namely, 
poultry  and  fish,  with  a  moderate  share  of  vegetable  matters. 

3.  Under  all  circumstances,  and  at  every  period  of  life,  fermented 
liquors  and  wine  should  be  either  wholly  avoided,  or  very  sparingly 
used,  in  almost  all  convulsive  diseas  is  connected  with  affections  of 
the  head. 

In  convalescence  from  some  varieties  of  convulsive  diseases,  the 
nature  of  the  diet  must  depend  on  circumstances  which  cannot  be 
judged  of  by  the  attendantt  of  the  sick-room  •  hence  it  should  bo 
referred  solely  to  the  medical  attendant.  In  8t.  Vitus's  Dance 
(chorea),  for  example,  although  a  tonic  plan  of  treatment  may  have 
been  successfully  pursued,  yet  the  diet  may  be  required  to  be  mild, 
and  wholly  free  from  stimulus. 

Attention  to  diet  in  Hysteria  is  most  important.  When  the  diseaoe 
is  connected  with  indigestion,  the  meals  should  be  moderate ;  and 
rest  in  the  horizontal  posture  should  be  indulged  for  an  hour  after-, 
wards,  and  then  moderate  exercise  taken.  Fluid  food,  such  as  broths 
and  gruel,  are  improper;  yet  animal  food  should  be  eaten  only  once 
a  day.     Tea  and  coffee  should  be  very  sparingly  taken  ;  and  the  sim- 


9 ;   which, 
on  to  diet 


8  very  apt 

ny  heredi- 

cers,  and 

he  aid  of 

properly 

strength 


small-pox 

any  prior 

IS  iu  other 

result  of 
the  stom- 
joting  the 
pions ;  but 
and  have 
i^ent  their 
s,  it  will 

ind  a  ten- 
'he  use  of 
libited  in 
egetables, 
1. 

md  chilli- 
should  be 
;  namelj', 

3. 

■ermented 
sparingly 
ctiona  of 

eases,  the 
annot  be 
hould  bo 
('s  Dance 
may  have 
be  mild, 

le  diseao& 
'ate ;  and 
lur  after- 
as  broths 
July  once 
the  sim- 


DOME8TIC   MANAGEMENT   OF   THE   SICK-ROOM. 


573 


plest  beverag''..,  even  water  and  toast-water,  should  be  taken  in  great 
moderation  after  a  meal,  and  should  not  be  drunk  during  dinner. 

In  convalescence  from  hysteria,  change  of  scene  and  air  are  abso- 
lutely requisite.  The  mind  should  be  directed  to  solid  studies,  and 
everything  which  can  cherish  morbid  sensil)ility  of  the  nervous  system 
avoided. 

Dropsy.  —  Ai  opinion  was  long  mamtained  that  fluids  are  to  be 
withheld  from  dropsical  patients.  No  opinion  was  ever  founded  on 
more  erroneous,  principles.  Dropsical  patients,  indeed,  should  be 
allowed  the  free  use  of  fluids.  With  respect  to  diet,  it  should,  gen- 
erally speaking,  be  light  end  unstimulating  :  but  much  depends  on  the 
causes  of  dropsy.  There  is,  however,  less  necessity  for  a  rigid  ad- 
herence to  low  diet  ill  this  than  in  other  inflammatory  aflTections. 

Iu  Palsy,  abstinence  from  all  stimulating  food,  solid  or  fluid,  must 
be  rigidly  observed ;  and  the  restriction  should  not  be  discontinued 
in  convalescence.  A^t  the  same  time,  change  of  air  and  of  scene  is  al- 
ways of  decided  advantage.  In  every  instance,  an  easy  state  of  mind, 
and  freedom  from  every  source  of  irritation,  as  well  as  from  the  anxi' 
eties  of  business,  are  indispensable. 

Gont  and  Rheumatism.  —  In  no  diseases  aflecting  the  general  habit 
are  abstinence  and  repose  more  essential  during  the  attacks  than  in 
the  two  which  head  this  paragraph,  when  they  assume  an  acute  form. 
When  they  occur  in  weakened  or  in  broken-down  habits,  it  is  too 
often  supposed  that  the  opposite  plan  of  diet  is  to  be  pursued,  and 
that  stimulating  food  and  a  liberal  supply  of  wine  should  be  indulged ; 
but  nothing  is  more  likely  to  prove  injurious. 

When  the  paroxysm  subsides,  it  is  too  customary  to  permit  the  in- 
valid to  glide  into  his  usual  habits  with  respect  to  diet  and  regimen ; 
consequently  the  plethora  which  originated  the  disease  gradually  re- 
turns ;  and  the  same  plan  being  continued,  paroxysm  follows  after 
paroxysm,  at  shortening  intervals,  until  scarcely  any  interval  occurs, 
and  life  is  sacrificed  on  the  altar  of  self-indulgence. 

For  some  weeks  after  the  paroxysm  of  gout  has  subsided,  in  a 
young  or  a  middle-aged  man,  animal  food  should  be  sparingly  taken, 
and  fermented  liquors  altogether  avoided. 

Chlorosis,  or  Green  Sickness,  is  a  state  of  the  habit  which  seems  to 
depend  on  an  impaired,  condition  of  the  blood  itself.  Its  treatment 
is  well  understood,  and  recourse  to  medical  advice  should  never  be 
neglected  ;  otherwise  it  may  terminate  either  in  mental  derangement 
or  iu  sudden  death.  In  convalescence  from  it,  the  diet  should  be  mild 
and  light,  but  nutritious ;  the  exercise  should  be  much  within  the  lim- 
its of  fatigue,  an*!  f^onsist  of  both  walking  and  horse  ex'jrcise,  daily, 
in  the  open  air :  the  body,  more  especially  the  lower  extremities, 
should  be  warmly  clothed  ;  the  mind  ought  to  bo  amused ;  all  seden- 
tary occupations  thrown  aside ;  and  confidence  placed  in  the  honor 
of  the  physician,  who  should  be  made  the  repository  of  any  mental 
anxiety,  especially  connected  with  the  tender  passion,  which  may  be 
preying  upon  the  vital  energy  of  the  body. 


574 


DOMESTIC   MANAOEMEXT  OF   THE   SICK-ROOM. 


Affections  of  the  Head. 

Whatever  may  bo  the  cause  of  Apoplexy,  no  disease  requires  more 
prompt  and  energetic  treatment :  the  alarming  nature  of  the  symp- 
t<jms  is  always  sufficient  to  prevent  any  time  from  being  lost  by  at- 
tempts to  relieve  the  suflferer  without  medical  assistance.  Should  the 
attack  not  prove  fatal  at  the  time,  and  should  it  not  bo  followed  by 
palsy,  still  the  utmost  caution  is  requisite  to  prevent  a  recurrence  of 
the  disease.  It  is  scarcely  necessary  to  insist  on  the  strictest  adhe- 
rence to  temperance,  both  as  to  meat  and  to  drink ;  and  the  impor- 
tance of  daily  exercise,  when  the  attack  is  over;  and  indeed  for  tlie 
remainder  of  life.  Prolonged  study  and  intense  thinking  must  bo 
given  up  ;  the  violent  and  exciting  passions  should  be  subdued  ;  and 
even  the  pleasurable  moderated. 

Inflammation  of  the  brain  is  one  of  those  diseases  which  require,  as 
observed  respecting  Apoplexy,  the  most  energetic  treatment.  When 
convalescence  has  fortunately  been  established,  the  attention  of  the 
physician  is  still  requisite,  during  several  weeks,  until  complete  re- 
covery be  fully  confirmed  ;  for  the  brain,  after  ^suffering  from  inflam- 
mation, is  very  apt  to  relapse  into  the  same  state,  from  the  excitement 
of  too  full  a  meal,  or  over-exercise,  or  even  slight  mental  exertions 
or  emotions.  On  this  account,  the  convalescent  must  be  kept  per- 
fectly quiet,  and  completely  free  from  the  smallest  excitement ;  and 
the  strictest  regimen  observed.  His  diet  should  not  only  be  mild 
and  unstimulating,  but  small  in  quantity. 

Inflammation  of  the  eyes  requires  the  same  caution  when  convales- 
cence is  secured  as  other  inflammatory  affections ;  namely,  quiet, 
great  moderation  in  diet,  and  avoiding  exposure  either  to  much  light, 
heat,  or  cold,  or  whatever  can  stimulate  the  still  highly  excitable 
organ. 

Affections    of  the   Chest. 


Inflammation  ;>'tlie  Lnng;s  {Pneumonia).  —  In  convalescence  from 
this  disease,  the  temperature  of  the  room  in  which  the  patient  sits 
should  not  exceed  60°  F. ;  and  it  should  be  free  from  currents  of  air  ; 
but,  at  the  same  time,  it  should  not  be  close.  The  necessity  for  con- 
tinuing the  same  elevated  position  of  the  shoulders  when  in  bed, 
which  is  demanded  during  the  existence  of  the  disease,  remains  even 
when  the  convalescence  is  advanced.  The  patient  should  be  pre- 
vented from  talking,  and  from  exerting  any  muscular  motion  that  can 
accelerate  the  circulation.  The  diet  should  be  of  that  desoiiption 
which  will  support  the  strength  without  exciting  or  producing  reple- 
tion. As  the  convalescence  advances,  and  exercise  is  permitted  by 
the  medical  attendant,  it  should  be  regular,  but  not  hurried  nor  vio- 
lent; and  evening  air  should  be  sedulously  avoided. 

Pleurisy. —  Inflammation  of  the  lining  membrane  of  the  chest  re- 
quires the  same  attention  to  diet  and  regimen  during  convalescence 


(uires  more 
the  symp- 
lost  hy  at- 
Should  the 
ollowc'd  hy 
urrouce  of 
ctest  adhe- 
the  impor- 
ed  for  the 
<y  must  ho 
lued;  and 

require,  as 
It.  When 
ion  of  the 
mplete  re- 
ora  inflam- 
exciteiuent 
exertions 
kept  per- 
ment ;  and 
ily  be  mild 

II  convales- 
ely,  quiet, 
nuch  light, 
y  excitable 


cence  from 
latient  sits 
nts  of  air ; 
ty  for  con- 
n  in  bed, 
naina  even 
Id  be  pre- 
>n  that  can 
iesQiiption 
jing  reple- 
•mitted  by 
d  nor  vio- 

9  chest  re- 
valescence 


lX)ME8nO  MANAGEMENT  OF  THE   SICK-BOOM. 


575 


as  the  last-mentioned  disease,  except  that  a  greater  strictness  with 
regard  to  abstemiousness  in  food  is  requisite ;  the  least  deviation 
being  likely  to  bring  on  a  renewal  of  the  inflammation.  When  the 
disease  assumes  a  chronic  character,  and  when  the  object  is  to  remove 
fluid  efl'used  into  the  cavity  of  the  chest,  and  pressing  upon  the  lungs 
so  as  to  circumscribe  their  action,  the  same  degree  of  strictness  with 
respect  to  diet  is  not  necessary  ;  but,  as  in  this  condition  of  the  habit 
the  physician  must  continue  his  attendance,  the  regulation  of  the  diet 
devolves  upon  him. 

Ang;ina.  —  In  that  condition  of  the  habit  which  is  connected  with 
a  predisposition  to  gout,  but  in  which,  instead  of  a  regular  paroxysm, 
the  heart  and  the  pulmonary  organs  become  affected,  and  the  disease 
assumes  that  form  which  has  been  denominated  diaphragmatic  gout 
[Angina pectoris) ,  the  regulation  of  diet  is  of  vital  importance  ;  and 
it  should  be  of  as  low  a  standard  as  the  constitutional  powers  will 
admit.  It  should  not  bo  of  a  description  either  to  nourish  much,  or 
to  augment  or  to  cause  fulness  of  habit :  mild  animal  food,  in  mod- 
crate  quantity,  may  be  allowed  ;  but  the  staple  should  be  of  a  farina- 
ceous kind  ;  every  stimulant,  whether  solid  or  fluid,  should  be  avoided  ; 
and  wine  and  malt  liquors  regarded  as  poisons.  The  invalid  himself 
should  be  made  aware,  that  whatever  tends  to  excite  or  to  hurry  the 
circulation  is  calculated  to  bring  on  a  paroxysm  ;  nor  is  it  suflicient 
that  he  avoids  all  stimulating  viands  and  beverages  ;  he  should  also 
be  instructed  that  the  same  deleterious  eflfects  are  likely  to  follow  a 
full  meal,  even  of  the  most  proper  and  mildest  food. 

The  same  attention  to  diet,  both  as  regards  quantity  and  quality,  is 
essential  in  palpitations  depending  on  organic  disease  of  the  haart. 

Astlima.  —  In  no  aflfectiun  of  the  chest  is  attention  to  diet  so  impor- 
tant as  in  asthma.  Sir  John  Floyer,  who  himself  suffered  from  the 
disease,  recommends  almost  a  degree  of  abstinence ;  which  is  correct 
in  reference  to  quantity  ;  but  the  diet,  although  of  a  light,  yet  should 
be  of  a  solid,  kind.  This  is  especially  necessary,  when  dyspepsia  is 
present  to  aggravate  and  excite  the  disease  of  the  lungs. 

In  Hooping-cough,  the  diet,  whether  the  patient  be  an  adult  or  a 
child,  should  be  of  the  mildest  description ;  and,  perhaps,  no  nutri- 
ment is  so  well  adapted  to  support  the  tone  of  the  body,  without 
exciting  it,  as  milk.  In  infancy,  nothing  but  the  breast  should  be 
given ;  the  system  of  the  nurse,  at  the  same  time,  being  kept  as  cool 
as  possible  by  mild  diet,  and  her  mind  in  a  tranquil  state.  If  convul- 
sions occur,  these  sometimes  depend  on  the  nature  of  the  milk  ;  in 
which  case  the  nurse  should  be  changed.  It  is  still  customary  with 
non-professional  persons  to  consider  change  of  air  est  ential  in  hooping- 
cough  ;  but  it  is  only  after  the  malady  has  run  its  course,  and  conva- 
lescence is  progressing,  when  the  cough  remains  as  a  habit,  that 
change  of  air  is  really  beneflcial.  It  is  unnecessary  to  combat  tne 
absurd  opinion,  that  a  change  ev«n  to  a  worse  air  is  salutary. 


v- 


576 


DOMESTIC   MANAOEMKXT   OP  THE   8ICK-ROOU. 


Affections  of  the   Stomach  and  Bowels. 

Kuniovonaculeinflammalion  of  (he  stomach  rarely  occurs,  yet  there 
is  a  chronic  form  of  tliut  disease,  in  which,  during  its  actual  exisiunco, 
and  also  in  convalescence  from  it,  much  of  the  safety  of  the  invalid 
depends  upon  domestic  management.  Every  source  of  excitement 
should  bo  avoided  ;  the  sick-room  should  be  airy,  and  its  temperature 
that  of  summer.  Tiie  food  should  be  of  the  blandest  kind,  given 
cold,  or  iced,  and  in  small  quantity  :  even  when  the  convalescence  is 
established,  the  diet  should  consist  of  farina*'  us  matters,  mixed  with 
small  quantities  of  beef-tea,  or  weak  broths ;  and  this  severe  diet 
should  be  persisted  m  for  a  considerable  time  after  recovery. 

Enteritis.  —  "When  inflammatory  action  extends  to,  or  exclusively 
exists  in,  the  mucous  lining  of  the  bowels,  constituting  this  disease, 
the  diet,  during  the  early  stage  of  it,  should  be  confined  to  cold  water, 
or  iced  almond-emulsion  ;  after  which,  milk  and  barley-water,  or  weak 
chicken  or  veal-tea,  may  be  given  in  small  quantities  ;  namely,  two  or 
three  tablespoonfuls,  at  intervals  of  three  or  four  hours.  Nothing 
stronger  should  bo  ventured  upon,  unless  expressly  ordered  by  the 
medical  attendant. 

Atonic  Dyspepsia,  ot  simple  indigestion. — During  the  attack,  absti- 
nence, to  a  certain  degree,  is  necessary  ;  but,  if  this  is  not  essential,  the 
diet  should  be  somewhat  stimulant,  but  simple;  namely,  a  small  cup 
of  moderately  strong  coffee,  with  little  sugar  or  milk ;  or  beef-tea, 
with  a  small  quantity  of  dry  toast ;  and,  as  the  stomach  begins  to 
retain  its  tone,  a  little  animal  food  of  easy  digestion,  such  as  mutton 
or  poultry. 

During  the  intervals  of  the  paroxysms  of  indigestion,  attention  to 
diet  is  of  the  first  importance.  As  a  general  rule,  the  patient  should 
be  confined  to  a  spare  animal  diet,  with  a  moderate  sha'^e  of  well- 
boiled  vegetables,  and  a  considerable  restriction  with  respect  to  the 
use  of  fluids. 

Dysentery,  which  implies  inflp-nmation,  acute  or  chronic,  of  the 
same  membrane  as  in  enteritis,  out  confined  to  the  larger  and  lower 
bowels,  requires  the  diet  to  consist  of  the  mildest  farinaceous  matters, 
strictly  avoiding  all  solid  animal  food.  It  should  be  given  in  small 
quantity  at  a  time,  and  the  whole  allowance  for  the  day  should  be 
moderate.  The  farinaceous  food  should  not  be  either  solid,  nor  yet 
altogether  fluid ;  the  former  may  prove  injurious  as  a  mechanical  irri- 
tant ;  the  latter  Is  apt  to  excite  griping,  from  the  extrication  of  much 
flatus. 

Diarrheea. —  Much  of  the  domestic,  as  well  as  the  medical  manage- 
ment of  diarrhoia  depends  on  the  nature  of  the  attack,  and  its  causes ; 
but  too  much  attention  cannot  be  paid  to  the  regulation  of  the  diet. 
It  should  be  both  small  in  quantity,  and  mild  in  quality.  In  the  early 
stage,  and  the  acute  form  of  the  disease,  barley-water,  arrow-root, 
made  with  water,  rice  or  grit  gruel,  and  light  broths,  are  proper.     In 


DOMESTIC  MANAGEMENT  OF  THE  SICK-ROOM. 


5i: 


«rels. 

i,  yet  there 
exisLenco, 
the  invalid 
excitement 
smpcraturo 
:iiid,  given 
lesconce  is 
nixed  with 
cvero  diet 

sxclusively 
Is  disease, 
!old  water, 
;r,  or  weak 
ely,  two  or 
Nothing 
red  by  the 

ack,  absti- 
iential,  the 

small  cup 
r  beef-tea, 

begins  to 
as  mutton 

ttention  to 
ent  should 
■e  of  well- 
ect  to  the 


chronic  diarrhoea,  rice,  properly  boiled,  and  mixed  with  a  small  quan- 
tity of  beef-tea,  forms  an  excellent  diet,  as  it  nourishes  m^^derately, 
and  leaves  scarcely  any  feculent  matter  behind  it 

In  Cholera,  convalescence  is  often  tedious  ;  and  nothing  is  so  likely 
to  cause  relapae  as  even  slight  irregularities  of  diet.  For  weeks  after 
the  feverish  symptoms  have  disappeared,  the  diet  should  consist  of  a 
rery  moderate  quantity  of  vegetable  matter  only.  The  feet  should 
be  kept  especially  warm,  and  the  whole  body  clothed  in  flannel,  to 
prevent  that  irregular  distribution  of  blood  which  so  strongly  charac- 
terizes the  disease. 

After  inflammation  of  the  lininp  membrane  of  the  cavity  of  the 
belly  (peritonitis)  has  been  subdued,  the  invalid  should  still  observe 
the  strictest  diet  and  regimen.  He  should  return  very  gradually  to 
the  use  of  animal  food  and  wine.  The  bowels  should  be  moderately 
and  daily  opened,  the  feet  kept  warm,  and  the  skin  maintained  in  a 
healthy  condition  by  wearing  flannel  next  to  it,  for  a  very  considerable 
time  aiter  every  trace  of  the  disease  has  disappeared. 

Diseases  of  the  Liver. — In  all  cases  of  recovery  from  these  diseases, 
whether  inflammatory  or  otherwise,  every  precaution  should  be  taken 
to  guard  against  the  deleterious  influence  of  alternations  of  tempera- 
ture and  also  of  damp,  by  clothing  in  flannel  next  the  skin.  Errors  in 
diet  should  be  avoided  ;  and  fermented  liquors  and  stimulating  bever- 
age of  every  kind,  refrained  from.  When  pains  of  the  side  continue, 
after  all  the  other  symptoms  of  the  disease  have  disappeared,  the 
introduction  of  a  seton,  if  prescribed,  should  not  be  objected  to ;  as 
th«  greatest  benefit  has  often  followed  that  mode  of  counter  irritatieo. 

73 


■    '''"'■■  '  '"^J 


'■Si 


lie,  of  the 
and  lower 
s  matters, 
n  in  small 
should  be 
i,  nor  yet 
inical  irri- 
n  of  much 


'/■cm 


m 


il  manage- 
ts  causes ; 
'  the  diet. 
1  the  early 
rrow-root, 
opcr.     In 


1-.* 


COOKERY  FOR  THE   SICK-ROOM. 


It  was  said  by  the  distinguished  Dr.  Rush,  in  his  lectures  before  hia 
class,  that  a  physician  ought  to  spend  six  months  in  a  kitchen  before 
beginning  practice.  A  Itnowledge  of  dietetic  preparations  fitted  for 
the  sick,  and  for  those  recovering  from  disease,  however  apparently 
unimportant,  adds  much  to  a  physician's  power  over  his  patient,  and 
to  his  popularity  and  usefulness. 

In  giving  nourishment  to  the  sick,  who  are  suffering  from  low  dis. 
eases,  it  is  an  important  rule  which  should  never  be  forgotten,  to  give 
but  little  at  a  time,  and  to  repeat  that  often.  In  cases  of  great  prostra- 
tion from  disease,  life  may  at  times  be  endangered  by  a  delay  in  giv- 
ing nourishment  of  even  a  few  minutes  beyond  the  proper  time. 

Barley-Water. 

Peasl  barley,  two  ounces  ;  boiling  water,  two  quarts.  Boil  to  one 
half,  and  strain.  A  little  lemon  juice  and  sugar  may  be  added,  if 
desirable.     To  be  taken  freely  in  inflammatory  diseases. 

Rice-Water. 

Rice,  two  ounces ;  water,  two  quarts.  Boil  an  hour  and  a  half, 
and  add  sugar  and  nutmeg. 

Rice,  when  boiled  for  a  considerable  time,  becomes  a  kind  of  jelly, 
and,  mixed  with  milk,  is  a  very  excellent  diet  for  children.  It  has  in 
some  measure  a  constipating  property,  which  may  be  increased  by 
boiling  the  milk. 

Decoction  of  Bran. 

New  wheat  bran,  one  pint ;  water,  three  quarts.  Boil  down  on© 
third,  strain  off  the  liquor,  and  add  sugar,  honey,  or  molasses,  accord- 
ing to  the  taste  of  the  patient.  A  bran  tea  may  be  made  by  using 
boiling  water,  and  suffering  the  mixture  to  stand  in  a  covered  vessel 
for  three  or  four  hours. 

Sage  Tea. 

Dried  leaves  of  sage,  half  an  ounce  ;  boiling  water,  one  quart  In- 
fuse for  half  an  hour,  and  strain.     Add  sugar  and  lemon  juice  as 


I  before  hia 
hen  before 
3  fitted  for 
apparently 
atient,  and 

<m  low  dis. 
en,  to  give 
at  prostra- 
jlay  in  giv- 
time. 


Boil  to  one 
;  added,  if 


md  a  half, 

nd  of  jelly, 

It  has  in 

creased  by 


down  on© 
jes,  accord- 
B  by  using 
ered  vessel 


quart     In* 
>n  juice  aa 


COOKERY  FOR  THE  SICK-ROOM. 


67i> 


required  by  the  patient     Balm  and  other  teas  are  made  in  the  same 
manner. 

The  above  infusions  form  agreeable  and  useful  drinks  in  fevers,  and 
their  diaphoretic  powers  may  be  increased  by  adding  a  little  sweet 
spirits  of  nitre. 

Barley  Coffee. 

Roast  one  pint  of  common  barley  in  the  same  way  in  which  coffee 
is  roasted.  Add  two  large  spoonfuls  of  this  to  a  quart  of  boiling 
water ;  boil  five  minutes.     Add  a  little  sugar. 

Lemon-Water. 

Put  two  slices  of  lemon,  thinly  pared,  into  a  teapot,  a  little  bit  of  the 
peel  and  a  bit  of  sugar.  Pour  in  a  pint  of  boiling  water,  and  cover  it 
close  two  hours. 

A  Refreshing  Drink  in  Fevers. 

Put  a  little  sage,  two  pprigs  of  balm,  and  a  little  sorrel  into  a  stone 
jug,  having  first  washed  and  dried  them.  Peel  thin  a  small  lemon, 
i<lice  it,  and  put  a  small  piece  of  the  peel  in ;  then  pour  in  three  pints 
of  boiling  water.     Sweeten,  and  cover  it  close. 

Another. 

Boil  an  ounce  and  a  half  of  tamarinds,  three  ounces  of  cran- 
berries, and  two  ounces  of  stoned  raisins,  in  three  pints  of  water,  till 
the  water  is  reduced  to  two  pints.  Strain,  and  add  a  bit  of  lemon 
peel,  which  must  be  removed  in  an  hour,  as  it  gives  a  bitter  taste  if 
left  too  long. 

A  Very  Pleasant  Drink. 

Put  a  teacupful  of  cranberries  into  a  cup  of  water,  and  mash  them. 
In  the  mean  time,  boil  two  quarts  of  water  with  one  large  spoonful 
of  corn  or  oat  meal  and  a  bit  of  lemon  peel;  then  add  the  cranberries. 
As  much  fine  sugar  as  shall  leave  a  smart  flavor  of  the  fruit,  and  a 
wineglassful  of  sherry.  Boil  the  whole  gently  for  fifteen  mini-ites, 
and  strain. 

Crust  Coffee. 

Toast  slowly  one  or  two  slices  of  brown  or  white  bread,  pour  boil, 
ing  water  over  it,  and  drink  hot  or  cold,  according  to  preference. 

Infusion  of  Malt. 

To  one  pint  of  ground  malt  add  three  pints  of  scalding  water,  that 
is,  water  not  quite  brought  to  the  boiling  point;  infuse  two  hours, 


•■  J    \ 


•J 


•I 


61) 


COOKERY  FOR  THE  SICK-ROOM. 


niul  strain.     Add  sugar  or  lemon  juice  aa  desired.     An  excellent  pre< 
paration  in  inflammatory  fevers. 

Lemonade. 

Fresh  lemon  juice,  four  ounces  ;  thin  peel  of  lemon,  half  an  ounce; 
white  sugar,  four  ounces  ;  boiling  water,  three  pints.  Let  them  stand 
until  cold,  and  strain.  When  used  in  fevers,  a  little  nitrate  of  potash 
or  sweet  spirits  of  nitre  may  be  added.  It  may  be  further  diluted  to 
the  taste  of  the  patient. 

Water  Oruel. 

Oat  or  corn  meal,  two  tablespoonfuls ;  water,  one  quart.  Boil  for 
ten  or  fifteen  minutes,  and  strain,  adding  salt,  and  sugar  if  desired  by 
the  patient. 

Milk  for  Infants. 

Cows'  milk,  one  part ;  water,  two  parts  ;  sweeten  slightly  with  loaf 
sugar. 

It  is  necessary  when  children  are  to  be  raised  by  hand  to  dilute  the 
milk.  The  above  proportions  may  be  altered  as  the  child  advances 
in  age. 

Rice  Gruel. 

Ground  rice,  one  heaping  tablespoonful ;  ground  cinnamon,  one 
teaapoonful;  water,  one  quart.  Boil  gently  for  twenty  minutes,  add- 
ing the  cinnamon  near  the  conclusion.  Strain  and  sweeten.  Wine 
may  be  added  in  some  cases. 

Panada. 

White  bread,  one  ounce;  ground  cinnamon,  one  teaspoonful; 
water,  one  pint.  Boil  them  until  well  mixed,  and  add  a  little  sugar 
and  nutmeg.     Wine  or  butter  may  also  be  added,  if  desirable. 

Compound  Salep  Powders. 

Salep,  tragacanth,  and  sago,  each  four  ounces ;  cochineal,  half  a 
dram  ;  prepared  oyster  shells,  one  ounce.  Mix,  and  divide  into  pow- 
ders of  one  dram  each.  Stir  one  of  these  powders  into  a  pint  of 
milk,  and  boil  for  ten  or  fifteen  minutes.  To  be  drunk  freely  in  diar- 
rhoea and  dysentery. 

Another. 

Gum  arabic,  tragacanth,  maranta,  sago,  tapioca,  each  two  drams. 
Mix  them  well  together,  and  boil  in  a  pint  of  milk,  flavored  with  nut- 
meg or  cinnamon.     To  be  used  as  a  diet  in  dysentery,  diarrhoea,  etc. 


COOKERY  FOR  THE  SICKROOM. 


6H1 


llent  pre* 


[em  stand 
of  potash 
diluted  to 


Boil  for 
lesired  by 


with  loaf 

dilute  the 
advances 


[.mon,  one 
;ute8,  add- 
n.    Wine 


Lspoonful ; 
ittle  sugar 
)le. 


Sago  Oruel. 

Sago,  two  tablespoonfuls ;  water,  one  pint  Boil  gently  until  it 
thickens,  frequently  stirring.  Wine,  sugar,  and  nutmeg,  may  b« 
addedi  according  to  circumstances. 

Arrow-Root  Gruel. 

Arrow-root,  one  tableapoonful ;  sweet  milk,  half  a  pint ;  boiling 
water,  half  a  pint.     To  be  sweetened  with  loaf  sugar.     Excellent  ali 
raent  for  children  when  the  bowels  are  irritable. 


Tapioca  Jelly. 

Tapioca,  two  tablespoonfuls ;  water,  one  pint.  Boil  gently  for  an 
hour,  or  until  it  assumes  a  jelly-like  appearance.  Add  sugar,  wine, 
and  nutmeg,  with  lemon  juice  to  suit  the  taste  of  the  patient,  and  the 
nature  of  the  case. 

Jelly  of  Irish  Moss. 

Irish  moss,  half  an  ounce ;  fresh  milk,  a  pint  and  a  half.  Boil 
down  to  a  pint.  Femove  any  sediment  by  straining,  and  add  the 
proper  quantity  of  sugar  and  lemon  juice,  or  peach  water,  to  give  it 
an  agreeable  flavor. 

Isinglass  Jelly. 

Isinglass,  one  roll.  Boil  in  one  pint  of  water  until  it  is  dissolved. 
Strain,  and  add  one  pint  of  sweet  milk.  Put  it  again  over  the  fire, 
and  let  it  just  boil  up.  Sweeten  with  loaf  sugar,  and  grate  nutmeg 
upon  it.     When  properly  made,  it  resembles  custard. 

This  forms  an  excellent  diet  for  persons  recovering  from  sickness, 
and  is  well  adapted  to  the  bowel  complaints  of  children. 


;al,  half  a 
into  pow- 
a  pint  of 
ly  in  diar- 


^o  drams. 
I  with  nut- 
hcea,  etc. 


Apple  Water. 

Cut  two  large  apples  in  slices,  and  pour  a  quart  of  boiling  water 
on  them.  Or,  pour  the  same  amount  of  water  on  roasted  apples.  In 
two  or  three  hours,  strain  and  sweeten  slightly. 

Milk  Porridge. 

Wheat  flour,  corn  meal,  or  oatmeal,  two  tablespoonfuls ;  milk,  one 
pint;  water,  one  pint.  Mix  the  flour  or  meal  with  cold  water,  to 
form  a  thin  paste ;  put  the  milk  and  water  over  the  fire,  and  when 
they  come  to  the  boiling  point,  add  the  paste,  carefully  stirring. 


i 


I 


Siii 


582 


roOKKUY  FOH  THE  SICKROOM. 


French  Milk  Porridge. 

Stir  somo  oatrnt'iil  and  water  together ;  lot  the  mixture  stand  to 
clear,  and  pour  oti'  the  waU'r.  Then  put  more  water  to  the  meal,  stir 
it  well,  and  let  it  stand  till  the  next  day.  Strain  through  a  fine  sieve, 
and  boil  the  water,  adding  milk  while  so  doing.  The  proportion  of 
water  must  be  small.  With  toast,  this  is  a  good  preparation  foC 
weak  persons. 

Ground-Rice  Milk. 

Boil  one  spoonful  of  good  rice,  rubbed  down  smooth,  with  a  pint 
and  a  half  of  milk,  a  little  cinnamon,  lemon  peel,  and  nutmeg 
Sweeten  when  nearly  done. 

Boiled  Flour. 

Tie  up  as  tight  as  possible,  in  a  linen  cloth,  one  pound  of  flour; 
and,  after  frequently  dipping  it  in  cold  water,  dredge  the  outside  with 
flour  till  a  crust  is  formed  round  it,  which  will  prevent  the  water  from 
soaking  into  it  while  boiling.  Place  it  in  water  and  boil  until  it  be- 
comes a  hard,  dry  mass. 

Two  or  three  spoonfuls  of  this  may  be  grated,  and  prepared  in  the 
same  manner  as  arrow-root  gruel,  for  which  it  is  an  excellent  substi* 
tute. 

Vegetable  Soup. 

Take  one  turnip,  one  potatoe,  and  one  onion,  let  them  be  sliced 
and  boiled  in  one  quart  of  water  for  an  hour.  Add  as  much  salt  as 
is  agreeable,  and  pour  the  whole  upon  a  piece  of  dry  toast. 

This  forms  an  agreeable  substitute  for  animal  food,  ard  may  be 
given  when  the  latter  is  inadmissible. 

Beef  Tea. 

Lean  beef,  cut  into  shreds,  one  pound ;  water,  one  quart.  Boil  for 
twenty  minutes,  taking  off"  the  scum  as  it  rises.  When  it  grows  cold, 
■train. 

Essence  of  Beef. 

Lean  beef  sliced.  Put  a  sufficient  quantity  into  a  porter  bottle  to 
fill  up  its  body,  cork  it  loosely,  and  place  it  in  a  pot  of  cold  water, 
attaching  the  neck,  by  mean^.of  a  string,  to  the  handle  of  the  vessel. 
Boil  this  for  an  hour  and  a 'half  or  two  hours ;  then  pour  off  the 
liquor  and  skim  it. 

To  this  preparation  may  be  added  spices,  salt,  wine,  brandy,  eta, 
according  to  the  taste  of  the  patient,  and  nature  of  the  disease. 


COOKKUY  FOU  TIIK  HICKUOOM. 


58y 


Calfs-feet  Jelly. 

Take  two  calf's  feet,  and  add  to  them  one  gallon  of  water.  Boil 
down  to  one  quart.  Strain,  and  when  eold,  »kim  off  the  fat.  Add 
to  this  tlie  white  of  six  or  fight  eggs  well  beaten,  a  pint  of  wine,  half 
a  pound  of  loaf  sugar,  and  the  juice  of  four  leinouH,  and  let  them  bo 
well  mixed.  Boil  the  whole  for  a  few  minutes,  stirring  constantly, 
and  then  pass  it  through  a  flannel  strainer. 

This  forms  a  very  nutritious  article  of  diet  for  the  sick,  and  for 
those  recovering  from  disease.  The  wine  may  bo  omitted  or  added, 
according  to  choice. 

Chicken  Water. 

Take  half  a  chicken,  divested  of  all  fat,  and  break  the  bones ;  add 
to  this  half  a  gallon  of  water,  and  boil  for  half  an  hour.  Season 
mith  salt 

Suet  Ptisan. 

Sheep's  suet,  two  ounces;  milk,  one  pint;  starch,  half  an  ounce. 
Boil  slowly  for  half  an  hour.  This  may  be  used  as  a  common  drink 
in  dysentery. 

Rennet  Whey. 

New  milk,  one  quart;  rennet,  a  large  spoonful.  Heat  the  milk,  and 
then  add  the  rennet.  Boil  until  the  curd  separates,  which  is  to  be 
taken  off.     To  many  persons,  this  forma  an  agreeable  nutriment 

Vinegar  Whey. 

Milk,  one  pint ;  vinegar,  one  tablespoonful.  Boil  for  a  few  min< 
utes,  and  separate  the  curd. 

Tartar  Whey. 

Milk,  one  quart;  cream  of  tartar,  one  dessert  spoonful.  Boil,  and 
separate  the  curd. 

Mustard  Whey. 

Bruised  mustard-seed,  one  tablespoonful ;  milk,  one  pint.  Boil 
together  for  a  few  minutes,  and  separate  the  curd. 

This  has  been  found  a  useful  drink  in  dropsy.  A  teacupfui  may 
be  taken  at  a  time. 

Alum  Whey. 

Alum,  one  teaspoonful ;  milk,  one  pint.  Boil  together,  and  strain, 
to  separate  the  curd. 


I-  - 


584 


COOKEKV  FOR  THE  8ICK-U00M. 


Oiange  Whej. 

Mn,K,  one  pint ;  tho  juice  of  an  orange  with  a  portion  of  the  peol. 
Boil  the  milk  ;  then  put  the  orange  to  it,  and  let  it  stand  till  coagulu- 
tion  takes  place.     Strain. 

Sweet  Whey. 

8kimmf.d  milk,  two  quarts  ;  a  piece  of  prepared  calf's  rennet  Miii, 
and  put  in  a  warm  place  till  coagulation  takes  place ;  then  strain. 

Whey  with  Tamarinds. 

Milk,  boiling,  one  pint;  tamarinds,  two  ounces.  Boil  them  to> 
gether  till  coagulation  takes  place. 

Wine  Whey. 

Milk,  two  thirds  of  a  pint ;  water,  one  third  of  a  pint ;  Madeira, 
or  other  wine,  one  gill ;  sugar,  one  dessert  spoonful.  Place  the  uiilk 
and  water  together  in  a  deep  pan  on  the  fire,  and  at  the  moment 
when  it  begins  to  boil,  pour  in  the  wine  and  the  sugar,  stirring  assidu- 
ously whilst  it  boils,  for  twelve  or  fifteen  minutes.  Laoily,  strain 
through  a  sieve.  This  is  excellent  in  all  forms  of  fever,  given  in 
small  quantities.  It  may  be  drunk  either  cold  or  tepid,  a  wineglassful 
at  a  time. 

Milk  and  Soda  Water. 

Heat  nearly  to  boiling,  a  teacupful  of  milk ;  dissolve  in  it,  a  tea- 
spoonful  of  refined  sugar;  put  this  into  a  large  tumbler,  and  fill  with 
soda  water.  This  is  an  excellent  mode  of  taking  milk  when  the 
stomach  is  charged  with  acid,  and  is  oppressed  by  milk  alone. 


:i 


Sippets. 

On  an  extremely  hot  plate,  put  two  or  three  slices  of  bread,  and 
pour  over  them  some  of  the  juices  of  boiled  beef,  mutton,  or  veal,  if 
there  be  no  butter  in  the  dish.     Sprinkle  over  them  a  little  salt 


Restoratiye. 

Take  two  calf's  feet,  one  quart  of  water,  and  one  quart  of  new 
milk ;  place  all  in  a  close-covered  jar,  and  bake  three  hours  and  a 
half.  When  cold,  remove  the  fat  Any  desired  flavor  may  be  given, 
by  adding  lemon-peel,  cinnamon,  or  maoe,  while  baking.  Add  sugar 
afterwards. 


COOKKRY  FOR  TIIK  SICKROOM. 


086 


Coffee  Milk. 

Boil,  ft  dpHsertspoonful  of  ground  coffee  in  nonrly  a  pint  of  milk,  for 
a  quarter  of  an  hour,  then  put  into  it  a  shaving  of  iKinghiHS,  and  clear 
it.  Let  it  boil  a  few  minutes,  and  set  it  beside  the  tire  to  clarify, 
bwecten  with  loaf  sugar. 

Nutritive  Fluid. 

Take  two  teaspoonfuls  of  lump  magnesia,  one  teaspooiifnl  of  sal- 
eratus,  one  teaspoonful  of  salt,  two  teaspoonf.ils  of  flour,  h;iif  a  [  1  '.t 
of  milk,  and  one  pint  of  water.  Put  the  milk  and  water  united  ovei 
the  tire,  and  rub  up  the  flour  with  a  little  cold  water  v)  make  a  thii: 
paste.  Just  when  the  milk  and  water  begin  to  boil,  stir  in  the  paste. 
This  will  make  a  thin  porridge,  which  should  boil  about  five  minutes. 
At  the  end  of  this  time,  remove  from  the  fire,  and  pour  into  a  pitcher. 
Now  add  the  magnesia,  pulverized,  and  mixed  with  the  saleratus  and 
Bait.     Sweeten  to  suit  the  taste. 

This  may  be  drank  freely,  several  times  a  day,  so  as  to  produce  two 
evacuations  of  the  bowels  in  twenty-four  hours,  in  those  cases  of  dys- 
pepsia attended  by  acidity  of  the  stomach,  and  in  many  debilitated 
conditions  of  the  system  in  which  there  is  a  tendency  to  loss  of  flesh. 

This  is  one  of  the  leading  fluids  used  by  those  who  pursue  what  is 
called  the  ^^  Nutritive  System"  of  treating  disease,  and  is  really  a  val- 
Qable  preparation,  iiaving  the  effect  often  to  increase  the  flesh,  even 
while  it  acts  as  a  cathartia 


■^  : 


MEDICINES  AND  THEIR  PREPARATIONS. 


Materia  Medica. 

That  department  of  medicine  which  treats  of  remedies,  their  doses, 
modes  of  using,  and  influences  upon  the  constitution,  is  called  materia 
medica.  The  agents  employed  in  the  treatment  of  disease  are  taken 
from  three  kingdoms  of  nature,  —  the  vegetable,  the  animal,  and  the 
mineral. 

The  largest  portion  of  medicinal  substances  are  taken  from  the 
vegetable  world.  They  consist  of  leaves,  flowers,  seeds,  barks,  and 
roots.  These  lose  much  or  all  of  their  medicinal  powers  unless  gath- 
ered at  the  right  seasons  of  the  year,  and  are  properly  curea.  The 
different  parts  of  a  plant  are  to  be  gathered  when  their  peculiar  juices 
are  most  abundant  in  them. 

Tlie  Roots  of  Annual  Plants  are  best  supplied  with  their  juices  be- 
fore they  are  in  flower ;  they  should  be  gathered  at  this  time. 

The  Roots  of  Biennial  Plants  should  be  gathered  in  the  autumn, 
after  their  first  year's  gi-owth. 

The  Roots  of  Perennial  Plants  should  be  gathered  in  the  spring, 
before  vegetation  has  begun. 

Before  they  are  dried,  the  solid  parts  of  these  roots  are  to  be  cut  in 
slices,  after  being  washed,  and  the  small  fibres,  unless  they  are  the 
parts  used,  are  to  be  thrown  away. 

Bulbous  Roots  are  to  be  gathered  at  the  time  their  leaves  decay. 
Their  outer  covering  being  rejected,  they  must  be  sliced,  strung  upon 
threads,  and  hung  in  a  warm,  airy  room  to  dry.  After  being  dried, 
roots  shoula  be  packed  in  barrels  or  boxes,  and  kept  as  free  as  possi« 
ble  from  moisture. 

Barks,  whether  of  the  roots,  trunk,  or  branches,  must  be  gathered 
in  autumn,  or  early  in  the  spring,  when  they  peel  off  most  easily,  and 
the  dead  outside  and  all  rotten  parts  being  separated,  they  must  be 
dried  in  the  same  manner  as  roots.  The  most  active  barks  are  gen- 
erally from  young  trees. 

Leaves  are  to  be  gathered  when  they  are  full  grown,  and  just  before 
the  fading  of  the  flower. 


beir  doses, 

:d  materia 

are  taken 

il,  and  the 

from  the 
jarks,  and 
iless  gath- 
red.  The 
diar  juices 

juices  be- 

;  autumn, 

he  spring, 

I  be  cut  in 

!y  are  the 

ms  decay, 
•ung  upon 
ing  dried, 
i  as  possi* 

!  gathered 
iasily,  and 
f  must  be 
8  are  gen- 

ust  before 


MEDICINES  AND  THEIR  PREPARATIONS. 


587 


Those  of  biennial  plants  are  not  to  be  collected  until  the  second 
year.  For  drying,  they  should  be  thinly  spread  on  the  floor  of  a 
room  through  which  a  current  of  air  passes.  For  preservation,  they 
should  be  packed  in  vessels,  and  kept  free  from  moisture,  and  insecta. 

Flowers  must  generally  be  collected  about  the  time  of  their  open- 
ing,—  either  a  little  before,  or  just  after. 

They  should  be  dried  as  rapidly  as  possible,  but  not  in  the  sun,  and 
may  be  packed  away  in  the  same  manner  as  leaves. 

Fruits,  Berries,  etc.,  may  be  spread  thinly  upon  the  floor,  or  hung 
up  in  bunches  to  dry. 

Articles  to  Accompany  a  Medicine  Chest. 

As  the  author  intends  to  prepare  a  Medicine  Chest  to  accompany 
this  volume,  it  is  well  to  mention  the  following  articles  as  necessary 
to  be  had  with  it : 

1.  A  Spatula  for  mixing  ointments  and  pills,  and  for  spreading 
plasters. 

2.  A  piece  of  smooth  mavble  on  which  the  above  articles  may  be 
mixed,  divided,  and  spread. 

3.  A  glass  funnel. 

4.  A  domestic  syringe  for  injections. 

5.  Adhesive  or  sticking  plaster. 

6.  Lint. 

7.  Scales  and  weights. 

8.  A  glass  or  wedgewood  mortar  and  pestle. 

9.  A  graduated  wineglass  for  measuring  teaspoonfuls  and  table- 
spoonfuls  of  liquids. 

10.  A  minim  graduated  measure. 

11.  A  two-ounce  graduated  measure. 


9  Dnn 


Fio.  186. 


Mtnlm. 


3  Onnc». 


Fio.  187. 


3  Dnaa. 


M      IM  MEASUBB 


TWOOUNCS  MBASUBfc 


The  minim  measure  is  represented  by  Fig.  186,  and  contains  one 
fluid  dram,  or  sixty  miuims,  which  is  divided  by  twelve  lines,  —  each 
line  representing  five  minims.  A  minim  is  considered  about  equal  to 
one  and  a  half  drops. 


\ 


Uf-^ 


^■1 


■   -\^ 


1'^ 


"  .-,1 


'  .1 


588 


MEDICINES  AND  THEIR  PREPARATIONS. 


The  two  ounce  measure  ia  represented  by  Fig.  187,  and  is  divided 
off  from  half  a  dram  upward. 


ii 


a. a 


Doses,  Weights,  etc. 

Apothecary's  weights,  by  which  all  medicinal  preparations  ought 
to  be  weighed,  are  divided  into  pounds,  ounces,  scruples,  drams,  and 
grains. 

The  characters  marked  on  weights  and  graduated  measures,  are 
explained  as  follows : 


§j   one  ounce, 
f gj  one  fluid  ounce. 
§SB  half  an  ounce. 
3j    one  dram. 


f^  one  fluid  dram 
Sss  half  a  dram, 
gj    one  scruple. 
9ss  half  a  scruplei 


The  grain  weights  are  stamped  with  punch  marks. 


20  grains  make  one  scruple. 
8  scruples  make  one  dram. 
8  drams  make  one  ounce. 

By  apothecary's  weight : 

R>     The  pound  is  equal  to  12  ounces. 
S       "    ounce  "  8  drams. 

By  apothecary's  measure : 


5 

a 


60  drops  make  one  fluid-dram. 
8  drams  make  one  fluid-ounce. 
16  ounces  make  one  pint 


The  dram  is  equal  to  3  scruples. 
"    scruple       "     20  grains. 


0    The  pint  is  equal  to  sixteen  ounces. 

3        "    dram        "        ninety  drops,  or  sixty  minims. 

The  marks  and  words  used  by  physicians  and  apothecaries  may  be 
a  little  more  fully  explained  by  the  following  table  : 

"R  stands  for  recipe,  and  means  take. 

aa  stand  for  ana,  and  mean  of  each. 

fi>  stands  for  libra  vel  libree,  and  means  a  pound  or  pounds. 

S  stands  for  uncia  vel  unciae,  and  means  an  ounce  or  ounces. 

3  stands  for  drachma  vel  drachma,  and  means  a  dram  or  drams. 

Q  Stands  for  scrupulus  vel  tcrupuli,  and  means  a  scruple  or  scruples. 

O  stands  for  octarius  vel  octarii,  and  means  a  pint  or  pints. 

f  S  stands  for  Jluiduncia  vel  JluiduncioB,  and  means  a  fluid  ounce  or  fluid 
ounces. 

f  3  stands  for  fiuidrachma  vel  fiuidrachmee,  and  means  a  fluid  drachm  or  fluid 
drachms. 

m  stands  for  minimum  vel  minima,  and  means  a  minim  or  minims. 

Chart,  stands  for  chartula  vel  chartxtUe,  and  means  a  small  paper  or  papers. 

Coch.  stands  for  cochlear  vel  coc/Uearia,  and  means  a  spoonAil  or  spoonfuls. 

CoUyr.  stands  for  coUyrium,  and  means  an  eye-water. 

Cong,  stands  for  conguit  vel  conguii,  and  means  a  gallon  or  gallons. 

Decoct,  stands  for  decoctum,  and  means  a  decoction. 

■Fi.  stands  for  Jiat,  and  means  make. 


MEDICINES  AND  THEIR  PREPARATIONS. 


589 


9  divided 


ns  ought 
ams,  and 

lures,  are 


Garg.  stands  for  gargarytma,  and  means  a  gargle. 

Gr.  stands  for  granutn  vel  grana,  and  means  a  grain  or  grains. 

Gtt.  stands  for  gutta  vel  guttce,  and  means  a  drop  or  drops. 

Haust.  stands  for  haustus,  and  means  a  draught. 

Inftu.  stands  for  infusum,  and  means  an  infusion. 

M.  stands  for  misce,  and  means  mix. 

Mass,  stands  for  matta,  and  means  a  mass. 

Mist,  stands  for  mistura,  and  means  a  mixture. 

Pil.  stands  for  pilula  vel  pilulee,  and  means  a  pill  or  pills. 

Pulv.  stands  for  pulves  velpulveres,  and  means  a  powder  or  powders. 

Q.  S.  stands  for  quantum  sufficit,  and  means  a  sufficient  quantity. 

S.  stands  for  signa,  and  means  write. 

Ss.  stands  for  semis,  and  means  a  half. 

Domestic,  or  Approximate  Measm'es.  —  A  tablespoon  contains  aboul 
four  drams ;  a  teaspoon,  one  dram ;  a  dessertspoon,  three  drams ;  a 
wineglass,  two  ounces.  Spoons  vary  so  much  in  size,  that  they 
should  not  be  used  as  measures  in  giving  powerful  medicines. 


1-dram. 

d-ounce. 

It. 


scruples, 
grains. 


3  may  be 


p  papers, 
oonfuls. 


The  Approximate  Value  of  French  Decimal  Weights. 

One  centigramme  is  equal  to  J  grain. 

Two  ccntigra,mmes       "  J  grain. 

One  demi-decigramme  "  1  grain. 

One  decigramme  "  2  grains. 

One  gramme  "  18  grains. 

One  gramme  and  three  decigrammes  is  equal  to    1  scruple. 
Two  grammes  "  ^  drachm. 

Four  grammes  "  1  drachm. 

One  decagramme  is  equal  to  2  drachms  and  3G  grains. 
Three  decagrammes  and  two  grammes  is  equal  to  1  ounce. 
Demi-kilogramme  "  1  pound. 

Kilogramme  "  2  pounds. 

At  Paris,  the  scruple  is  equal  to  24  grains;  the  drachm,  to  72 
grains. 

Everywhere  else,  the  scruple  is  equal  to  20  grains ;  and  the  drachm, 
to  60  grp.ins. 

The  following  table  shows  the  relative  doses  for  young  people  of 
different  ages : 


The  dose  for  a  person  of  middle  age  being 
That  of  a  person  from  14  to  21  years  will  be 
"       7  to  14 


u 
u 
u 
u 
u 
u 


(( 
<( 
(( 
u 
u 


of 


4  to  7 

4 

3 

2 

1 


u 
« 

« 


<( 
(( 
u 

(( 


1  or  1  drachm. 
§  or  2  scruples. 
^  or  ^  draclim. 
^  or  1  scruple. 
J  or  15  grains. 
I  or  10  grains. 
J  or  8  grains, 
^j  or  5  grains. 


In  administering  medicines,  it  is  always  well  to  begin  with  the 
smallest  dose  mentioned  and  gradually  increase  until  the  desired  in- 
fluence is  produced. 


lei:  ■ 


iiaiiil 


m 


590 


MEDICINES  AND  THEIR  PREPARATIONS. 


Tinctures. 

Thr  prpparationa  called  tinctures  are  made  by  grinding  or  bruising 
the  roots,  leaves,  or  barks  used,  to  a  coarse  powder,  placing  it  in  the 
proper  amount  of  either  alcohol  or  diluted  alcohol,  letting  it  stand 
from  seven  to  fourteen  days, — shaking  each  day, — and,  fnially,  filter- 
ing through  pajHT.  A  large  proportion  of  tinctures  arc  made  by  tak- 
ing one  ounce  of  the  medicinal  substance  to  one  pint  of  tiie  spirit ;  and 
whenever  tinctures  are  spoken  of  in  this  Materia  Medica,  and  llie 
({uantities  are  not  named,  the  above  proportions  are  to  be  pr('suiiu<l. 
When  a  larger  proportion  of  the  medicine  is  to  be  used,  I  shall  simply 
indicate  the  proportions  in  the  fewest  words,  as  under  "Bla(;k  Cohosh, 
—  this  tincture,  four  ounces  to  the  pint  of  alcohol,"  meaning  thereby, 
that  the  tincture  is  made  by  using  four  ounces  of  the  root  to  the  pint 
of  alcohol.  Tilden  &  Co.'s  fluid  extracts,  which  are  the  most  reliable 
of  any  with  which  I  am  acquainted,  have  the  same  strength,  ounce 
for  ounce,  with  the  roots,  barks,  leaves,  etc.,  of  which  they  are  made. 
Tinctures  may  therefore  be  made  with  very  little  trouble,  by  substi- 
tuting, in  each  case,  the  same  number  of  ounces  of  their  (luid  extracts 
to  the  pint  of  alcohol,  which  I  name  of  the  gross  substance,  or,  when 
no  quantity  is  named,  one  ounce  to  the  pint. 

Infusions. 

Infusions  are  solutions  of  vegetable  medicines,  generally  obtained 
by  pouring  boiling  water  upon  the  substance,  and  letting  it  stand  till 
it  cools.  When  a  more  prolonged  application  of  heat  is  desired,  tlie 
vessel  may  stand  for  a  while  by  the  fire,  but  must  not  be  permitted  to 
boil.     The  vessel  should  usually  be  covered. 

As  in  the  case  of  tinctures,  I  have  uniformly,  while  writing  this 
Materia  Medica,  briefly  named  the  quantity  to  be  used  to  the  pint, 
whenever  it  varies  from  one  ounce. 

Acetic  Acirt. —  This  is  a  clear  liquid,  without  color,  and  has  a  strong, 
sour  taste,  and  an  agreeable  smell.  When  held  to  the  nose,  its  fine, 
pungent  odor  often  relieves  headache.  A  piece  of  cambric  wetted 
with  it  and  ap|)lied  to  the  skin,  excites  heat  and  redness,  and,  very 
soon,  a  blister,  —  for  which  this  acid  may  be  substituted  in  inflamma- 
tory sore  throat,  and  other  cases  requiring  speedy  action.  Applied  to 
corns  and  warts,  with  a  camel's-hair  brush,  it  destroys  them.  One 
part  to  seven  of  water,  makes  a  good  vinegar. 

Citric  Acid. — This  acid  is  extracted  from  lemon,  or  lime  juice;  it  is 
also  present  in  the  cranberry,  currant,  strawberry,  raspberry,  tamarind, 
and  is  very  abundant  in  the  red  elderberry.  It  is  refrigerant,  and  anti- 
septic, and  is  chiefly  employed  as  a  substitute  for  lemonade.  Nine 
and  a  half  drams  of  the  crystals,  two  drops  of  oil  of  lemon,  and  one 
pint  of  water,  answers  a  good  purpose,  in  place:  of  lemon-juice. 

Diluted  Mitric  Acid.  —  This,  in  the  undiluteJ  state,  passes  under  the 


MEDICINES  AND  THEIR  PREPARATIONS. 


591 


name  of  aqua-fortis.  It  is  tonic  and  antiseptic.  Largely  diluted  with 
water,  it  forms  a  good  drink  in  fevers,  especially  typhus.  Taken  in 
large  doses,  it  is  a  powerful  poison.  One  dram  of  this  preparation,, 
thirteen  ounces  of  soft  water,  and  one  ounce  of  simple  syrup,  make  a 
good  drink  in  fevers,  of  which  half  a  wineglass  to  a  winegiassful  is  a 
dose.     Excellent  in  cases  of  '"'•  ning-cough. 

Nitro-Nuriatic  Acid. —  This  acid,  when  properly  diluted,  has  a  tonic 
and  stimulant  influence.  It  is  much  used  as  a  foot-bath  in  affections 
of  the  liver,  and  in  deficient  secretions  of  the  bile. 

Diluted  Hydrochloric  Acid. — This  is  known  by  the  name  of  diluted 
muriatic  acid.  It  is  tonic,  antiseptic,  and  diuretic,  and  is  used  in 
typhus,  eruptions  of  the  skin,  and  with  other  articles,  as  a  gargle  in 
inflammatory  and  putrid  sore  throats.  Dose,  from  five  to  twenty 
drops,  in  a  winegiassful  of  water.  It  is  given  in  scarlet  and  typhoid 
fevers,  about  twenty  drops  being  put  into  a  bowl  of  barley-water  or 
gruel. 

Diluted  Ilydrocyiiiiic  Acid. — This  is  c./mmonly  known  by  the  name 
of  prussic  acid.  It  is  sedative  and  antispasmodic,  and  is  useful  in 
wpahiinodic  coughs,  asthma,  hooping  cough,  nervous  affections,  hic- 
cough, palpitation  of  tiie  heart,  irritable  stomach,  and  dyspepsia. 
Dose,  from  two  to  five  drops,  in  a  glass  of  water  or  tea  of  Peruvian 
bark. 

Diluted  Snlpliuric  Acid.  —  This  acid,  known  by  the  name  of  diluted 
oil  of  vitriol,  is  tonic,  antiseptic,  refrigerant,  and  astringent.  It  is 
useful  in  dyspepsia,  diabetes,  menorrhagia,  haemoptysis,  eruptions  of 
the  skin,  hectic,  and  diarrhoea.  It  is  often  given  with  some  bitter  in- 
fusions, as  cascarilla,  columbo,  peruvian  bark,  or  quassia.  The  aro- 
matic sulphuric  acid  is  often  used  in  place  of  it,  being  sometimes 
considered  more  grateful  to  the  taste.  Dose  of  each,  from  five  to 
fifteen  drops. 

Tannic  Acid.  —  This  is  an  astringent  preparation,  and  passes  under 
the  name  of  tannin.  It  is  prepared  from  galls.  It  is  used  in  diar- 
rha3a,  dysentery,  passive  hemorrhages,  and  diabetes.  Dose  of  the 
powder,  from  one  to  five  grains. 

Tartaric  Ac.  i.  —  This  is  refrigei^nt  and  antiseptic,  and  is  used  in 
inflammatory  affections,  fevers,  and  scurvy.  It  is  much  used  in  pre- 
paring what  is  called  lemon  syrup,  and  forms  an  agreeable  and  healtli- 
ful  drink. 

Alcoliol.  —  Alcohol  is  the  result  of  the  fermentation  of  the  juices  of 
many  vegetables.  It  is  the  intoxicating  constituent  in  whiskey,  rum, 
brandy,  gin,  wines,  porter,  ale,  beer,  and  cider.  Its  principal  use  in 
medicine  is  in  the  preparation  of  tinctures,  essences,  and  extracts. 
One  part  of  pure  alcohol,  to  one  part  of  water,  forms  the  diluted  alco- 
hol of  the  shops. 

Almonds. —  The  Amygdalus  Communis,  or  almond  tree,  grows  in  the 
south  of  Europe  and  Asia,  and  yields  the  sweet  and  bitter  almond. 


i  t 


592 


MEDICINES  AND  THEIR  PREPARATIONS. 


The  oil  of  the  sweet  almond  ia  used  as  a  demulcent,  in  coughs,  etc 
A  dose  is  a  teaspoonful.  The  oil  of  the  bitter  almond  is  poisonous, 
and  is  occasionally  used  as  a  valuable  sedative.  Its  taste  is  like  thai 
of  a  peach  kernel.  Dose,  from  a  quarter  of  a  drop  to  a  drop.  It 
owes  its  poisonous  properties  to  hydrocyanic  acid.  Cakes,  etc.,  are 
sometimes  flavored  with  an  essence  prepared  from  it 

llo«s<  —  This  is  the  hardened  juice  of  the  leaves  of  several  species 
of  the  aloe  tree,  in  North  and  South  Africa,  in  the  south  of  Europe, 
and  in  the  island  of  Socotra.  Aloes  is  purgative,  acting  chiefly  upon 
the  rectum,  or  lower  bowel,  in  which  it  frequently  produces  irritation, 
and  is  apt  to  aggravate  and  induce  piles.  It  is  much  used  to  excite 
the  flow  of  the  menses,  and  should  never  be  given  to  women  during 
pregnancy.  It  produces  "jriping  of  the  bowels,  which  may  be  dimin- 
ished by  combining  it  witii  soap,  or  carbonate  of  potash. 

Alum  (Alumen).  —  The  chemical  name  of  this  is  sulphate  of  alu- 
mina and  potassa.  In  ordinary  doses,  alum  is  astringent  and  anti- 
spasmodic. In  large  doses  it  is  purgative  and  emetic,  and  is  used 
both  externally  and  internally.  It  is  often  used  in  solution  as  a  gar- 
gle in  sore  throat,  and  falling  down  of  the  uvula,  and  as  an  injection 
in  leucorrtujea.  In  doses  of  thirty  or  forty  grains,  it  acts  as  a  purga- 
tive, and  used  in  this  way,  is  useful  in  painter's  colic.  When  exposed 
to  heat  in  a  vessel  till  it  ceases  to  boil,  it  becomes  dry,  and  is  then 
called  burnt  alum,  which,  when  pulverized,  is  applied  with  advantage 
to  canker  spots  in  the  mouth,  and  to  proud  flesh. 

American  Hellebore  {Veratrum  Viride).  —  This  plant  grows  in  many 
parts  of  the  United  States,  usually  in  swamps,  wet  meadows,  and  on 
the  banks  of  mountain  streamlets.  The  root  is  the  part  used.  It 's 
slightly  acrid,  alterative  in  a  marked  degree,  very  decidedly  and  ac- 
tively expectorant  and  diaphoretic,  and  it  is  an  excellent  nervine, 
though  not  narcotic.  But  its  most  marked  and  valuable  quality  — 
that  in  which  it  has  no  rival — is  its  sedative  action  upon  the  circula- 
tion. In  suitable  doses,  it  can  be  relied  upon  to  bring  the  pulse  down 
from  a  hundred  and  fifty  beats  in  a  minute  to  forty,  or  even  to  thirty. 
In  fevers,  therefore,  in  some  diseases  of  the  heart,  in  acute  rheuma- 
tism, and  in  many  other  conditions  which  invol  ■  an  excited  state  of 
tlie  circulation,  it  is  an  article  of  exceedingly  great  value,  because  it  is 
always  reliable.  It  has  recently  come  into  use  ;  and  I  doubt  whether 
80  valuable  a  contribution  has  been  made  to  our  list  of  medicines  in 
a  hundred  years. 

Preparations.  —  Veratrum  is  used  chiefly  in  the  form  of  tinctura^ 
six  ounces  to  the  pint  of  diluted  alcohol,  or  of  fluid  extract.  Tho 
dose  of  each  of  these  preparations,  for  a  grown  person,  is  three  or 
four  drops,  every  hour  or  two,  in  a  little  sweetened  water,  and  gradu- 
ally increased,  if  necessary,  till  the  pulse  comes  down  to  sixty  or 
seventy.  If  taken  in  so  large  a  dose  as  to  produce  vomiting,  or  too 
much  depression,  a  full  dose  of  morphine  or  laudanum,  in  a  little 
brandy  or  ginger,  is  a  complete  antidote. 

Veratrin,  the  active  principle  of  veratrum,  is  also  used,  in  doses  of 
one-half  to  one-third  of  a  grain. 


MRDICINKS  AND  THEIR  PREPARATIONS. 


593 


American  Ipecacuuiilia  (Euphorbia  Ipecac).  —  This  plant  ia  peren- 
nial, and  grows  in  sandy  soils  in  the  Middle  and  Southern  States. 
When  cut  or  broken  it  gives  out  a  milky  juice.  The  root  is  the 
medicinal  part.  It  is  emetic,  cathartic,  and  diaphoretic.  Dose,  as  a 
cathartic,  ten  or  twelve  grains  ;  as  a  diaphoretic,  three  or  four  grains, 
every  three  or  four  hours. 

American  Ivy  (Ampelopsis  Quinquefolia).  —  This  vine  grows  in  all 
parts  of  the  United  States.  It  is  known  by  the  names  oi  false  grape^ 
and  wild  woodbine.  It  is  alterative,  tonic,  astringent,  and  expecto- 
rant.    Used  in  scrofula  and  syphilis. 

Water  of  Ammonia  {Liquor  Ammonia:).  —  This  preparation,  called 
hartshorn,  o*"  spirits  of  hartshorn,  is  formed  by  the  union  of  water 
with  ammonia  gas.  It  has  a  powerful  ammoniacal  odor,  and  an 
alkaline,  caustic  taste.  Taken  internally  it  is  stimulant,  sudorific,  and 
antacid,  and  applied  externally,  it  is  rubefacient.  It  stimulates  par- 
ticularly the  heart  and  arteries,  without  very  mm^h  exciting  the  brain. 
It  is  an  excellent  remedy  in  heartburn,  and  for  sick  headache,  depend- 
ent on  sourness  of  the  stomach.  A  dose  is  from  ten  to  thirty  drops, 
largely  diluted  with  water.  United  with  oils,  or  with  alcohol  in  about 
eejual  proportions,  and  applied  externally,  it  reddens  the  skin,  and,  if 
the  cloth  wet  with  it  be  covered  with  oiled  silk,  or  with  flannel  to  pre- 
vent evaporation,  it  will  sometimes  quickly  raise  a  blister.  In  cases 
of  fainting,  it  is  frequently  applied  to  the  nostrils,  to  excite  the  brain, 
and  rouse  the  system. 

Carbonate  of  Ammonia. —  This  is  a  v/hite,  moderately  hard,  crys- 
talline salt,  —  having  a  pungent,  ammoniacal  smell,  and  a  sharp,  pen- 
etrating taste.  When  exposed  to  the  air,  it  loses  some  of  its  ammo- 
nia, becomes  a  bicarbonate,  and  falls  to  powden  It  is  stimulant, 
diaphoretic,  antispasmodic,  powerfully  antacid,  and,  in  large  f'oses, 
emetic.  Internally,  it  is  more  often  used  than  water  of  ammc  lia, 
and  for  similar  purposes.  Coarsely  bruised,  and  scented  with  oil  of 
lavender,  it  constitutes  the  common  smelling  salts,  so  much  used  in 
fainting  and  hysterics.  For  internal  use,  the  dose  is  from  five  to 
twenty  grains,  taken  in  the  form  of  pills,  every  two,  three,  or  four 
tiours. 

Muriate  of  Ammonia  {Sal  Ammoniac).  —  This,  also  called  hydro- 
chlorate  of  ammonia,  is  a  white,  translucent,  tough,  fibrous  salt,  in 
large  cakes,  about  two  inches  thick,  convex  on  one  side,  and  concave 
on  the  other. 

It  has  a  saline,  pungent  taste,  but  no  smell,  dissolves  in  one  part 
of  boiling  wat^r,  and  three  parts  of  cold.  Taken  internally,  it  is 
stimulant  and  alterative.  It  is  a  valuable  remedy  in  chronic  bron- 
chitis, pleurisy,  and  inflammation  of  the  serous  and  mucous  mem- 
branes generally.  But  it  must  only  be  used  after  the  first  violence  of 
these  inflammations  has  abated.  Pulverized,  and  placed  over  a  spirit 
lamp  in  a  tin  cup,  the  fumes  which  arise  when  it  sublimes,  may  be 
inhaled  five  or  ten  minutes  once  or  twice  a  day,  with  groat  advantage 
in  chronic  bronchitis,  and  in  chronic  inflammations  generally  of  the 

75 


II 


\^ 


594 


MEDICINES  AND  THEIR  rUErAUATlON'S. 


air  passages.  A  solution  composed  of  one  ounce  of  the  salt  dissolved 
in  nine  fluid  ounces  of  water,  and  one  of  alcohol,  may  be  used  as  a 
wash,  for  bruises,  indolent  tumors,  and  ulcers. 

8<)liifion  of  Acetiite  of  Aimnoiiia  {Liquor  Ammonia;  Acetatis).  —  This 
is  known  by  the  common  name  of  spirit  of  mindererus.  The  taste 
is  saline,  and  is  like  that  of  a  mixture  of  nitre  and  sugar.  It  is  a 
valuable  diaplioiotic,  and  is  much  employed,  alone  or  mixed  with 
•weot  spirit  of  nitre,  two  parts  to  one,  in  fevers  and  inflammations. 
It  is  a  valuable  external  application  in  mumps,  applied  hot  upon  a 
piece  of  flannel.  One  ounce  mixed  with  seven  ounces  of  rose-water, 
and  two  drams  of  laudanum,  forms  a  valuable  wash  for  the  eyes  in 
chronic  ophthalmia.  The  dose  is  from  two  drams  to  half  a  fluid 
ounce,  mixed  with  sweetened  water,  every  two  or  three  hours. 

Aromntic  Spir.'t  of  Ammonia  {Spiritus  Ammonice  Aromaticus). — 
Taken  internally,  this  answers  the  same  purpose  of  other  prepara- 
tions of  ammonia,  and  is  much  used  on  account  of  its  agreeable 
taste  and  smell.  It  is  valuable  as  an  antacid  in  sick  headache. 
Dose,  from  thirty  drops  to  a  dram,  sufficiently  diluted  with  water. 

Anise  {Pimpinella  Anisum).  —  This  is  a  perennial  plant,  and  grows 
in  Egypt.  Its  fruit  is  called  anise-seed.  It  is  aromatic  and  carmina- 
tive. It  is  much  used  to  allay  nausea,  flatulency,  and  colic,  particu- 
larly in  children.  It  la  frequently  added  to  other  medicines  to  make 
them  more  agreeable,  and  to  lessen  the  griping  effects  of  physic. 

The  oil  extracted  from  the  seeds,  dissolved  in  alcohol,  an  ounce  of 
the  former  to  a  pint  of  the  latter,  forms  what  is  called  the  essence  of 
anise.  Dose  of  the  essence,  from  thirty  drops  to  a  dram  in  sweetened 
water.     Anise  forms  a  very  valuable  addition  to  cough  preparations. 

Arnica  {Arnica  MorUana).  —  This  is  a  perennial  plant,  growing  in 
mois"",  shady  places  in  Siberia,  etc.  It  is  often  called  leopard's  bane. 
It  is  much  used  externally  as  a  stimulating  application  to  bruises, 
local  inflammation,  etc. 

Preparations.  —  It  is  chiefly  used  in  the  form  of  tincture,  or  fluid 
extract.  Dose,  ten  to  ,^ixty  drops.  Half  an  ounce  of  tincture,  five 
and  a  half  ounces  of  boiling  vinegar,  and  two  drams  of  carbonate  of 
ammonia,  used  warm,  make  in  some  cases  a  valuable  fomentatioa 
It  is  one  of  the  leading  homoeopathic  remedies. 

Arrow-root.  —  This  is  prepared  from  the  Maranta  Arundinacea,  a 
plant  of  the  West  Indies.  It  is  chiefly  used  in  forming  dietetic  pre- 
parations, and  belongs  to  the  first  or  saccharine  group  of  food-articles 
(see  page  66). 

Assafoetida.  —  This  is  the  hardened  juice  from  the  root  of  a  Persian 
plant.  It  is  stimulant,  antispasmodic,  and  expectorant,  and  is  much 
used  in  nervous  complaints.  A  dose  of  the  powder,  is  from  ive  to 
ten  grains,  and  of  the  tincture,  made  by  macerating  two  ounces  in  a 
pint  of  diluted  alcohol,  from  thirty  to  sixty  drops.   ■ 

Balm  {Melissa  Officinalis). —  This  is  a  perennial  plant,  growing  in 
Europe  and  this  country.    It  is  moderately  stimulant  and  diaphoretic 


■(J"*-/-..^-  -i-V.Tli.^' 


:V^.W»  ■■>*•'.•',!*■  r^W-^iW^  i  fl«a».;=aj^i:fi'(ii^:ir  kST«  " 


MEDICINES  AND  THEIR  rUEl'AUATIONS. 


59.5 


t  dissolved 
;  uyed  as  a 

ts).  — This 
The  taste 
r.  It  is  a 
lixed  with 
minatioiiA 
lot  upon  a 
rose-water, 
lie  eyes  in 
iiif  a  fluid 
irs. 

naticm).^- 

•t  prepara- 

agreeablo 

headache. 

th  water. 

[ind  grows 

I  carmina- 
ie,  particu- 
s  to  make 
lysic. 

II  ounce  of 
essence  of 
sweetened 
)arations. 

jrowing  ii> 
ard's  bane, 
to  bruiscs; 

•e,  or  fluid 
cture,  five 
rbonate  of 
mentatioa 

tdinacea,  a 
etetic  pre- 
»od-articles 

a  Persian 
d  is  much 
jm  ive  to 
unces  in  a 


{rowing  in 
iaphoretic 


The  warm  infusion  causes  perspiration,  and  is  used  to  relieve  painful 
mens'trniiiion. 

Kiilin  of  Oiletul  {Popuhis  Candicans).  —  This  is  a  tree  growing  in 
the  northern  parts  of  our  country.  A  tincture  made  from  the  buds,  in 
doses  of  from  one  to  four  fluicl  drams,  is  useful  in  ad'ections  of  the 
kidneys,  in  scurvy,  and  rheumatism.  Steeped  in  lard  they  form  a  use- 
ful ointment  for  some  purposes. 

Biiliiioiiy  {Ckchme  Glabra).  —  This  is  a  perennial  plant,  common  tc 
the  L'liiicd  States.  It  is  tonie,  cathartic,  and  vermifug(;.  It  is  used 
in  indigestion,  debility,  a  d  derangements  of  the  liver.  A  dose  of  the 
powdered  leaves,  is  one  uram  ;  of  the  tincture,  two  fluid  drams  ;  o/ 
the  decoction,  one  or  two  fluid  ounces;  of  the  active  principle  called 
(lu'lonin,  one  to  two  grains.  A  decoction  of  balmony  combined  with 
tiiicvure  of  assafcetida,  forms  a  valuable  injection  for  worms.  An 
ointment  made  from  the  fresh  leaves,  is  valuable  for  piles,  inflamed 
breasts,  tumors,  and  painful  ulcers. 

Balstllii  Cu|Ulivti.  —  This  is  obtained  from  a  South  American  tree 
cal'  d  the  Copaifera  Ojficina/is.  It  is  a  clear  yellowish  fluid,  about 
the  consistence  of  honey.  It  is  a  stimulating  diuretic,  and  is  much 
used  in  chronic  gonorrhoea,  gleet,  irritable  conditions  of  the  bladder, 
and  chronic  bronchitis.  In  some  persons  it  causes  an  eruption  on  the 
skin,  with  itching,  etc. 

In  large  doses,  it  acts  as  a  cathartic. 

Balsiliil  Tolu.  —  This  is  the  juice  of  the  tree  Myrospernum  Tolui- 
ferum,  growing  in  South  America.  It  is  soft,  tenacious,  and  of  a 
pale  brown  color ;  and,  like  balsam  copaiva,  is  soluble  in  alcohol, 
ether,  and  volatile  oils.  It  has  been  used  in  asthma,  cough,  bronchitis, 
etc.     Dose  from  ten  to  thirty  grains,  in  mucilage  or  syrup. 

Barberry  {Berberis  Vulgaris).  —  This  shrub  grows  along  the  Atlan- 
tic coast,  from  Canada  to  Virginia.  The  parts  used  are  the  bark  and 
berries.  It  is  tonic  and  laxative,  and,  in  doses  of  a  teaspoonful,  porw- 
dered,  is  useful  in  jaundice,  chronic  diarrhoea,  and  chronic  dysentery. 
A  decoction  of  the  berries  forms  an  agreeable  acid  drink  in  fevers, 
cholera  infantum,  etc.,  and  as  a  gargle,  it  is  useful  for  ulcers  of  the 
mouth,  etc.,  as  a  wash,  for  chronic  inflammation  of  the  eyes,  and  as  au 
injection  for  leueorrhoea.  ' 

Bear-berry  {Uvaursi).  —  This  plant,  also  called  upland  cranberry 
has  a  wide  range,  being  fo  '  in  the  northern  parts  of  Asia,  Europe, 
and  America.  It  flowers  troin  June  to  September,  and  ripens  its 
berries  in  the  winter.  The  leaves  are  the  only  medicinal  p  irts.  It  is 
astringent  and  tonic,  and  acts  particularly  upon  the  urinary  organs, 
for  complaints  of  which  it  is  particularly  used.  It  is  specially  valued 
as  au  antilithic  in  gravel,  and  as  a  remedy  for  chronic  inflammation 
of  the  kidneys,  and  ulceration  of  the  bladder, etc. 

Preparations.  —  Fluid  extract,  dose,  one  third  of  a  dram  to  a  dram ; 
solid  extract,  dose,  five  to  fifteen  grains ;  tincture,  dose,  one  to  two 
ounces. 


; 


t    ; 


»  ■'•• 

r. 

1 

MEDICINES  AND  TilElS  ?RE?AR*.'nO>'?. 


Bayberry  (Mi/rica  Cerifsra).  —  This  is  foun-l  iri  damp  places,  in 
inany  jwrts  of  the  United  States,  and  is  very  abiuidunt  in  New  Jersey. 
'J'he  bark  of  the  rix)t  is  the  part  used.  It  is  astringent  and  stimulant. 
Pulverized,  and  eombined  with  powdered  blood-root,  it  forms  an  ex- 
cellent application  to  indolent  ulcers.  In  the  form  of  poultice,  com* 
bined  with  powdered  Blip|)ery  elm,  it  is  a  useful  a|)plication  to  scrofu- 
lous tumors  or  ulcers.  The  decoction  is  a  good  wash  for  sore  mouth, 
and  spongy,  bleeding  gums.  It  is  chiefly  used  in  the  form  of  tincture, 
dose,  halt  an  ounce ;  fluid  extract,  dose,  onv.  to  two  drams :  and  the 
active  principle  myricin,  dose,  two  to  ten  grains. 


ino.188. 


BKAU-BEBUY. 


SAYBEHBV. 


Beef's  Galls  (Fel  Bovinum). —  This  being  dried  by  evaporation,  la 
sometimes  used  as  a  tonic,  and  laxative,  in  torpor  of  the  liver,  jaun- 
dice, indigestion,  and  costiveness,  in  doses  of  from  one  to  ten  grains. 
Three  drams  of  ox  gall,  one  dram  of  extract  of  conium,  two  drams 
of  soda  soap,  and  one  ounce  of  sweet  oil,  make  ;i  valuiilile  prepara- 
tion, which,  when  applied  txternally,  has  a  surprisingly  rapid  eftect  in 
reducing  enlargement  and  ha»dening  of  the  breasts,  glandular  tumors, 
particularly  enlargement  of  the  tonsils,  and  is  useful  in  hypertrophies 
generally.  For  application  to  the  tonsils,  the  gall  piay  be  rubbed  up 
with  water,  to  the  consistence  of  an  ointment,  and  may  be  applied 
with  a  camel's-hair  brush. 

Benzoin.  —  This  is  the  hardened  juice  of  a  tree  of  Sumatra  and 
Borneo.  It  is  very  brittle,  of  a  reddish  brown  color,  and  is  soluble  in 
alcohol  and  ether.  It  is  chiefly  used  for  inhalation  in  chronic  laryn- 
gitis and  bronchitis.  When  used  for  this  purpose,  it  may  be  added  to 
boiling  water,  and  the  vapor  be  inhaled ;  or  it  may  be  burned  upon 
coals,  or  a  hot  shovel,  the  fumes  being  inhaled. 

Benzoic  Acid.  —  This  is  prepared  by  heating  benzoin,  and  causdng 
it  to  sublime.  It  consists  of  silky,  feathery  crystals,  which  are  white 
and  soft  It  has  been  found  useful  in  the  phosphatic  variety  of  gravel 
A  convenient  way  of  giving  it  is  to  unite  one  part  of  it  with  four  parts 
of  phosphate  of  soda,  the  dose  of  which  is  from  ten  to  thirty  gp^ins. 


I 


MRDICINKS  AND  THEIR  PnEPARATIONS. 


097 


places,  in 
w  Jersey, 
itimulant. 
ns  ail  ox- 
tice,  com- 
to  Bcrofu- 
re  mouth, 
f  tincture, 
and  the 


•oration,  la 
iver,  jaun- 
ten  grains, 
wo  drams 
e  prepara' 
id  effect  ill 
ar  tumors, 
)ertrophies 
rubbed  up 
be  applied 

matra  and 
soluble  in 
onic  laiyn- 
e  added  to 
rned  upon 

id  caui^ng 
I  are  white 
f  of  gravel 
four  parta 
f  grains. 


kki.  ino. 


Betlimot  {Trillium  Pemluhim).  —  A  perennial  plant,  growing  in  rich 
PoiJH,  in  Ihr  Midcile  and  WcHtcrn  Stak's.  The  root  \a  used,  and  in 
astringent,  tonic,  and  antiseptic.  It  is  useful  in  bleeding  from  tlu; 
lungs  and  kidneys;  also  in  excessive  incnstrualion,  cough,  asthma, 
and  difiicult  breathing.  Boiled  in  milk,  it  is  used,  in  the  western 
country,  in  diarrhtra  and  dynent«ry. 

Pre/faratiotm.  —  Fluid  extract,  dose,  one  to  three  drams ;  Irilliin, 
dose  four  to  liulit  grains;  infusion,  dose,  two  to  four  ounces ;  decoc- 
tion, used  as  a  local  application  to  ulcers  and  sore  mouth,  an<l  as  an 
iiijeetion  in  leucorrluca  and  gleet.  A  poultice  made  from  the  root,  is 
useful  for  earbimcles,  indolent  tumors,  buboes,  foul  ulcers,  and  foi 
stings  of  insects. 

Bitter  root  {Ajiocynwn  Androstemifolium).  —  An  indigenous  plant, 
growing  in  rich  soils  in  the  United  States  and 
Canada.  The  root  is  the  part  us<'d,  and  is  laxa- 
tive, tonic,  diaphoretic,  and  alterative.  It  is  em- 
ployed in  chronic  ailections  of  the  liver,  syphilis, 
scrofula,  intermittents,  and  the  low  stage  of  ty- 
phoid fevers.  Forty  to  sixty  grains  will  ciuae 
vomiting  without  much  nausea. 

Preparations.  —  Fluid  extract,  dose,  as  a  tonio, 
ten  to  twenty  drops ;  as  a  diaphoretic^  fifteen  to 
twenty-five  drops ;  as  an  emetic,  half  a  dram 
to  a  dram.  Solitl  extract,  dose,  two  to  eight 
grains;  apocynin,  the  active  prinei|)le  of  the  root, 
dose,  half  a  grain  to  two  grains;  tincture,  dose, 
two  to  three  dr^jms;  infusion,  ilose,  a  wineglasa- 
ful,  three  times  a  day. 

Bismuth. —  The  principal  preparation  of  this  metal  used  in  medi- 
cine, is  the  trisnitrale  of  bismuth,  also  called  nitrate,  suhnitrute,  and 
while  oxide  of  bismuth.  It  is  a  white  powder,  without  smell  or  taste. 
It  is  used  for  various  irritable  and  painful  affections  of  the  stomach, 
when  there  is  no  acute  inflammation.  It  is  j)articularly  useful  in 
chronic  diarrhoea,  more  especially  the  diarrhcca  of  the  latter  stages  of 
consumption,  —  over  tvhich  it  has  mare  control  than  an//  other  kuown 
remedy.  To  show  its  best  effects  in  this  form  of  diarriuEa,  it  should 
be  given  in  large  doses,  not  less  than  twenty  to  thirty  grains,  immedi- 
ately after  each  meal.  The  small  doses  usually  given  are  compara- 
tively useless.  Given  in  these  full  doses,  it  is  also  almost  a  s{)i'citic 
in  heartburn  and  water-brash.     The  unpleasant  symptoms  spoken  of 


JllTTKIl-BlMJT. 


in  books,  as  arising  from  large  doses,  arc  fabulous. 

Bittersweet  (Solanum  Dulcamara).  —  This  is  common  in  Europe 
and  North  Anx-iica.  It  is  a  woody  vine,  the  roots  and  stalks  of  which 
are  used  in  medicine.  It  Is  slightly  narcotic,  and  has  alterative  and 
diaphoretic  properties.  It  is  used  in  scaly  and  syphilitic  affections  of 
the  skin.  It  is  said  to  have  antephrodisiac  properties,  and  is  servicea- 
ble in  mania,  connected  with  strong  venereal  propensities. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  solid 


I 


;^tA^  •- :i*i3iBW  tara:. . 


098 


MEDICINES  AMD  THEIR  PRErABATIOMS. 


extract, do8c,  three  to  eight  grains;  infusion, dose, one  to  three  ounces, 
three  or  four  tiinos  a  day. 

Black  Alder  {Prinos  VerticiUatus). —  Thia  shrub  is  common  in  the 
United  HtatcM ;  itu  bark  nnd  berries  are  used.  It  has  been  found  use- 
ful in  jaundice,  diarrhwa,  iiitermittent  fever,  and  other  diHcases  con- 
neeted  with  debility.  Applied  locally  in  the  form  of  a  wash  or 
poultice,  and  given  mternally,  it  is  popular  in  chronic  eruptions  of  tha 
skin,  and  in  Hubby,  ill-conditioned  ulcers,  and  mortification. 

Preparations.  —  Fluid  extract,  dose,  two  drams ;  tincture,  dose,  two 
to  four  drams. 

Two  drams  of  the  fluid  extract  of  black  alder,  one  dram  of  the 
fluid  extract  of  golden  seal,  and  one;  pint  of  water,  mixed,  and  taken 
in  doses  of  four  fluid  ounces,  three  or  four  times  a  day,  are  vtduable 
in  dyspepsia. 

Blu;;klH>rry  {Rubus  Villosus). —  There  ani  many  species  of  this 
growing  in  the  United  States.  The  bark  of  the  root  is  the  part  used. 
It  is  tonic,  and  strongly  astringent,  and  i^  a  valuable  remedy  in  diar- 
rhoea, dysentery,  cholera-infantum,  relaxed  conditioii  of  the  bowels  of 
children,  and  the  passive  discharge  of  blood  from  the  stomach,  bowels, 
and  womb. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  solid 
extract,  four  to  six  grains ;  tincture,  dose,  two  to  four  drams ;  infu- 
sion, dose,  one  ounce.  This  last  preparation  is  also  useful  as  an  injec- 
tion in  gleet,  leucorrhcea,  and  prolapsus  of  the  rectum  and  womb. 
The  syrup  of  the  blackberry  root  is  also  a  valuable  preparation  ;  so 
also  is  blackberry  brandy,  so  called,  which  is  the  juice  of  the  fruit 
mixed  with  brandy.     This  is  excellent  in  summer  complaints. 


Via.  191. 


FlO.  193. 


BLACK  COHOSH. 


BLOODBOOl'. 


Black  Cohosh  (Cimicifuga  Racewosa).  —  This  grows  in  rich  soils 
throughout  the  United  States.  The  root  is  the  part  used.  It  ia 
slightly  narcotic,  sedative,  antispasmodic,  antiperiodlc,  and  exerts  a 
marked  influence  over  the  nervous  system ;  being  useful  in  St  Vitus's 


z&,r,3;!^iJii^:iX^l-:,i^:i^jgs:^0isSt: 


MEDICINES  ANn  TinCIR  PREPARATIONS. 


fil)9 


dance,  epilepHV.  nervous  excitability,  asthma,  delirium  tremens,  and 
many  spii^modic  afl'ectiunH.     It  has  an  CMpccial  affinity  for  the  uterus. 

It  reduces  the  arterial  action  very  materially,  and  hence  is  useful 
in  palpitation  of  the  heart.  It  has  been  used  successfully  in  acute 
rheumatism,  but  more  particularly  in  chronic  rheumatism. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams ; 
polid  extract,  dose,  four  to  eight  f»rnjns ;  tincture,  four  ounces  to  the 
pint  of  alcohol;  do^<e,  one  to  three  drama;  cimicifugin,  the  active 
principle,  dose,  one  to  six  grains. 

Illttck  Willow  {SalU  A7^rr«).  — This  tree  is  found  in  the  Northern 
States,  along  the  banks  of  rivers,  especially  in  Nev/  York  and  Penn- 
sylvania, and  is  known  by  the  common  name  of  pussy  willow.  It  is 
a  bitter  tonic,  and  is  sometimes  used  in  fever  and  ague.  A  decoction 
made  from  the  buds,  is  said  to  be  a  powerful  antaphrodisiac,  and  is 
accordingly  useful  in  the  treatment  spermatorrhea. 

ItliMNlroot  {Sanf^inaria  Canadensis). —  A  perennial  plant,  growing 
in  light,  rich  soils,  in  most  parts  of  the  United  States.  The  root  is 
{he  part  used.  It  is  emetic,  narcotic,  expectorant,  alterative,  escha- 
rotic,  and  errhine.  It  is  used  in  typhoid  pneumonia,  bronchitis,  rheu- 
matism,  dyspepsia,  etc.  Three  to  five  grains  stimulates  the  digestive 
organs,  and  accelerates  the  pulse. 

Preparations.  —  Fluid  extract,  dose,  five  to  fifteen  drops  ;  solid  ex- 
tract, half  a  grain  to  a  grain  and  a  half;  tincture,  twenty  drops  to  a 
drain  ;  sanguinaria,  the  alkaloid  principle,  from  one  twentieth  to  one 
tenth  of  a  grain  ;  sanguinarin,  the  resinous  principle,  one  quarter  to 
one  grain. 

Four-grain  j)!!!.-*,  made  of  sanguinarin,  twelve  grains,  caulophyllin, 
twelvi}  grains,  st)lid  extract  of  cimicifuga,  twelve  grains,  are  said  to  be 
etilcacious  in  amenorrhtea,  dysmenorrhoea,  and  other  female  disorders. 

Fid.  VM. 


Fio. 

198. 

■  Aj 

M 

>=^--.y 

' 

< 

'      •    ,'-0^', 

J 

BLUB  COHOSH. 


BLUE  VLAO. 


Bine  Cohosh   ( Caulophyllum    Thalictroides).  —  A  perennial  plant, 
growing  in  low,  moist  grounds  in  most  parts  cf  the  United  States. 


It 


MEDICINES  AND  THEIR  PREPARATIONS. 


The  root  is  the  part  used.  It  is  antispasmodic,  diuretic,  diaphoretic, 
alterative,  emmenagogue,  rnthelmintic,  parturient,  and  tonic.  It  is 
used  in  rheumatism,  dropsy,  epilepsy,  hysterics,  cramps,  amenorrhcea, 
dysmenorrhoja,  chorea,  leucorrlioea,  hiccough,  to  hasten  delivery,  and 
to  relieve  after-pains. 

Preparations.  —  Fluid  extract,  dose,  fifteen  to  forty  drops ;  Solid 
extract,  dose,  one  to  five  grains ;  tincture,  dose,  half  a  dram  to  a 
dram ;  infusion,  dose,  two  to  four  ounces ;  caulophyllin,  the  active 
principle  of  the  root,  dose,  one  quarter  of  a  grain  to  two  grains. 

In  cases  of  protracted  labor,  occasioned  by  fatigue  or  debility,  the 
infusion  is  said  to  be  fully  equal  to  ergot  in  hastening  delivery.  A 
wash  made  by  Combining  one  ounce  of  fluid  extract  with  one  ounct 
of  the  fluid  extract  of  golden  seal,  and  eight  ounces  of  water,  is  very 
excellent  for  apthous  sore  mouth. 

Blue  Flag  (Iris  Versicolor).  —  A  perennial  plant,  growing  in  damp 
places,  in  most  parts  of  the  United  States.  The  root  is  the  part  used 
for  medicinal  purposes.  It  is  cathartic,  alterative,  sialagogue,  and 
diuretic.  It  acts  particularly  on  the  glandular  system  ;  in  large  doses, 
it  evacuates  and  exhausts  the  system,  acting  on  the  liver,  and  fulfill- 
ing the  purposes  of  mercury. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  sixty  drops;  solid 
extract,  one  to  four  grains ;  tincture,  one  to  two  drams.  Iridin,  the 
active  and  resinous  principle,  dose,  half  a  grain  to  four  grains.  Equal 
parts  of  blue  flag,  mandrake,  and  prickly-ash  bark,  mixed,  and  given 
in  five  to  ten-grain  doses,  every  two  or  three  hours,  will  act  as  a  pow- 
erful alterative,  and  cause  free  salivation,  without  making  the  breath 
offensive  or  injuring  the  gums.  Three  grains  of  iridin,  five  grains  of 
leptandrin,  and  twenty  grains  of  bitartrate  of  potassa,  '.,rm  an  excel- 
lent cathartic  in  dropsy,  producing  free  watery  stools. 

Blue  Pill  (Hydrarffyri  Pilulte).  —  This  mercurial  preparation,  gen- 
erally known  by  the.  common  name  of  blue  mass,  or  blue  pill,  is  made 
by  rubbing  mercury,  confection  of  roses,  and  pulverized  liquoricoroot 
together  until  all  the  mercurial  globules  disappear.  The  mass  is  di- 
vided into  pills  when  wantefj.  It  is  the  mildest  of  all  the  mercurial 
preparations,  and  the  least  liable  to  produce  salivation  or  irritation 
of  the  system.  But  even  this  should  be  used  sparingly,  and  with 
caution. 

The  blue  mass  is  alterative  and  cathartic,  and  is  considerably  given 
to  stimulate  the  action  of  the  liver,  and  to  produce  an  alterative  effect 
upon  the  digestive  organs.  The  leptandra  and  the  podophyllum  have 
become  its  rivals,  and  will,  I  sincerely  hope,  finally  take  its  place. 

Boneset  [Eupatorium  PerfoUatmn).  —  An  indigenous  plant  growing 
in  most  parts  of  the  United  States.  The  tops  and  leaves  are  medic« 
inal.  It  is  tonic,  diaphoretic,  expectorant,  and,  in  large  doses,  or 
when  taken  as  a  warm  infusion,  emetic,  and  aperient. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams;  solid  extract, 
dose,  five  to  twenty  grains ;  tincture,  dose,  one  to  two  ounces ;  infu- 
sion, dose,  one  to  three  ounces.     Eupatorin,  dose,  one  to  three  grains. 


MKDICINES  AND  THEIR  PKEPARATIONS. 


601 


Two  scruples  of  eupatorirs,  one  scruple  of  xanthoxylin,  and  one  grain 
of  strychnia,  mixed,  and  made  into  twenty  powders,  is  excellent  fof 
torpor  of  the  liver,  or  kidneys,  and  for  rheumatism ;  one  powder  being 
taken  three  or  four  times  a  day. 


Fio.  195. 


Fio.  196. 


110NE8KT. 


Bachu  (Barosma  Crenata).  —  It  grows  at  the  Cape  of  Good  Hope, 
The  leaves  are  the  medicinal  portion  ;  they  are  stimulant,  diuretic, 
antispasmodic,  and  tonic.  Buchu  is  chiefly  given  in  complaints  of 
the  urinary  organs,  attended  with  increased  uric-acid  gravel,  chronic 
inflammation  or  morbid  irritation  of  the  bladder,  urethra,  and  prostate, 
and  retention,  or  incontinence  of  urine. 

Preparations. —  Fluid  extract,  dose,  half  a  dram  to  two  drams: 
tincture,  dose,  two  to  six  drams  ;  infusion,  one  to  six  ounces.  A  com- 
bination of  fluid  extract  of  buchu,  half  an  ounce ;  acetate  of  potash, 
two  drams ;  and  water,  eight  ounces,  taken  in  doses  of  four  ounces, 
three  or  four  times  a  day,  is  a  valuable  diuretic. 

This  combination,  however,  may  be  improved  by  the  addition  of  a 
little  sweet  spirits  of  nitre. 

Buckhorn  Brake  ( Osmunda  Reg-alts).  —  This  is  a  fern  growing  in 
moist  grounds  in  most  parts  of  the  United  States.  The  root,  which 
is  the  medicinal  part,  should  be  gathered  in  tlie  latter  part  of  May,  and 
in  August,  and  very  carefully  dried,  to  prevent  moulding.  It  is  mucil- 
aginous and  tonic,  and  is  used  in  coughs,  diarrhrea,  and  dysentery,  and 
as  a  tonic  while  getting  up  from  exhausting  disease.  One  root  infused 
in  a  pint  of  hot  water  for  half  an  hour  will  convert  it  into  a  thick  jelly. 
This  mucilage  may  be  sweetened  with  sugar,  and  freely  taken. 

Buckthoni  {Rliamnus  Gatharticus).  —  This  plant  grows  in  Europe, 
where  it  is  much  esteemed  by  practitioners.  The  berries  and  juice 
are  actively  medicinal.  It  is  a  powerful  cathartic,  producing  large 
watery  discharges.  It  is  seldom  used  alone  on  account  of  the  severity 
of  its  action. 

Preparations.  —  Fluid  extract,  dose,  one  dram ;  syrup  of  buckthorn, 
made  by  uniting  four  ounces  of  fluid  extract  with  twelve  ounces  of 
bimple  syrup,  dose,  two  drams. 


PS"**^ 


€02 


HEDICINKS^NI)  TUEIB  PREPARATIONS. 


Bugleweed  {Lycopus  Virginicus).  —  This  grows  in  shady  and  wet 
places  throughout  a  greater  part  of  the  United  States.  The  whole 
herb  is  used.  It  is  a  mild  narcotic,  sedative,  sub-astringent,  and  styp- 
tic. It  is  a  valuable  remedy  in  bleeding  from  the  lungs,  incipifiit 
consumption,  and  pneumonia.  It  quiets  irritation,  and  allays  cough, 
and  nervous  excitement. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams ;  infusion, 
Jose,  two  to  four  ounces. 

Burdock  {Lappa  Minor).  —  A  native  of  Europe,  and  growing  in  tYifc 
United  States.  The  root  is  used,  which  is  useful  in  scurvy,  syphilis, 
scrofula,  gout,  leprosy,  and  disease  of  the  kidneys.  It  needs  to  be 
used  for  a  long  time.  It  is  said  to  be  useful  for  persons  aiilicted  with 
boils,  stye,  etc.  An  ointment  prepared  from  it  is  serviceable  in  some 
diseases  of  the  skin,  and  obstinate  ulcers. 

Preparations.  —  Fluid  extract,  dose,  one  dram ;  solid  extract,  dose, 
five  to  twenty  grains;  tincture,  dose,  half  an  ounce  to  an  ounce. 

Bttrg;imdy  Pitch. —  This  is  the  concrete  juice  of  the  Norway  pine, 
abies  excelsa,  growing  in  Europe  and  Northern  Asia,  and  of  the  silver 
fir  tree  of  Europe,  abies  picea.  It  gently  excites  the  skin,  and  is  used 
chiefly  in  the  form  of  plasters,  either  alone  or  mixed  with  other  gums 
and  resins. 

Bnttenint  {Julians  Cinerea).  —  This  is  a  forest  tree,  growing  in 
various  parts  of  the  continent,  known  also  by  the  names  of  oilnut, 
and  white  walnut.  The  inner  bark  of  the  root  is  used,  and  is  a  mild 
cathartic, — being  useful  in  cases  of  constipation.  It  is  much  employed 
by  families,  as  a  domestic  remedy,  in  intermittent  and  remittent  fevers. 
It  evacuates  the  bowels  without  debilitating  them. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams ;  solid  ex- 
tract, dose,  five  to  twenty  grains ;  juglandin,  the  active  principle,  dose, 
one  to  five  grains.  A  very  good  pill  is  made  by  mixing  one  and  a 
quarter  drams  of  the  solid  extract  of  butternut,  three  quarters  of  a 
dram  of  the  solid  extract  of  jalap,  and  ten  ^^  ^  is  of  soap,  and  divid- 
ing the  whole  into  sixteen  pills.  From  two  to  five  may  be  taken  for 
a  dose. 

Calcined  Deer's  Iloni  {Cornu  Cervirue  Ustum). —  The  horns  of  the 
deer  are  said  to  be  in  velvet  betwe<^n  August  anc  December^  and  dur- 
ing this  period,  those  which  fall  are  collected,  coarsely  rasped,  and 
placed  in  an  iron  vessel,  which  is  tightly  eov>ired,  and  placed  in  an 
oven,  or  elsewhere,  and  subjected  to  a  heat  of  200°  F.,  which  is  con- 
tinued until  the  rasped  horn  becomes  of  the  color  of  roasted  coffee. 
When  cooled,  it  is  reduced  to  powder  by  trituration,  and  preserved  in 
closely  stopped  viak.  It  is  a  powerful  styptic,  taken  in  te^spoonful 
doses,  every  half  hour ;  or,  p  t^aspoonful  added  to  a  gill  of  hot  water, 
and  a  tablespoonful  ot  t^is  takin  every  five  or  ten  minutes.  It  has 
much  eflficacy  in  floodingi>  f'-oni  the  womb,  and  in  excessive  menstru- 
ation. 

Ciilomel  (Hydrargyri  Chloridum  Mite).  —  This  is  prepared  from 
mercury,  sulphuric  acid,  nnd  common  salt.     It  is  alterative,  aniisyphi- 


MEDICINES  AND  THEIR  PREPARATIONS. 


603 


litic,  and  anthelmintic,  and,  in  large  doses,  purgative.  It  is  much 
used  in  venereal  diseases,  and  chronic  affections  of  the  liver,  combined 
with  opium ;  in  dropsies,  combined  with  squill,  foxglove,  and  elate- 


leprosy,  combined  with  antimonials, 
In  the  beginning  of  fevers  and  other 


Fio.  197. 


rium ;  and  in  rheumatism  and 

guaiacum,  and  other  sudorifics. 

complaints,  it  is  often  combined  with  purgatives,  as  gamboge,  scam- 

mony,  jalap,  and  rhubarb.     Given  in  small  doses,  not  large  enough  to 

purge,  it  gradually  excites  salivation.     Do.se,  from  one  to  ten  grains. 

The  tendency  of  this  a-ticle  to  produce  salivation,  to  injure  the 
gums,  loosen  the  teeth,  etc.,  has  given  rise  ^o  much  prejudice  against 
it  in  the  public  mind ;  and,  indeed,  it  mast  be  confessed  that  it  has 
been  used  by  many,  from  time  immemorial,  with  great  indiscretion. 
In  the  hands  of  sensible  s»:.d  prudent  men,  it  is  very  serviceable  in 
some  cases;  but  the  podophylluri^  and  leptandra  have  so  fine  an  action 
I  pon  the  liver,  that  they  are  fast  t?.king  the  place  of  calomel  and  other 
iricrcurials,  and  possibly  may  in  time  wholly  supersede  them.  I  have 
prescribed  calomel  but  Two  or  three  times  in  this  book,  and  am  willing 
to  see  it  banished  from  the  materia  medica,  as 
soon  as  the  careful  investigations  of  science 
shall  find  cause  to  decree  its  expulsion. 

Camphor.  —  This  is  obtained  from  an  ever- 
green tree,  growing  in  the  East  Indies,  —  the 
hitints  campliora.  It  is  a  white,  shiny,  crystal- 
line substance,  extracted  from  the  wood  and 
roots  of  the  above  named  tree,  by  boiling  them, 
and  is  subsequently  purified  by  sublimation. 
It  has  a  penetrating,  peculiar  diffusible  odor, 
and  a  pungent,  cooling  taste.  It  is  moderately 
stimulant,  diaphoretic,  and  antaphrodisiac.  Dose, 
from  one  to  ten  grains. 

Canada  Bulsaiii.  —  This  is  the  fluid  obtained 
from  the  fir  balsam,  abies  bulsamea,  of  Canada, 
Maine,  etc.  It  is  a  stinmlating  diuretic,  and,  in  large  doses,  cathartic. 
A  dose  is  from  ten  to  twenty  drops,  two  or  three  times  a  day,  in  pills, 
or  in  emulsion.  It  forms  a  part  of  several  ointments  and  plasters.  It 
is  used  to  mount  objects  in  microscopic  investigations. 

Canada  Fleabane  (Erig-eron  Canadense).  —  An  annual  plant,  grow- 
ing in  the  Northern  and  Middle  States.  It  is  diuretic,  tonic,  and 
astringent,  and  has  been  found  useful  in  dropsical  complaiiits,  and 
diarrhoea.  The  dose  of  the  powder  is  from  thirty  grains  to  a  dram  ; 
nf  the  infusion,  from  two  to  four  fluid  ounces ;  of  the  solid  extract, 
from  five  to  ten  grains ;  to  be  repeated,  in  each  case,  every  two  or 
three  hours. 

Canella  (Canella  Alba).  —  This  is  the  bark  of  a  South  American 
tree,  and  is  an  aromatic  stimulant,  and  a  gentle  tonic,  and  useful  in 
debility  of  the  stomach. 

Caraway  {Carum.  Carui).  —  This  biennial  plant  grows  in  Europe. 
The  seeds  are  the  part  used,  and  are  aromatic  and  carminative  ;  they 


CAMPHOR  TRBE. 


1 


\    ^1 


604 


MEDICINES  AND  THEIR  PREPARATIONS. 


:l  f  Ml 


are  used  in  wind  colic,  and  to  improve  the  flavor  of  other  medicine. 
The  dose  is  from  ten  to  sixty  grains.  The  dose  of  the  oil  of  caraway, 
extracted  from  the  seeds,  is  from  one  to  ten  drops. 

C)irdaiiioiil  {A!pinia  Cardamomum). —  This  plant  grows  on  the 
mountains  of  Malabar.  The  seeds,  which  are  the  medicinal  parts,  are 
aromatic,  and  carminative,  and  are  used  to  expel  wind,  and  to  flavor 
medicines.  Dose,  from  ten  grains  to  two  drams.  The  volatile  oil 
obtained  from  them  has  similar  properties. 

Cascarilla.  —  This  medicine  is  the  bark  of  the  West  India  shrub, 
croton  eleuferia.  It  has  an  aromatic  odor,  and  a  warm,  spicy  taste. 
It  is  a  pleasant  aromatic  and  tonic,  and  is  used  in  dyspepsia,  chronic 
diarrhcea  and  dysentery,  wind  colic,  and  other  debilities  of  the  stom- 
ach and  bowels.  It  counteracts  the  tendvincy  of  cinchona  to  produce 
nausea. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  thirty  drops;  tincture, 
dose,  one  dram ;  infusion,  dose,  one  to  three  drams.  An  alkaline  infu- 
sion, composed  of  fluid  extract,  three  our.^cs ;  carbonate  of  potassa, 
two  drams ;  and  water,  ten  ounces,  is  excellent  in  weak  stomach,  with 
acidity.     Dose,  one  dram.  ^ 

Castor  (Castoreum).  —  A  peculiar  substance  obtained  from  the  bea- 
ver. It  is  antispasmodic  and  emmenagogue.  It  is  used  in  typhus, 
hysterics,  epilepsy,  retention  of  the  menses,  and  in  many  other  ner- 
vous diseases.  Dose,  from  ten  to  twenty  grains.  A  medicine  of  no 
great  value. 

Castor  Oil  {Oleum  Ricini). —  This  is  obtained  by  expression  from 
the  seeds  of  the  castor  oil  bush,  ricinus  communis.  When  exposed  to 
the  air,  it  turns  rancid,  and  spoils. 

As  a  mild  cathartic,  this  oil  is  extensively  used,  particularly  among 
children.  It  is  an  exceedingly  nauseous  medicine,  but  may  be  ren- 
dered less  offensive  by  being  mixed  with  a  few  drops  of  oil  of  winter- 
green,  peppermint,  or  cinnamon ;  and  its  bad  taste  may  be  nearly 
destroyed  by  rubbing  it  up  to  a  thick  batter  with  carbonate  of  mag- 
nesia. Or,  if  boiled  a  fevir  minutes  with  a  little  sweet  milk,  sweetened 
with  loaf  sugar,  and  flavored  with  essence  of  cinnamon  or  pepper- 
mint, it  may  be  easily  taken.  Dose,  for  an  adult,  one  to  three  table- 
spoonfuls  ;  foi-  d  child,  one,  two,  or  three  teaspoonfuls,  according  to 
its  age. 

Catecha.  —  This  is  a  solid  extract,  made  from  the  wood  of  the 
acacia  catechu,  a  tree  growing  in  Asia.  It  is  in  dark,  brown,  and 
brittle  pieces,  and  is  soluble  in  alcohol.  It  is  a  powerful  astringent, 
and  is  used  in  chronic  diarrhoea,  and  chronic  dysentery.  It  makes  a 
useful  gargle  in  some  forms  of  sore  mouth,  in  elongated  uvula,  spongy 
gums,  and  sore  nipples.  The  dose  of  the  powder  is  from  ten  to  thirty 
grains,  and  of  the  tincture,  from  one  to  two  teaspoonfuls. 

Catnip  (Nepeta  Cataria).  —  A  native  of  Europe,  and  widely  natural- 
ized in  this  country.  The  tops  and  leaves  are  the  medicinal  part,  and 
are  carminative  and  diaphoretic  when  drank  as  a  warm  infusion.     It 


MEDICINES  AND  THEIIl  rREPAUATIONS. 


605 


is  useful  in  fevers,  in  wind  colic,  nervous  iieadache,  hysterics,  and  ner- 
vous irritability. 

Preparations.  —  Fluid  extract,  dose,  two  to  four  drams;  infusion, 
dose,  two  to  four  ounces.  Fluid  extract  of  catnip,  two  ounces  ;  and 
the  fluid  extract  of  aaflron,  one  ounce  and  a  half,  united,  make  a 
popular  remedy  for  colds,  and  the  rashes  of  children.  In  nervous 
complaints,  a  combination  of  fluid  extract  of  catnip,  six  drams ;  fluid 
extract  of  valerian,  four  drams ;  and  fluid  extract  of  scuUcap,  four 
drams,  is  a  valuable  remedy.     Dose,  one  to  three  drams. 

Cayenne  Pepper  ( Capsicum  Annuum).  —  This  plant  grows  in  hot 
climates,  and  is  known  by  the  cominon  name  of  red  pepper.  The 
berry,  which  is  the  part  used,  has  an  intensely  hot  and  pungent  taste. 
It  is  a  powerful,  diflusible  stimulant,  and  is  about  the  only  stimulus 
which  the  stomach  will  bear  in  certain  forms  of  dyspepsia.  It  is  use- 
ful in  all  cases  of  diminished  vital  action,  and  is  frequently  united 
with  other  medicines,  either  to  promote  their  action,  or  to  lessen  the 
severity  of  their  operation.  It  is  much  used  in  colds,  hoarseness,  etc., 
as  it  promotes  a  free  discharge  of  mucus  and  phlegm.  Taken  in 
small  doses,  it  has  a  fine  effect  upon  the  mucous  membrane  of  the 
stomach  and  bowels,  lessening  very  nmch  the  severity  of  piles,  and 
sometimes  curing  them.  It  may  be  sprinkled  daily  upon  the  food,  oi 
taken  in  the  form  of  cayenne  lozenges ;  it  is  frequently  useful  as  a 
gargle  in  sore  throats,  scarlet  fever,  etc.  Dose  of  the  powder  from 
one  to  ten  grains. 

Preparations.  —  Fluid  extract,  dose,  five  to  fifteen  drops  ;  tincture, 
dose,  half  a  dram  to  a  dram,  used  in  low  forms  of  fever,  and  gastric 
insensibility ;  infusion,  dose,  one  to  three  drams.  A  valuable  gargle 
in  scarlet  fever  may  be  made  by  combining  fluid  extract  of  cayenne; 
one  ounce  ;  common  salt,  one  dram  ;  boiling  vinegar,  one  pint ;  boil' 
ing  water,  one  pint, 

Celandine  (Chelidonium  Maj'us).  —  This  plant  is  indigenous  to 
Europe,  and  is  extensively  naturalized  in  the  United  States.  It  is  a 
drastic  purge,  producing  watery  stools,  and  is  equal  to  gamboge  ;  it  is 
useful  in  affections  of  the  liver,  and  particularly  in  those  of  the  spleen. 
In  the  form  of  a  poultice  it  is  effective  in  scrofula,  indolent  ulcersj, 
ekin  diseases,  and  piles. 

Preparations.  —  Fluid  extract,  dose,  ten  to  twenty  drops  ;  solid  ex- 
tract, dose,  five  to  ten  grains  ;  tincture,  dose,  half  a  dram  to  a  dram  ; 
infusion,  dose,  two  and  a  half  to  five  drams.  A  very  good  hydra- 
gogue  cathartic  is  made  by  compounding  two  and  a  half  drams  of 
fluid  extract  of  celandine,  with  half  a  dram  of  fluid  extract  of  hen- 
bane, one  ounce  of  sulphate  of  potassa,  one  grain  of  tartar  emetic, 
six  ounces  of  elder  water,  and  ounce  of  syrup  of  squill. 

Chalk.  —  On  account  of  its  gritty  particles,  it  is  unfit  for  medicinal 
use  until  it  has  been  levigated,  after  which  it  is  called  prepared  chalk. 
This  is  the  only  form  in  which  it  is  used  in  medicine.  It  is  an  excel- 
lent antacid,  and  is  admirably  adapted  to  diarrhoea,  accompanied  with 
acidity.     The  most  convenient  form  of  administering  chc.'k  is  that  of 


?.T«7  :x  jitij.ii'.-:.i«  A'-  4i<..^v\--.^-. , 


N. 


606 


MEDICINES  AND  THEIR  PREPARATIONS. 


the  chalk  mixture,  which  consists  of  prepared  chalk,  half  an  ounce ; 
sugar  and  powdered  ^urn  arable,  two  drams  each  ;  cinnamon-water 
and  water,  four  lluid  ounces  each,  and  rubbed  together  in  a  mortar 
till  they  are  thoroughly  mixed.  Dose,  a  tablespoonful  frequently  re- 
peated. 

Fio. loa 


Fio.  199. 

^^Hm 

\             '                    7        4.                 1 

/"^■••■':- 

CATEITNB  PSPFBB. 


OBAMOMILa. 


Chamomile  {Anthemis  Nobilis).  —  This  perennial  plant  grows  in 
Europe,  and  its  /lowers  are  considerably  used  in  medicine,  the  whitest 
of  which  are  best.  They  are  gently  tonic,  and  are  generally  used  in 
cold  infusion,  in  cases  of  weak  stomach,  dyspepsia,  etc.  In  large 
doses,  the  warm  infusion  will  act  as  an  emetic. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  solid 
extract,  dose,  four  to  twenty  grains ;  infusion,  dose,  half  an  ounce  to 
an  ounce.  For  dyspepsia,  wind  in  the  stomach,  etc.,  thirty  pills  may 
be  made,  by  combining  one  dram  of  solid  extract  of  chamomile  with 
five  grains  of  the  solid  extract  of  rhubarb,  and  ten  grains  of  assa- 
foetida,  and  taken,  one  pill  at  a  time,  two  or  three  times  a  day,  with 
advantage. 

Charcoal  ( Carlo  Ligni).  —  Prepared  charcoal  is  antiseptic  and  ab- 
sorbent, and  is  employed  with  great  advantage,  in  certain  forms  of 
dyspepsia,  attended  with  bad  breath,  and  putrid  eructations ;  it  has  a 
good  effect  in  correcting  the  fetor  of  the  stools  in  dysentery :  it  is  con- 
siderably used,  and  with  much  advantage  as  an  ingredient  in  poul- 
tices.    Dose,  when  taken  internally,  from  one  to  four  teaspoonfuls. 

Chloroform  (Chloroformum).  —  This  is  an  anaesthetic,  used  to  pro- 
duce insensibility  during  surgical  operations.  A  teaspoonful  or  more 
is  poured  upon  a  handkerchief,  which  is  held  to  the  patient's  nose, 
but  not  so  closely  as  to  prevent  the  admission  of  air.  The  numerous 
sudden  deaths  which  have  occurred  from  its  use,  prove  it  to  be  an 
unsafe  agent,  and  it  is  now  seldom  employed  by  careful  surgeons. 
Taken  internally  it  is  sedative  and  narcotic ;  applied  externally,  com- 
bined with  other  articles,  it  is  useful  in  painful  affections,  as  nervous 


solid 


MEDICINES  AND  THEIU  PREPARATIONS. 


60" 


headache,  rheumatisin,  neuralgia,  etc.     The  doftc  when  takea  irtten 
iially,  is  from  ten  to  sixty  drops,  in  flax-seed  tea. 

Ciniiniiioil. —  This  is  the  bark  of  trees  growing  in  Ceylon,  Malabar, 
and  Sumatra.  It  is  a  very  grateful  aromatic,  being  warm  and  cordial 
to  the  stomach ;  it  is  also  carminative  and  astringent. 

It  is  not  often  prescribed  alone,  but  is  chiefly  used  as  an  aid  to  less 
pleasant  medicines,  and  cntiTs  into  a  great  number  of  preparations. 
It  is  peculiarly  adapted  to  diarrlitt-a  ;  and  in  treating  this  complaint 
it  is  often  joined  with  chalk  and  stringcnts.  Dose  of  the  bark,  from 
ten  to  twenty  grains.  The  oil  has  properties  similar  to  those  of  tlie 
bark. 

Cassiil  Binls.  —  This  spice  is  a  product  of  China.  It  consists  of  the 
calyx  surrounding  the  young  germ  of  one  or  more  species  of  cinni\« 
mon.  Cassia  buds  have  some  resemblance  to  cloves,  and  are  com- 
pared to  small  nails  with  round  heads.  They  may  be  used  for  tlic- 
same  purposes  as  the  cinnamon  bark. 

Cleiivors  (Gnlium  A/mrine).  —  An  annual  plant,  common  to  this 
country  and  Europe,  having  an  acid,  astringen*^  taste.  The  whole 
herb  is  used  in  iiitusion,  as  a  cooling  diuretic,  in  scalding  of  the  urine, 
inllammation  of  the  kidneys  and  bladder,  in  gravel,  suppression  of  lln^ 
urine,  etc. 

It  is  also  usfd  in  fevers,  and  all  acute  diseases.  The  infusion  is 
made  by  adding  two  ounces  of  the  herb  to  a  pint  and  a  half  of  warm 
water.  It  should  stand  three  or  four  hours,  and  be  drank  freely  when 
told.  Equal  parts  of  elder-blows,  cleavers,  and  maiden-hair,  infused 
in  warm  water,  make  a  refreshing  drink  iu  scarlet  fever,  and  other 
eruptive  diseases. 

Cloves  {Caryophyllus  Aromaticus).  —  The  flowers  of  this  tree,  a 
native  of  tropical  climates,  collected  before  they  are  fully  developed, 
form  cloves.  They  are  highly  stimulant  anrl  aromatic,  and  are  used 
to  give  tone  to  the  digestive  organs,  particularly  when  flatulency 
exists,  and  to  relieve  nausea  and  vomiting.  They  are  more  generally 
employed  to  improve  the  taste  and  modify  the  action  of  other  medi- 
cines. The  dose  in  powder  is  from  five  to  ten  grains.  The  oil  of 
cloves  has  similar  properties ;  dose,  two  to  five  drops.  A  little  cotton 
moistened  with  the  oil,  and  pressed  into  a  decayed  tooth,  will  fre- 
quently relieve  the  toothache. 

Cochineal  ( Coccvs  Cacti).  —  An  insect  found  in  Mexico,  inhabiting 
iifl'erent  species  of  cactus.  They  are  gathered  for  use  by  detaching 
them  from  the  plant  with  a  blunt  knife,  and  dipping  them,  enclosed 
in  a  bag,  into  boiling  water.  Cochineal  is  anodyne,  and  has  been 
used  with  advantage  in  hooping-cough  and  neuralgia.  It  is  much 
used  for  coloring  tinctures,  and  ointments,  and  the  color  called  car- 
mine is  prepared  from  it.  A  tincture  is  prepared  by  macerating  two 
ounces  of  cochineal,  in  one  pint  of  alcohol,  for  seven  days,  and  filter- 
ing through  paper.     Dose,  from  twenty  to  thirty  drops,  twice  a  day. 

Cod  Liver  Oil  {Oleum  Morrhuw).  —  This  oil  is  obtained  from  the 


MEDICINES  AND  TllEIU  rUEl'AUATIONS. 


livers  of  codfish,  and  is  nutritive  and  alterative.  It  is  a  popular  rem. 
edy  in  consumption  and  scrofula,  and  in  those  complaints  generally 
in  which  there  is  impaired  digestion,  assimilation,  and  nutrition. 
Dose,  a  tablespoonful  three  times  a  day. 

Inability  to  digest  this  oil,  to  eat  fat  meats,  or  to  take  fats  in  any 
form,  is  an  unfavorable  indication  in  consumption. 

Collodion.  —  This  is  gun-cotton  dissolved  in  ether.  It  is  applied 
with  a  camel's-hair  brush,  to  cuts,  burns,  wounds,  leech-bites,  etc., 
over  which  it  forms  a  thin  pellicle  or  skin,  protecting  the  injured  part 
from  the  atmosphere.  It  should  be  kept  in  well  stopped  bottles,  to 
prevent  its  evaporating  and  becoming  unfit  for  use. 

Colocynth  ( Cucumis  Colocynthis).  —  A  native  of  northern  Africa. 
The  part  used  in  medicine  is  the  fruit,  deprived  of  its  rind.  It  is  a 
powerful  drastic,  hydragogue  cathartic ;  causing  by  its  harsh  action, 
griping,  vomiting,  and  sometimes  bloody  discharges;  from  the  severity 
of  its  operations,  it  is  rarely  used  alone.  Useful  in  dropsy,  derange, 
ments  of  the  brain,  and  for  overcoming  torpid  conditions  of  the  diges- 
tive and  biliary  organs. 

Preparatimis.  —  Solid  extract,  dose,  two  to  thirty  grains;  compound 
extract,  dose,  two  to  thirty  grains. 

Colombo  {Cocculus  Palmatus).  —  A  perennial  climbing  plant,  grow- 
ing in  east  Africa,  and  cultivated  in  the  Isle  of  France.  It  is  a  pure, 
bitter  tonic,  and  is  used  in  dyspepsia,  bilious  vomitings  which  attend 
pregnancy,  and  during  recovery  from  exhausting  diseases. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  sixty  drops ;  solid 
extract,  dose,  four  to  ten  grains ;  tincture,  dose,  one  to  four  drams ; 
infusion,  dose,  three  drams  to  an  ounce.  A  compound  infusion  made 
by  uniting  on«  dram  of  fluid  extract,  four  drams  of  orange  peel,  and 
one  ounce  of  water,  is  useful  in  a  weakened  state  of  the  bowels, 
showing  itself  in  Ck  diarrhoea.  Dose,  two  drams  every  hour.  Fluid 
extract  of  Colombo,  one  ounce ;  fluid  extract  of  ginger,  two  drams, 
and  water,  one  pint,  also  make  a  useful  compound  for  the  same  pur- 
pose. Fluid  extract  of  Colombo,  one  dram  ;  fluid  extract  of  rhubarb, 
one  dram;  fluid  extract  of  ginger,  half  a  dram;  water,  one  pint, — 
this  is  useful  for  a  like  purpose.  The  following  is  also  a  very  good 
preparation  for  a  similar  use :  fluid  extract  of  Colombo,  half  an  ounce; 
fluid  extract  of  cascarilla,  two  drams ;  tincture  of  orange  peel,  two 
drams  ;  syrup  of  cinnamon,  one  ounce  ;  water,  six  ounces.  Dose,  one 
dram  every  hour. 

Coltsfoot  (Tussilago  Farfara).  —  A  native  of  Europe,  and  natural- 
ized  in  this  country,  especially  in  the  Northern  States.  It  grows  in 
wet  places,  and  low  meadows.  The  leaves  are  principally  used. 
They  ace  emollient,  demulcent,  and  slightly  tonic ;  used  in  coughs, 
asthma,  and  hooping-cough ;  and  externally  in  the  form  of  poultice 
for  scrofulous  tumors.  _  '  • 

Comfrey  ( Symphytum  Officinale).  —  A  perennial  European  plant, 
cultivated  in  this  country.     The  root  is  the  part  used.     It  is  demui- 


MEDICINES  AND  THEIR  IMlErAUATIONS. 


60i> 


cent,  and  slightly  astiingont,  and  is  scrvicoahle  in  diseases  of  the 
mucous  tissues,  and  in  scrofulous  habits;  also  in  diarrluita,  dysentery, 
coiighs,  bleeding  from  th(!  lungs,  whites,  etc;.  It  may  be  taken  as  an 
infusion,  or  as  a  syrup,  one  ounce  to  a  pint  of  water;  the  dose  being 
one  to  four  fluid  ounces,  three  to  four  times  a  day.  The  frc^sh  root 
bruised  forms  a  valuabht  application  to  ulcers,  bruises,  fresh  wounds, 
pore  breasts,  and  white  swellings. 

Common  Sllk-Wenl  {Asrkpins  >%/riaca). —  This  is  a  perennial  plant, 
common  throughout  the  United  States.  It  gives  out  a  milky  juice 
upon  being  wounded,  and  hence  is  often  called  milk-weed.  The  root 
is  diuretic,  alterative,  emmenagogue,  and  anodyne  ;  and  is  somelimer 
used  in  dropsy,  retention  of  urine,  suppressed  menstruation,  scrofula., 
and  rheumatism.  Dose  of  the  powder,  from  eight  to  twenty-five 
grains ;  of  the  decoction,  from  one  to  three  fluid  ounces. 


Copper  (Cuprvtn).- 
used  in  medicine. 


The  following  are  the  principal  salts  of  copper 


Siilmcetrtte  of  Copper  (Cupri  Subacetas).  —  This  is  known  by  the 
name  of  verdigris,  and  is  used  as  a  detergent  and  escharotic ;  it  is 
applied  to  warts  and  fungous  growths,  and  to  foul  ulcers  and  ring- 
worm. When  reduced  to  a  line  powder,  by  trituration  in  a  porcelain 
mortar,  the  finer  parts  of  this  are  separated,  and  called  prepared  sub- 
acetate  of  copper ;  this  is  the  preparation  used  for  the  purposes  above 
named.  \ 

Sulphate  of  Copper  {Oupri  Sulphas).  —  In  small  doses,  the  sulphate 
of  copper  is  astringent  and  tonic  ;  in  large  ones,  a  prompt  emetic.  It 
is  given  in  small  doses  in  hysterics,  epilepsy,  and  intermittent  fevers  ; 
and  in  large  doses,  to  produce  speedy  Yomiting  in  croup,  and  to  eject 
poisons  from  the  stomach.  A  weak  solution  is  sometimes  used  for 
syphilitic  ulcers,  and  as  an  injection  in  gleet.  Dose,  as  a  tonic,  one 
(juarter  of  a  grain  to  two  grains,  in  pill ;  as  a  rapid  vomit,  from  two 
to  ten  grains,  in  two  ounces  of  water.  The  medicines  which  are  in- 
compatible with  copper,  are  alkalies,  earths,  and  their  carbonates, 
borax,  salts  of  lead,  acetate  of  iron,  and  astringent  vegetable  infu- 
sions, decoctions,  and  tinctures. 

Corrosive  Sublimate.  —  This,  in  chemical  language,  is  the  bichlo 
ride  of  mercury.  It  is  one  of  the  milder  mercurial  preparations 
although  when  taken  in  large  doses,  it  is  a  violent  poison,  and  oper- 
ates very  quickly.  It  is  less  apt  to  salivate  than  any  other  mercurial, 
except  blue  pill.  It  is  much  used  as  a  remedy  in  Ryphilis,  particu- 
larly in  the  secondary  stage,  in  which,  in  many  cases,  it  does  much 
good.  It  is  also  popular  in  many  skin  diseases,  as  leprosy.  When 
employed  for  this  purpone,  it  is  generally  associated  with  alterative 
and  diaphoretic  medicines,  such  as  the  compound  decoction  or  syrup 
of  sarsaparilla,  preparations  of  yellow  dock,  etc.  In  order  to  avoid 
its  irritating  effects,  it  is  often  united  with  opium,  or  extract  of  conium. 
Dissolved  in  water,  it  is  valuable  as  a  wash  in  some  skin  diseases.  It 
is  an  ingredient  in  many  of  the  quack  nostrums  which  are  extensively 

77 


^1 

■i-'vl 


61U 


MEDICINES  AND  THEIR  I'HKl'ARATIOXS 


I'- 


1:4 


§ 


advertifit'd,  and  wnH  tho  active  priiu-ipio  in  Swaitn's  Pannccii,  which 
hud  «o  vast  a  Hale  a  ffw  yoarK  Mince,  and  gave  sncli  a  princely  I'ortnne 
to  itH  proprietor.  One  ounce  of  corrosive  Hnbliinate,  dissolved  in  one 
quart  of  alcohol,  is  a  complete  bed-bug  exterminator. 

Cotton  (Gossi/pium  Herbaceum). —  Cotton  is  chiefly  employed  in 
cases  of  recent  burns,  and  Bcalds,  —  an  application  of  it,  which  sur-/ 
geons  have  learned  from  popular  use.  It  diminishea  the  inllamma- 
iion,  prevents  blistering,  and  hastens  the  cure.  It  is  applied  in  thin 
and  successive  layers.  The  inner  bark  of  the  root  is  said  to  be  em- 
menagogue,  parturijent,  and  abortive.  A  decoction  of  it,  made  by 
boiling  four  ounces  of  the  inner  bark  of  the  root  in  a  (piart  of  water, 
down  to  a  pint,  is  said  to  be  given  in  wineglassful  doses  by  the  female 
slaves  of  the  South,  for  the  purpose  of  producing  abortion.  It  is  ex- 
cellent in  chlorosis. 

Preparation.  —  Fluid  extract,  v'ose,  four  drains. 

CniiiesbiU  {Geranium^  Maculatum).  —  An  indigenous  plant,  growing 
In  all  parts  of  the  United  States,  in  the  open  woods.  The  root  is  the 
medicinal  part.  It  is  a  powerful  astringent, 
similar  to  kino,  and  catechu,  and  a  valuable 
substitute  for  those  articles,  because  less  ex- 
pensive. It  forms  an  excellent  gargle  in  sore 
throats  and  ulcerations  of  the  mouth,  and  is 
valuable  for  treating  those  discharges  arising 
from  debility,  after  the  exciting  causes  are 
removed.  It  has  no  unpleasant  taste,  and  is 
therefore  well  adapted  to  infants,  and  persons 
of  delicate  stomachs.  As  an  injection,  it  is 
used  in  gleet,  and  whites. 

Preparations.  —  Fluid  extract,  dose,  half  a 
dram  to  a  dram  ;  solid  extract,  dose,  three  to 
fifteen  grains ;  geraniin,  the  active  principle, 
dose,  one  to  five  grains ;  tincture,  dose,  two 
and  a  half  to  four  drams ;  infusion,  dose,  one 
to  two  ounces.  A  valuable  astringent  wash 
for  sore  mouth,  etc.,  and  as  an  injection  in  leueorrhcea,  etc.,  is  made 
by  uniting  fluid  extract  of  cranesbill,  half  an  ounce  ;  fluid  extract  of 
black  cohosh,  half  an  ounce;  fluid  extract  of  golden  seal,  half  an 
ounce ;  fluid  extract  of  witch-hazel,  half  an  ounce  ;  and  water,  one 
quart.  Geraniin,  dioscorein,  and  caulophyllin,  united  in  equal  parts, 
and  given  to  an  adult  in  six-grain  doses,  every  fifteen  or  twenty  min- 
utes, have  an  excellent  effect  in  c.iarrhcea  and  cholera-morbus,  when 
there  is  much  pain  and  rumbling  of  the  bowels. 

Crfi\r\ey  {Corallorhiza  Odontorhiza). —  A  perennial  plant,  growing 
on  barren  hills  and  hard  clay  soils  in  New  York.  The  root  is  the 
part  used.  It  is  sedative  and  diaphoretic,  and  is  used  in  inflamma- 
tory diseases,  and  in  typhoid  fever ;  also  in  flatulency,  cramps,  hectic 
fever,  and  night  sweats.  When  the  liver  requires  to  be  acted  r  "i, 
it  should  be  combined  with  mandrake  or  Culver's  root.    The  powdered 


0RA.M1C8BILL. 


y- 


n'  "'»<  f;  ).*vii'"-  ^, . 


^ps*-iii.^-tiiV>^i-nA' 


\ 


n 


iloycd  in 
liicli  8ur-/ 
illuiniiiit- 
I  ill  lliiii 
()  l)<!  L'in« 
made  by 
)f  Wiitcr, 
ic  fcmule 
It  is  ex- 


MKDIC1NE8  AND  THEIR  PUKPAWATIONS. 


611 


'■■i 


root  phoiild  be  kept  in  wcll-Htoppcd  viiih  ;  its  do.se  is  from  twenty  to 
thirty  gniiiM,  in  warm  water,  every  hour  or  two. 

Creosote  (Creosolmn),  —  Tliis  is  obtained  by  the  distiihition  of  tar. 
It  is  irritant,  iiarc"«)tie,  styptic,  antiseptic,  and  moderately  escharotic. 
It  has  been  given  in  diabetes,  epilepsy,  hysterics,  neuralgia,  bleeding 
from  the  lungs,  and  chronic  bronchitis.  It  is  an  excellent  remedy  for 
arresting  naus(>a  and  vomiting,  when  not  dcpeiuh'iit  on  inliammation. 
The  dose,  when  given  int(>riialiy,  is  one  or  two  drops.  It  is  most  easily 
taken  in  the  form  of  pill.  In  some  forms  of  bronchitis,  the  vapor  of 
creosote  is  inhaled  with  advantage.  It  may  sometimes  be  applied 
with  excellent  cfl'ect,  to  indolent  or  ill-conditioned  ulcers,  in  which  case, 
two,  four,  or  six  drops  may  be  dis.solved  in  an  ounce  of  distilled  water. 
In  some  cases  tlie  .solution  is  mixed  with  poultices.  One  or  two 
drops  of  pure  creosote,  introduced  into  a  hollow  tooth  on  a  little  cot- 
ton, is  generally  a  8|)ee(iy  remedy  for  toothache,  but  great  care  must 
be  taken  that  it  does  not  come  in  contact  with  the   ongue  or  cheek. 

Cn>toil  on  (Oleum  'riglii). —  This  is  obtained  from  the  seeds  of  the 
Croton  Tig'liunun.  plant  growing  in  the  East  Indies.  It  is  a  powerful 
cathartic,  producing  watery  stools,  and  is  used  in  torpidity  of  the 
bowels,  dropsy,  apoplexy,  mania,  inflammation  of  the  brain,  hydro- 
ccphalus,  coma,  and  wherever  a  powerful  revulsive  action  is  needed 
to  call  the  blood  away  from  the  brain.  A  drop  placed  on  the  tongue 
of  a  person  in  the  comatose -etate,  will  generally  operate.  Two  to  six 
drops,  rubbed  upon  the  skin,  produce  an  eruption  or  pimples  in  twelve 
hours.  In  this  way,  it  is  used  in  diseases  of  the  throat  and  chest,  and 
some  other  affections.  If  the  skin  is  very  sensitive,  let  it  be  combine^ 
with  an  equal  quantity  of  sweet  oil. 

Cubebs  {Oubehce). —  A  chmbing  perennial  plant,  growing  in  the 
East  Indies.  The  berries  are  the  medicinal  part.  They  are  stimu- 
lant, purgative,  and  diuretic,  acting  particularly  upon  the  urinary 
organs,  and  arresting  discharges  from  the  water  pipe,  and  much  used 
in  tlie  treatment  of  gonorrhoea  and  gleet.  It  should  not  be  used  dur- 
ing active  inflammation.  Dose  of' powdered  cubebs,  from  thirty  to 
sixty  grains. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  and  a 
half;  ethereal  fluid  extract,  dose,  one  to  two  drams;  solid  extract, 
dose,  two  to  twenty  grains ;  tincture,  dose,  one  to  two  drams.  A 
compound,  made  of  fluid  extract  of  cubebs,  five  drams ;  fluid  extract 
of  ergot,  one  and  a  half  drams ;  cinnamon  water,  half  a  dram  ;  and 
powdered  loaf  sugar,  one  dram,  may  be  taken  with  advantage  in 
gonorrhoea,  gleet,  and  leucorrhoea ;  dose,  one  dram.  -   , 

Culver's  Root  (Leplandra  Virginica).  —  A  perennial  plant  growing 
throughout  the  United  States  in  limestone  districts,  and  flowering  in 
July  and  August.  The  root  is  the  medicinal  part.  It  is  frequently 
called  black  root.  "When  dried,  it  is  tonic,  cholagogue,  and  laxative, 
and  is  a  very  valuable  remedy  in  affections  of  the  liver,  as  it  acts 
upon  this  organ  with  energy,  without  purgation.  It  is  also  useful  in 
typhdid  fevers,  and  in  dyspepsia,  diarrhcea,  and  dysentery.     A  powder 


^ 


■>i 


) 


.1' 


■  i 
1* 


'I 


012 


MEDICINKS  AND  TIIF.IK  PKKI'ARATIONS. 


i.i  intulo  from  it,  coiituiiiiiig  its  active  principle,  and  called  leptandrin, 
whicli  has  n  line  ellii>ct  in  diarrlura,  cholera  infantum,  typhoid  lever, 
s«)nie  forms  of  dy:<pepsiu,  mid  in  all  diseases  conne(;te<i  with  dt-ranj^e- 
MK'nts  of  the  liver. 

Prc/iarations. —  Fluid  extract,  dose,  one  third  of  a  dram  to  u  dram; 
leptandrin,  the  active  principle,  dose,  in  acute  cases,  one  fourth  of  a 
^rain  to  one  grain  ;  in  chronic  cases,  one  to  two  grains  ;  tincture,  two, 
ounces  to  u  pint  of  alcohol,  do^r,  one  dram  to  one  ounce. 

iUluU'Umi  {Turdxacum,  Dens-Leoms).  —  This  peremiial  herb  is  din- 
ret  ic;,  aperient,  and  tonic.  It  is  gent^rally  thought  to  act  cspeciixlly 
upon  the  liver.  lJs<!d  in  dyspepsia,  diseases  of  the  liver  and  spleen, 
■and  in  debilitated  and  irritable  conditions  of  the  stomach  and  bowels. 

Preparations. —  Fluid  extract,  dose,  one  to  two  drams;  compound 
lluid  extract,  dose,  one  to  two  drams;  fluid  extract  of  dandelion  and 
senna,  dose,  one  to  two  drams ;  solid  extract,  dose,  ten  to  twenty 
•  grains ;  infusion,  two  ounces  to  one  pint  of  water,  dose,  four  to  six 
c-unces.  In  dropsical  afl'ections,  the  following  compound  infusion  will 
l)(!  found  useful :  (luid  extract  of  dandelion,  six  drams ;  fluid  extract 
of  rhubarb,  one  and  a  half  drams;  fluid  extract  of  henbane,  twenty- 
four  drops ;  bicarbonate  of  soda,  half  a  dram ;  tartrate  of  potaaaa, 
three  drams;  water,  three  and  a  half  ounces;  take  one  third,  three 
limes  a  day.  For  jaundice,  and  diseases  of  the  liver  and  kidneys, 
ihe  following  pills  have  much  eflicacy.  Solid  extract  of  dandelion, 
one  dram;  solid  extract  of  bloodroot,  one  dram;  leptandrin,  one  scru- 
ple; podophyllin,  five  grains;  oil  of  peppermint,  five  minims;  to  be 
divided  into  fifty  pills,  and  one  or  two  taken  three  times  a  day. 


Fio.  201. 


Kio.  202. 


I  . 


DIADLT  HIOHTBHADB. 


DOGWOOD. 


:•»  t 


Deadly  Nightshade  {Atropa  Belladonna).  —  A  perennial  piant,  grow- 
ing in  Europe  and  this  country,  and  having  a  faint  odor,  and  a  sweet, 
nau..eous  taste.  It  is  narcotic,  diaphoretic,  and  diuretic;  is  a  valuable 
remedy  in  convulsions,  neuralgia,  hooping-cough,  rheumatism,  gout, 
paralysis,  and  many  diseases  having  their  seat  in  the  nervous  system. 
It  has  been  much  praised  as  a  preventive  of  scarlet  fever,  though  its 
powers  for  this  purpose  are  doubtful. 

Preparations.  —  Fluid  extrn*  t,  dose,  five  to  ten  drops  ;  solid  extract, 
dose,  one  quarter  to  one  gr,.iii;  tincture,  two  ounces  to  a  pint  of 


MEDICINEH  AND  THEIR  rUKl>ARATI()N8. 


6i;j 


diliitrd  iilcohol,  d(wr,  from  fiftcni  to  thirty  drops.  The  solid  pxtract  is 
UHcd,  mixed  with  lard  or  with  other  H<ii)Ktmu-es,  nn  a  l(M>al  application 
for  relieving  pain,  dilating  the  pupil  of  the  eye,  for  reinoving  Htricture 
of  the  urethra,  the  anus,  rigidity  of  the  mouth  of  the  womb,  etc. 

Du((Wuoil  (Cornus  Florida). —  This  in  a  small  tree  growing  most 
abundantly  in  the  Middle  States.  The  bark  is  used  as  a  medicine. 
It  iu  tonic,  astringent,  antiperiodic,  and  stinmlant.  It  increased  the 
fre([uency  of  the  pulse,  and  elevates  the  temperature  of  the  body.  It 
has  been  substituted  for  peruvian  hark  in  intermittent  fevers.  Dose 
of  the  powdered  bark,  from  ten  to  sixty  grains. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams : 
solid  extract,  dose,  five  to  ten  grains ;  tincture,  four  ounces  to  a  pint 
of  alcohol,  dose,  one  to  four  drams ;  infusion,  two  ounces  to  a  pint  of 
water;  dose,  half  an  ounce  to  two  ounces;  cornin,  the  active  prmciple, 
dose,  one  to  ten  grains. 

Dwiirf  Elder  (AralUi  Hispida). —  A  perennial  under-shrub,  growing 
from  New  England  to  Virginia.  The  bark  of  the  root  is  diuretic  and 
alterative.  An  infueiou  made  from  it  is  used  in  gravel,  suppression 
of  urine,  and  dropsy ;  to  be  taken  in  wineglasaful  doses,  three  or  four 
times  a  day. 

Elder  (Sambucus  Canadensis).  —  The  flowers,  berries,  and  inner 
bark  of  the  elder,  are  used  in  medicine,  A  warm  infusion  of  the 
flowers  is  diaphoretic,  and  gently  stimulant.  A  cold  infusion  is  diu- 
retic, alterative,  and  cooling";  used  in  erysipelas,  liver  aflections  of  chil- 
dren, rheumatism,  scrofula,  and  some  syphilitic  diseases.  The  bark, 
pounded  with  lard,  forms  a  useful  ointment  for  burns  and  scalds,  and 
some  diseases  of  the  skin. 

Elecailiptiiie  (Inula  Helenium). —  This  perennial  plant  is  a  native  of 
Europe  and  Japan,  and  is  cultivated  in  this  country.  The  root  is 
stimulant,  tonic,  diuretic,  and  expectorant,  and  is  used  in  chronic 
affections  of  the  lungs  and  air  passages.  It  is  said  a  decoction  from 
the  root  forms  a  good  application  for  the  itch,  and  other  skin  diseases. 
Dose  of  the  powdered  root,  from  a  scruple  to  a  dram;  of  the  infusion, 
one  or  two  fluid  ounces. 

Electro-MiipietiKni.  —  Within  a  few  years,  electro-magnetistn  has 
been  employed  extensively  as  a  remedial  agent,  particularly  in  th»! 
various  forms  of  nervous  dis<»rders.  That  it  is  a  valuable  agent  in  the 
treatment  of  disease,  few  thinking  physicians  doubt ;  yet,  like  most 
other  new  things  in  medicine,  it  has  had  its  enthusiastic  admirers, 
who  have  claimed  for  it  remedial  powcii;  beyond  what  it  really  has, 
and  who  have  applied  it  to  purposes  beyond  its  sphere  of  usefulness. 
Various  instruments  have  been  constructed  for  ap|)lying  this  remedy, 
but  no  one  has  appeared  to  me  so  well  adapted  to  its  purpose,  as  that 
manufactured  by  Messrs.  Hinds  &  Williams,  of  this  city. 

Feverfew  (Pyrethiwn  Parthenium).  —  In  warm  infusion,  this  herb  ia 
valuable  in  recent  colds,  flatulency,  worms,  irregular  menstruation. 


BDI 


G14 


MEDICINKS  AJI1)  THEIR  PREPARATIONS. 


Iiy.uerica,  atul  suppression  of  t.ie  uriiie.     The  cold  infusion  is  a  tonia 
A  poultice  made  of  the  leaver,  soothes  and  alleviates  pain. 

Fjjfwort  (ScrophvJaria  Nodosa).  —  The  leaves  and  root  are  diuretic, 
alterative,  and  anodyne,  and  in  some  places  are  used  in  liver  com- 
plaints, scrofula,  dropsy,  and  diseases  of  the  skin.  Applied  externally 
in  the  form  of  ointment,  or  fomentation,  it  is  said  to  be  useful  in  piles, 
painful  tumors,  bruises,  ringworm,  and  inflammation  of  the  breasts. 
Dose  of  the  infusion,  from  two  to  four  fluid  ounces,  three  times  a  day. 

Flaxseed  (Limmi  Usilatissimum).  —  This  is  demulcent  and  nutri- 
tive, and  is  much  used  in  coughs,  bronchial  diseases,  inflammation  of 
the  urinary  organs,  bowels,  and  lungs ;  chiefly  taken  in  the  form  of 
flaxseed  tea.  The  infusion  is  sometimes  used  as  an  injection  in  dy»» 
entery  and  piles.     Linseed  oil  ia  prepared  from  flaxseed. 


Fio.a08. 


Fia.ZOi. 


FOXOLOVB. 


OiMBIlfO; 


Foxglove  (Dig^Ualis  Purpurea).  —  A  biennial  plant,  growing  in  the 
temperate  parts  of  Europe.  The  leaves,  in  proper  doses,  are  sedative 
and  diuretic,  reducing  the  pulse,  and  increasing  the  flow  of  urine.  In 
largo  doses,  they  are  a  narcotic  poison.  The  medicinn  has  been  much 
used  in  inflammatory  diseases,  palpitation  of  the  heart,  and  in  dropsy 
connected  with  diseased  heart  or  kidneys.  When  taken  for  some 
lime,  it  is  liable  to  accumulate  in  the  system,  and  suddenly  t'j  mani- 
fest poisonous  and  alarming  symptoms,  as  if  a  large  dose  had  been 
taken.  The  American  hellebore  is  fast  supplanting  it  as  a  remedy. 
Dose  of  the  powdered  leaves  of  foxglove,  from  one  to  three  grains; 
of  the  tincture,  from  eight  to  *welve  drops. 

Frosfwc-ert  [IhUanlheimim  Canadense).  —  This  herb,  also  known  by 
<lii'  name  of  roi-k-ose,  is  tonic,  astringent,  and  alterative,  and  has  been 
eonsicic-abl^  used  in  scrofula;  combined  with  turkey  corn,  and  queen's 
root,  it  is  said  to  have  elfected  curet:  in  secondary  syphilis.  A  decoc- 
tion forms  a  useful  gargle  in  ulcerations  of  the  mouth  and  throat  in 


^ 


iMi:i)icixi:s  AXi)  tiieiu  prepabations. 


615 


scarlet  fever,  and  other  diseases,  and  as  a  wash  in  scrofulous  inflam- 
mation of  the  eyes.  Dose  of  the  fluid  extract,  one  to  two  drams, 
three  or  four  times  a  day. 

(ii)l!Is.  —  These  are  the  unhealthy  excrescences  found  growing  on 
the  young  boughs  of  the  dyer's  oak,  quercus  infecloria,  growing  in 
Asia.  They  are  powerfully  astringent.  In  the  form  of  infusion,  or 
decoction,  made  in  the  proportion  of  half  an  ounce  to  a  pint  of  water, 
they  are  useful  as  an  astringent  gargle,  wash,  or  injection  ;  and  finely 
powdered  galls,  one  part  to  eight  parts  of  lard,  make  a  valuable  oint- 
ment for  bleeding  piles.  Dose  of  powdered  galls,  from  ten  to  twenty 
grains. 

Gniuboj^e.  —  The  hardened  juice  of  trees  growing  in  Sianl  and 
Cochin  China.  This  gum-resin  is  a  hydragogue  cathartic,  acting 
.severely  and  harshly  upon  the  bowels,  and  hence  is  not  often  used 
alone.  On  account  of  the  severity  of  its  action,  it  is  improper  to  use 
it  during  inflammation  of  the  stomach  or  bowels,  piles,  pregnancy, 
diseased  womb,  or  excessive  menstruation.  Combined  with  cream  of 
tartar  and  jalap,  it  is  a  valuable  remedy  in  dropsy.  The  dose  is  one 
or  two  grains. 

(iltU'lic  (Allivm  Sativum).  —  The  bulb  is  the  part  used.  It  is  stimu- 
lant, diuretic,  expectorant,  and  rubefacient;  useful  in  coughs,  hoarse- 
ness, hooping-cough,  and  in  the  nervous  spasmodic  coughs  of  children. 
Dose,  from  twenty  grains  to  three  drams ;  dose  of  the  juice,  mixed 
with  sugar,  half  a  teaspoonful  to  a  teaspoonful. 

The  bruised  bulbs  are  sometimes  usefully  applied  3-8  a  poultice 
to  the  chests  of  young  children  having  inflammation  of  the  lungs, 
«nd  as  lirafts  to  the  feet  in  inflammation  of  the  brain,  fevers,  etc. 

Tiientiail  {Gentiana  Lutea).  —  It  grows  among  the  Alps,  Apennines, 
and  Pyrenees.  The  root  is  the  part  used,  and  is  brought  to  this  coun- 
try from  Germany.  This  medicine  has  long  maintained  its  reputa- 
tion, having,  it  is  said,  derived  its  name  from  Gentius,  king  of  lUyria. 
It  is  a  pure  and  simple  bitter,  exciting  the  appetite,  and  invigorating 
the  digestive  powers.  It  may  be  used  in  all  cases  def<endent  on  pure 
debility.  It  is  much  employed  in  dyspepsia,  and  during  recovery 
from  exhausting  diseases. 

Preparalions.  —  Fluid  extract,  dose,  half  a  dram  to  p.  dram;  com- 
pound fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid  extract,  dose, 
three  to  fifteen  grains;  tincture,  four  ounces  to  one  pint  of  diluted 
!  alcohol,  dose,  two  to  five  drams.  A  valuable  preparation  is  made,  by 
I  uniting  fluid  extract  of  rhubarb,  two  ounces  ;  fluid  extract  of  gentian, 
I  half  an  ounce,  diluted  alcohol,  two  pints;  dose,  half  an  ounce  to  two 
!     fJiinoes.  . 

fiii'XP.'  '/Zingiber  Officinale).  —  This  is  a  native  of  Hindostan,  and 
is  cu.  ivateu  in  all  parts  of  India.  The  root  is  the  part  use  Tt  is  a 
grateful  stimulant  and  carminative,  and  is  much  used  for  psia, 

wind  in  the  stomach,  colic,  gout,  etc.  It  is  an  excellent  atK  .ion  to 
l)itter  infusions,  and  is  much  used  to  disguise  the  taste  of  nauseous 
medicines.     Dose,  from  ten  to  thirty  grains. 


616 


MEDICINES  AND  THEIR  PREPARATIONS. 


PreparcUions.  —  Fluid  e\tract,  dose,  half  a  dram  to  a  dram  ;  tincture, 
four  ounces  to  one  pint  of  diluted  alcohol,  dose,  two  to  four  drams; 
infusion,  dose,  one  to  t  vo  ounces ;  syrup,  dose,  one  to  two  drams. 

Ginseng  {Panax  Quinguifolium).  —  A  perennial  plant,  growing  in 
the  Middle  and  Southern  States.  It  is  a  mild  tonic  and  stimulant, 
and  has  some  reputation  for  improving  impaired  appetite,  and  for 
nervous  debility,  weak  stomach,  etc.  Some  persona  are  in  the  habit 
of  chewing  it,  and  it  is  considerably  used  in  this  way.  Dose  of  the 
powdered  root,  from  ten  to  sixty  jrains  ;  of  the  infusion,  from  two  to 
four  fluid  ounces. 

Glycerin.  —  This  is  the  sweet  or  sugary  portion  of  oils,  and  is  ob- 
tained from  them  during  the  manufacture  of  lead  plaster.  It  is  demul- 
cent and  antiseptic,  and  has  been  recently  recommended  and  used,  to 
some  extent,  in  place  of  cod  liver  oil,  in  consumption.  It  has  been 
still  more  used,  however,  as  a  soothing  and  emolient  external  applica- 
tion in  skin  diseases,  and  also  in  place  of  lard  in  the  preparation  of 
ointments. 

Gold.  —  The  chief  sort  of  gold  used  in  medicine,  is  the  chloride  or 
muriate  ot  gold  and  soda.  It  is  diuretic  and  alterative.  It  is  used 
in  scrofula,  skin  diseases,  goitre,  scirrhous  tumors,  opthalmia,  dropsy, 
and  syphilis.  The  dose  is  from  one  thirtieth  to  one  twelfth  of  a  grain, 
and  is  given  dissolved  in  water,  or  made  into  pill  with  starch  or  gum 
arable. 

Golden  Seal  (Hydrastis  Canadensis).  —  A  perennial  plant,  growing 
throughout  the  United  States,  particularly  in  the  West.  The  root  i* 
the  r..8dicinal  part.  It  is  a  tonic,  having 
especial  action  upon  diseased  mucous  tis- 
sues, und  is  particularly  beneficial  during 
recovery  from  exhausting  diseases.  It  is 
used  in  dyspepsia,  chronic  affections  of  the 
nervous  coats  of  the  stomach,  erysipelas, 
and  remittent,  intermittent,  and  typhoid 
fevers.  United  with  geranium,  it  has  a  fine 
effect  in  chronic  diarrhoea  and  dysentery. 

Preparations.  —  Fluid  extract,  dose,  half  a 
dram  to  two  drams ;  solid  extract,  dose,  two 
to  five  grainb ;  hydrastin  (resinoid),  dose,  one 
half  to  five  grains;  hydrastin  (neutral), dose, 
two  to  six  grains  ;  hydrastina  (alkaloid), 
dose, one  to  five  grains;  tincture,  dose,  three 
ounces  to  one  pint  of  diluted  alcohol,  dose, 
half  an  ounc.-  to  an  ounce  and  a  half.  For 
various  forms  of  sore  mouth  and  ulcerated 
Bore  throat,  the  following  is  a  useful  gargle  : 
fluid  extract  of  golden  seal,  half  an  ounce; 
fluid  extract  of  blue  cohosh,  half  an  ounce  ; 
fluid  extract  of  witch-hazel,  half  an  ounce;  puiverized  alum,  one  dram; 
honey,  three  drams  ;  water,  one  pint.     As  a  stimulant  for  a  sluggish 


Fio.  205. 


OOLUKN  SEAL. 


MEDICINES  AND  THEIR  PREPARATIONS. 


617 


liver,  and  as  a  tonic  in  enfeebled  mucous  membrane  in  epidemic  dys- 
entery, and  other  complaints,  the  following  powders  are  valuable : 
hydrastin,  twenty  grains;  leptandrin,  twelve  grains;  podophyllin,  two 
grains  ;  pulverized  cayenne,  two  grains ;  sugar  of  milk,  or  pulverized 
loaf  sugar,  one  drsim ;  rubbed  together  thoroughly  in  a  mortar,  and 
divide  into  twenty  powders;  give  one  every  two  hours. 

Ground  Ivy  {Nepeta  Glechoma).  —  A  perennial  herb,  common  to 
tiie  United  States  and  Europe ;  in  some  places  known  as  gill-over- 
the-grovnd.  The  leaves  are  the  part  used,  which  are  stimwlant,  tonic, 
and  pectoral ;  considered  useful  in  jaundice,  asthma,  and  diseases  of 
the  kidneys  and  lungs. 

Gaaiacuni.  —  This  medicine  is  the  shavings  or  chips  of  the  wood  of 
a  tree  growing  in  the  West  Indies,  also  resin  obtained  from  the  same 
tree.  It  is  stimulant  and  alterative,  and  is  used  in  chronic  rheuma- 
tism, diseases  of  the  skin,  scrofula,  and  venereal  complaints.  The 
tincture  of  the  resin  is  valuable  as  an  emmenagogue.  Dose  of  the 
tincture,  from  one-half  to  two  teaspoonfuls,  to  be  taken  with  milk. 
The  wood  is  much  used  as  an  ingredient  in  alterative  preparations  of 
sarsaparilla,  etc.  -  , 

Gam  Arabic. —  This  is  the  hardened  juice  of  trees  growing  in 
Egypt,  Arabia,  and  other  tropical  countries,  being  several  varieties 
of  the  acacia.  It  is  demulcent,  and  a  combustive  nutritive,  and  is 
much  used  in  forming  mixtures  for  hoarseness,  cough,  sore  throat, 
gonorrhoea,  inflammation  of  the  bladder,  strangury,  bronchitis,  and 
irritations  of  mucous  membranes  generally.  Mucilage  of  gum  arable 
is  a  preparation  made  by  dissolving  four  ounces  of  powdered  gum  in 
a  pint  of  boiling  water. 

Gom  Hemlock.  —  This  is  the  hardened  juice  of  the  hemlock,  Abies 
Canadensis,  a  tree  growing  in  Canada  and  Maine.  This  gum  is  a 
mild  rubefacient,  and  like  burgundy  pitch,  chiefly  used  to  make  plas- 
ters, etc.,  for  which  purpose  it  is  very  valuable.  A  tincture  of  the  gum 
is  diuretic  and  stimulant.  The  oil  of  hemlock  is  valuable,  in  combi- 
nation with  other  oils,  in  preparing  liniments.  The  bark  is  astringent, 
and  is  much  used  in  tanning  leather. 

Ueemnstiisis.  —  This  word  is  used  to  imply  the  retention  of  the 
venous  blood  in  the  limbs  by  ligatures.  A  cord  or  common  handker- 
chief, is  tied  round  the  upper  part  of  the  arms,  or  thighs,  and  a  piece 
of  wood  being  slipped  under  the  cord,  is  twisted  round  until  the  cord 
is  so  tightened  as  to  prevent  the  return  of  the  venous  blood,  but  not 
to  prevent  the  outward  passage  of  the  arterial  blood.  In  this  way, 
the  blood  passing  out  continually  in  the  arteries,  and  not  r'.'tuniing 
by  the  veins,  the  vessels  of  the  limbs  become  filled  to  their  utmost 
capacity,  and  a  great  quantity,  for  the  time  being,  is  withdrawn  from 
the  trunk,  —  greater  than  any  surgeon  would  dare  to  remove  with  the 
lancet.  This  process  is  useful  in  bleedings  from  the  lungs,  stomach, 
and  womb,  and  inflammation  of  the  brain,  lungs,  bowels,  etc.,  and 
m  whatever  case  it  may  be  thought  desirable,  for  the  time  being. 


.,1 


618 


MEDICINES  AND  THEIR  PREPARATIONS. 


to  lessen  the  blood  in  the   head  or  trunk,  without  debilitating  the 
patient. 

Hair-cap  Moss  {Polytrichum  Juniperum). —  An  evergreen  plant  grow- 
ing on  poor  sandy  soils  in  the  Northern  States.  A  strong  infusion  of 
it  is  powerfully  diuretic.  In  dropsical  cases,  two  fluid  ounces  of  the 
infusion  should  be  taken  every  half  hour.  It  is  useful  in  fevers,  in- 
flammations, gravel,  etc.         , 

Hardback  ( Spiraea  Tomentosa).  —  This  is  a  beautiful  shrub,  com- 
mon in  the  United  States.     Its  leaves  are  of  a  dark  green  color  above, 
and  white  underneath.     It  is  tonic  and  astringent,  and  is 
much  used  in  chronic  diarrhoea,  cholera  infantum,  etc.     It     *'«o  «>«. 
agrees  well  with  the  stomach,  and  is  deservedly  a  popular 
remedy  in  summer  complaints  of  children. 

A  fluid  extract  of  it  is  prepared  by  Tilden  &  Co. ;  dose, 
four  to  twenty  drops.  It  is  much  used  in  the  form  of  infu- 
sion. The  green  herb  boiled  in  milk  forms  a  valuable  pre- 
paration ,in  chronic  diarrhoea,  when  attended  with  much 
debility. 

Hardleaf  Golden-Rod  ( Solidago  Rigida).  —  A  perennial 
plant,  growing  throughout  the  United  States,  especially  on 
the  western  prairies.  It  is  tonic,  astringent,  and  styptic,  and 
useful  to  arrest  bleeding  from  the  nose,  lungs,  stomach,  and 
bowels.  The  powder  and  infusion  are  used,  both  externally 
and  internally. 

Helonias  {Helonias  Dioica).  —  This  herb  is  common  in  the  United 
States,  and  is  known  by  the  name  of  False  Unicorn  plant.  The  root, 
which  is  the  part  used,  is  tonic,  diuretic,  and  vermifuge.  In  large 
doses,  it  is  emetic,  and  when  used  fresh,  sialagogue.  In  five  or  ten 
grain  doses,  three  times  a  day,  it  relieves  dyspepsia,  restores  the  appe- 
tite, expels  worms,  and  relieves  colic.  It  is  a  valuable  womb  tonic, 
gradually  removing  debility  of  that  organ,  and  curing  whites,  pain- 
ful menstruation,  and  a  tendency  to  habitual  abortion.  Dose  of  the 
decoction,  from  two  to  four  fluid  ounces.  The  decoction  is  said  to 
kill  insects,  bugs,  etc. 

Preparations.  —  P'luid  extract,  dose,  one  to  three  drams ;  helonin, 
the  active  principle,  dose  half  a  grain  to  a  grain. 

Henbane  (Hyoscyamus  Niger).  —  This  plant  grows  abundantly  in 
Great  Britain,  and  on  the  continent  of  Europe,  and  is  rare  in  this 
country.  All  the  parts  arc  active.  It  is  narcotic,  gently  accelerating 
the  circulation,  increasing  the  general  warmth,  occasioning  a  sense  of 
heat  in  the  throat,  and  after  a  time  inducing  sleep.  It  is  often  used 
in  the  place  of  opium,  because  it  does  not  bind  the  bowels.  Used  in 
rheumatism,  gout,  bronchitis,  asthma,  consumption,  hooping-cough, 
hysterics,  and  spasmodic  affections  generally. 

Preparations.  —  Fluid  extract,  dose,  ten  to  twenty  drops;  solid  ex- 
tract, dose,  half  a  grain  to  a  gniin  ;  1in(tur:>,  two  ounces  to  one  pint 
of  diluted  alcohol,  dose,  half  a  dram  to  a  dtam  and  a  half;  hyoscya- 


HABDIIACK. 


MEDICINES  AND  THEIR  PREPARATIONS. 


619 


■min,  the  active  principle,  doso,  one  eighth  to  half  a  grain.  In  neural- 
gia, rheumatism,  St.  Vitus'a  dance,  painful  menstruation,  etc.,  the 
following  may  be  found  useful  :  solid  extract  of  hyoscyamus,  two 
drama  ;  solid  extract  of  valerian,  two  drams  ;  solid  extract  of  aconite, 
one  dram  ;  sulphate  of  quinia,  one  dram.  Mix,  and  divide  into  two 
grain  pills;  one  pill  every  two  or  three  hours. 

IIiS:li  Cnuiberry  ( Tiburmm  Opulux).  —  This  shrub  grows  in  rich 
soils  in  Canada,  and  in  the  northern  United  States.  The  bark,  which 
is  the  medicinal  part,  is  antispasmodic,  being  used  in  cramps,  spasms, 
asthmo,  hysterics,  and  is  useful  for  those  who  are  subject  to  convul- 
sions during  pregnancy,  and  at  the  time  of  childbirth.  It  is  popularly 
known  by  the  name  of  Cramp  Bark.  A  decoction  or  infusion  of  the 
bark,  may  be  used  in  tablespoonful  doses,  two  or  three  times  a  day. 
Dose  of  the  extract,  from  one  to  five  grains ;  in  womb  troubles,  it 
may  be  united  with  caulophyllin,  cimicifugin,  aletridin,  senecin,  and 
asclepidin  ;  and  in  (latulent  colic,  spasmodic  pains  of  the  stomach 
and  bowels,  it  may  be  combined  with  dioscorein. 


Fio.  ao7. 


Fio.  208. 


nCKBANK. 


HOBBHOCND. 


Horehoimd  (Marubium  Vul^are). —  This  well  known  perennial  herb 
is  a  native  of  Europe,  and  has  become  naturalized  in  this  country. 
It  is  tonic,  aperient,  pectoral,  and  sudorific.  It  is  deservedly  popular 
in  domestic  practice,  for  colds,  asthma,  throat-ails,  bronchitis,  and  other 
pectoral  affections,  attended  with  cough.     It  is  much  used  in  candy. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  one  dram  ;  solid 
extract,  dose,  five  to  ten  grains ;  tincture,  two  ounces  to  one  pint  of 
alcohol,  dose,  half  an  ounce  to  an  ounce;  syrup,  three  ounces  fluid 
extract  to  one  pint  of  simple  syrup,  dose,  three  to  six  drams. 

Hops  {Iliimulns  Liipidus).  —  The  cones  of  this  well-known  plant 
are  tonic,  hypi  otic,  antilithic,  and  anthelmintic.  They  are  chiefly 
used  for  prorpoting  sleep,  and  relieving  j)ain  and  irritability  of  the 
nervous  system.  Hops  are  valuable  in  the  form  of  fomentation,  either 
alone,  or  in  combination  with  boneset,  and  jother  bitter  herbs.     Ail 


*1 


620 


MEDICINES  AND  THEIR  PREPARATIONS. 


ointment  of  hops  and  stramonium  leaves  is  sometimes  used  in  salt- 
rheum,  and  upon  painful  tumors  and  ulcers.  A  pillow  stuffed  with 
hops,  dipped  in  hot  water,  and  placed  under  the  head  of  the  patient, 
relieves  pain  and  procures  sleep. 

Lupulin  is  the  yellow  powder  obtained  by  threshing  the  hops,  and 
is  preferable  to  the  hop  itself.  It  is  a  powerful  antaphrodisiac,  com- 
posing the  genital  organs,  and  quieting  painful  erections,  in  gonor- 
rhoea, etc. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  five  to  twenty  grains;  tincture,  two  and  half  ounces  to 
one  pint  of  alcohol,  dose,  three  to  six  drams  ;  infusion,  four  drams  to 
one  pint  of  water,  dose,  two  to  four  ounces  ;  lupulin,  dose,  six  to  ten 
grains;  tincture  of  lupulin,  two  ounces  to  one  pint  of  alcohol,  dose,  one 
to  two  drams,  in  sweetened  water ;  fifteen  to  twenty  grains  of  lupulin, 
well  rubbed  up  with  white  sugar  in  a  mortar,  is  very  efficacious  in 
priapism,  chordee,  and  spermatorrhcea. 

Horsemint  (Monarda  Punctata).  —  This  well-known  plant,  which  is 
common  to  the  United  States,  is  stimulant,  carminative,  and  diuretic 
A  warm  infusion  may  be  used  in  flatulence,  nausea,  and  vomiting. 
If  the  body  be  kept  cool  while  taking  it,  it  will  act  as  a  diuretic.  The 
oil  of  horsemint,  is  used  for  similar  purposes  with  the  plant  Dose, 
from  two  to  six  drops  on  sugar.  Dose  of  the  essence,  from  ten  to 
forty  drops  in  sweetened  water.  The  oil  is  frequently  used  as  an  in- 
gredient in  liniments.  .  / 

Horseradish  {Cochlearia  Armoracia).  —  The  fresh  root  of  this  well 
known  perennial  is  stimulant,  diuretic,  antiscorbutic,  and  rubefacient. 
It  is  useful  in  rheumatic,  paralytic,  scorbutic,  dropsical,  and  dyspeptic 
affections.  It  is  said  that  a  warm  infusion  of  the  fresh  root  in  cider, 
drank  freely  every  night,  will  cause  perspiration,  and  a  free  flow  of 
urine,  and  will  consequently  cure  dropsy.  The  fresh  root  grated  in 
vinegar,  and  eaten  with  meat  at  dinner,  strengthens  the  stomach,  and 
promotes  digestion. 

Hoiiseleek  (Sempervivum,  Tcctorum).  —  The  bruised  leaves  of  this 
perennial,  form  a  cooling  application  to  burns,  stings  of  insects,  ery- 
sipelas, and  other  intlammations ;  valuable  also  for  ringworm,  shingles, 
and  other  skin  diseases. 

Ilydrangcsi  {Hydrangea  Arborescens). —  This  grows  abundantly  in 
the  Southern,  Middle,  and  Western  States.  Its  root  is  medicinal.  It 
is  diuretic,  and  has  been  much  praised  for  its  power  of  relieving  the 
excruciating  pain,  caused  by  the  passage  of  stone  through  the  uretlna, 
as  well  as  for  infallibly  removing  snch  stones  from  the  bladder,  pro- 
vided they  are  not  already  too  large  for  passage  through  the  water 
pipe.  As  many  as  one  hundred  and  twenty  calculi  have  been  known 
to  pass  off  from  one  person,  under  the  use  of  this  remedy.  A  con- 
centrated decoction,  or  the  fluid  extract  prepared  by  Tilden  &  Co., 
may  be  taken  in  teaspoonful  doses  several  times  a  day,  —  care  being 
taken  not  to  push  the  raedicine  to  the  extent  of  dizziness,  or  oppres- 
Biou  of  the  chest. 


Hyssop  {II//ssofnis  Officinalis).  —  This  is  a  native  of  the  continent 
of  Eurojx3,  and  is  cultivated  in  tiiis  country.  Tl»e  tops  and  leaves  are 
the  parts  used.  They  are  stimulant,  aromatic,  carminative,  and  tonic. 
The  infusion  has  been  much  employed  in  chronic  bronchitis  of  old 
pi'0[)le,  and  those  of  debilitated  habits.  It  makes  the  raising  of  mucus 
more  easy.  The  infusion  may  be  combined  with  sage  and  alum,  and 
sweetened  with  honey.  The  fresh  leaves  bruised,  and  ai)plied  exter- 
nally, relievo  the  pain,  and  disperse  the  spots  and  marks  caused  by 
contusions. 

Iceliiiul  Moss  (Cetraria  Islandica).  —  This  plant  is  found  in  the 
;K)r!licrn  latitudes,  both  of  the  old  and  new  world,  and  is  abundant 
on  the  mountains,  and  in  the  sandy  plains  of  New  England.  It  re- 
ceived its  name  from  its  prevalence  in  Iceland,  in  which  country,  as 
well  as  in  Lapland,  it  serves,  in  consequence  of  the  gum  and  starch 
it  contains,  as  food  for  the  inhabitants.  It  is  demulcent,  tonic,  and 
nutritious,  and  Is  well  fitted  to  relieve  affections  of  the  mucous  mem- 
brane of  the  lungs  and  bowels,  connected  with  debility  of  the  digestive 
organs;  it  is  given  therefore  in  chronic  bronchitis,  and  other  affections 
of  the  chest,  attended  with  copious  expectoration,  especially  when 
the  matter  discharged  is  purulent ;  also  in  dyspepsia,  chronic  dys- 
entery, and  diarrheea.  It  is  usually  employed  in  the  form  of  decoc- 
tion ;  and  is  much  used  in  the  common  article  of  diet,  called  blanc 
mange. 

Ice  Plant  (Monotropa  Vniflora).  —  This  perennial  plant,  found  in 
various  parts  of  the  country,  is  snow  white,  resembling  frozen  jelly, 
and  is  juicy  and  tender,  dissolving  in  the  hands  like  ice.  The  flowers 
are  in  shape  like  a  pipe;  it  is  hence  called  the  pipe  plant.  The  root 
is  the  medicinal  part,  and  is  tonic,  nervine,  and  antispasmodic.  It 
has  also  been  considered  sedative  and  diaphoretic ;  and  the  powder 
has  been  sometimes  used  in  the  place  of  opium.  It  is  said  to  be 
valuable  in  epilepsy,  chorea,  and  other  spasmodic  affections.  Dose 
of  the  powdered  root,  from  thirty  to  sixty  grains,  two  to  three  times 
a  day. 

Indian  Hemp  (Apocynum  Cannabinum).  —  This  perennial  plant  re- 
sembles bitter-root,  and  grows  in  similar  situations.  The  root  is 
powerfully  emetic,  and  in  decoction,  diuretic,  and  diaphoretic.  It 
diminishes  the  frequency  of  the  pulse,  and  produces  drowsiness.  It 
has  great  efficacy  in  dropsy. 

Preparations.  —  Fluid  extract,  dose,  as  a  tonic,  five  to  fifteen  drops, 
as  an  emetic,  twenty  to  sixty  drops ;  solid  extract,  dose,  one  to  five 
grains  ;  tincture,  dose,  one  to  two  drams,  as  a  tonic,  half  an  ounce  to 
an  ounce,  as  an  emetic;  infusion,  half  an  ounce  to  a  pint  of  water, 
dose,  half  an  ounce  to  two  ounces. 

Indinn  Tnrnip  {Ariwi  Triphylhm).  —  This  is  a  perennial  plant, 
growing  in  damp  places  in  North  and  South  America,  and  known  by 
th(-'  name  of  dragon  root.  The  root  when  chewed,  is  excessively  acrid, 
producing  a  biting  sensation   which  may  be  somewhat  relieved   by 


1   .'tm 


022 


MEDICINES  AND  THEIR  PREPARATIONS. 


nulk.  The  fresh  root  is  acrid,  expectorant,  and  diaphoretic,  and  haa 
been  used  in  asthma,  hooping-cough,  chronic  bronchitis,  chronic  rheu- 
matism, and  colic,  and  externally,  in  scrofulous  tumors,  scald  head, 
and  other  skin  disorders.  Dose  of  the  grated  root,  in  syrup  or  mucil- 
age, ten  grains,  three  or  four  times  a  day. 

Iodine  (lodinum).  —  This  ia  prepared  from  the  ashes  of  kelp,  or  sea- 
weed, and  is  in  small  bluish-black,  shining  scales.  It  is  alterative, 
tonic,  and  somewhat  diuretic.  It  has  been  chiefly  employi'd  in  dis- 
eases of  the  absorbent  and  glandular  system,  partieuiurly  tfcrol'ula, 
goitre,  and  glandular  tumors  generally.  Dose,  in  substance,  half  a 
grain,  two  or  three  times  a  day,  in  form  of  pill ;  in  form  of  tincture, 
five  to  ten  drops. 

Iwlide  of  Pottissiiini  (Potassii  lodidum).  —  This  is  one  of  the  pre- 
parations of  iodine,  and  is  sometimes  improperly  called  hydriodate  of 
potassa.  It  is  formed  by  decomposing  the  iodide  of  iron,  by  carbon- 
ate of  potassa.  It  is  used  for  the  same  purposes  as  iodine,  but  chiclly 
as  an  alterative  in  tertiary  syphilis,  for  which  it  is  a  specific ;  also  in 
some  forms  of  chronic  rheumatism,  and  in  lepro.sy.  Dose  of  the  salt, 
from  two  to  twenty  grains.  It  is  much  combined  with  bitter  tinc- 
tures, and  particularly  with  the  compound  preparations  of  sarsapa- 
rilla,  yellow  dock,  and  queen's  root.  The  acids  anS  metallic  salts  are 
incompatible  with  it. 

Ipecacuanha. —  This  is  a  small  perennial  plant,  growing  in  moist 
woods,  in  several  countries  of  South  America.  The  root  is  the  part 
used.  It  is  a  very  valuable  emetic,  in  large  doses ;  in  smaller  doses, 
it  is  sudorific  and  expectorant.  Used  to  produce  vomiting  in  the 
commencement  of  fevers,  inflammatory  diseases,  swelled  testicles,  and 
before  the  paroxysms  of  ague ;  and  to  excite  nausea  in  dysentery, 
asthma,  hooping-cough,  various  hemorrhages,  and  inflammation  of 
the  lungs;  and, combined  with  opium, to  produce  diaphoresis  in  rheu- 
matism, gout,  and  febrile  complaints.  Dose,  as  an  emetic,  from  fifte'in 
to  thirty  grains ;  to  excite  nausea,  from  one  to  three  grains ;  and  to 
produce  diaphoresis,  two  to  six  grains,  with  one  grain  of  opium. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant,  five  to  ten 
drops  ;  as  an  emetic,  half  a  dram  to  a  dram  ;  tincture,  half  an  ounce 
to  an  ounce  and  a  half;  wine  of  ipecac,  three  ounces  to  one  pint  of 
sherry  wine,  dose,  a  quarter  to  half  a  dmm,  as  an  expectorant ;  two 
and  a  half  to  five  drams  as  an  emetic.  The  following  is  a  useful  ex- 
{)ectorant  for  young  children:  fluid  extract  of  ipecac,  two  drams; 
syrup  of  tolu.  five  drams  ;  mucilage  of  gum  arable,  one  ounce  ;  sherry 
wine,  three  drams, —  mix.     Dose,  one  dram.  ..  ^ 

Iron  {Ferrum).  —  As  this  is  the  most  abundant,  so  it  ia  the  most 
useful  of  all  the  metals.  It  is  widely  diffused  through  the  mineral, 
the  vegetable,  and  the  animal  kingdoms.  It  is  an  essential  constitu- 
ent in  the  blood  of  man,  and  as  a  medicine  it  has  great  value,  being 
a  powerful  tonic.  In  most  cases  where  the  blood  is  thin  and  reduced, 
iron  is  our  best  remedy ;  it  raises  the  pulse,  promotes  the  secretions, 
and  gives  color,  body,  and  nutritive  qualities  to  the  blood.     It  is  much 


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;,  and  haa 

oiiic  rhou- 

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alterative, 
:'(l  in  dis- 
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y  carboii- 
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ig  in  the 
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e  pint  of 
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is  much 


MEDICINES  AND  TUEIR  PRETAUATIONS. 


62» 


used,  in  some  one  of  its  prepared  forms,  in  chronic  antcmia,  chlorosis, 
hysterics,  whites,  rickets,  chorea,  dyspepsia,  neuralgia,  and  particularly 
consumption.  The  following  are  most  of  the  chemical  preparations 
of  iron  used  in  medicine. 

Animonio-CitnUe  of  Iron  {Ferri  Ammonio-Cilras). —  This  is  in  the 
form  of  thin  scales,  of  a  beautiful,  garnet-red  color,  and  has  a  slightly 
acid  taste.  It  is  very  soluble  in  water.  Its  great  solubility  gives  it 
■onie  advantages  over  the  citrate.  The  dose  is  five  grains,  three  time* 
a  day,  in  solution. 

niiick  Oxlile  of  Iron  {Ferri  Oxidvm  Nigrum).  —  This  i&  a  dark, 
grayish-black  powder,  unchangeable  in  the  air,  and  having  magnetic 
properties.  It  is  a  valuable  chalybeate,  and  may  be  given  in  five  to 
fifteen-grain  doses. 

Citrate  of  Iron  (Ferri  Citras).  —  This  is  a  valuable  preparation  of 
iron.  It  is  soluble  in  water.  Usually  given  in  the  form  of  pill,  in 
two  to  five  grain  doses,  three  times  a  day. 

Citnite  of  Iron  luid  Quinia  {Ferri  et  Quiruc  Citras).  —  In  the  form 
of  shining  scal(>s,  garnet-colored,  and  soluble  in  water.  An  excellent 
antiperiodic  and  tonic.  Given  in  intermittents,  when  the  blood  is  low. 
etc.     Dose,  fivf  to  ten  grains,  two  or  three  times  a  day. 

CJtrnte  of  Iron  nnil  .Strychnia.  —  Dr.  James  R.  Nichols  &  Co.,  of 
this  city,  wore  the  first  to  introduce  this  combination  of  strychnia 
with  iron,  to  American  physicians.  It  is  a  valuable  preparation,  aud 
is  constantly  winning  the  favor  of  the  profession.  It  combines  the 
properties  of  iron  and  strychnia,  and  has  proved  an  efficacious  remedy 
in  atonic  dyrpepsia,  absence  of  the  menses,  St.  Vitus's  dance,  green- 
sickness, hysterics,  etc.  It  is  a  beautiful  salt,  looking  like  citrate  of 
iron,  except  that  it  is  a  little  darker.  Three  grains  of  the  iron  are  com- 
bined with  one  sixteenth  of  a  grain  of  strychnia. 

Hydrated  Oxide  of  Iron  {Ferri  Oocidum  HydrcUum).  —  This  is  in 
a  reddish-brown,  moist  mass,  not  much  used  in  medicine,  except  as 
an  antidote  to  the  poison  of  arsenic,  for  which  it  is  very  valuable.  It 
should  be  given  in  tablespoonful  doses,  often  repeated. 

Iodide  of  Iron  {Ferri  lodidum). — The  iodide  of  iron  is  a  crystalline 
substance,  of  a  greenish-black  color,  and  styptic  taste.  It  has  tonic, 
alterative,  diuretic,  and  emmenagogue  properties.  It  is  employed 
chiefly  in  scrofulous  complaints,  swelling  of  the  glands  of  the  neck, 
chlorosis,  absence  of  the  menses,  and  leucorrhoea.  In  obstinate  syph- 
ilitic ulcers,  and  in  secondary  syphilis,  occurring  in  scrofulous  and 
debilitated  subjects,  it  has  been  used  with  success.  Dose,  three  grains, 
gradually  increased  to  eight.  It  should  never  be  given  in  the  form 
of  pill. 

Lactate  of  Iron  {Ferri  Lactas).  —  This  has  the  general  medicinal 
properties  of  the  ferruginous  preparations.  It  increas<;s  the  appetite 
in  a  marked  degree,  and  has  been  used  with  decided  benefit  in  chlo- 
rosis. Dose,  one  to  three  grains,  three  times  a  day.  The  dose  may 
be  gradually  increased.    Given  in  the  form  of  solution,  pill,  or  lozenge. 


G24 


MKDICINKS  AM)  THEIR  PREPAKATIONS. 


IMiospliiife  of  Iron  (Ferrl  P/iosphax). —  Thi»  in  a  slate-colored  pow. 
der,  insoluble  in  water.  It  is  a  valuable  remedy  in  coiisutnption, 
cancer,  and  nervons  diHcases,  accompanied  by  a  low  state  of  the 
blood.     Dose,  one  or  two  grains,  three  times  a  day. 

Per  Suit  of  Iron  {Mansers  Sti/ptic).  —  This  is  a  most  valuable  styp- 
tic, and  is  used  with  success  in  restraining  violent  bleeo.ngs.  It  pro- 
duces no  irritant  ell'ects  upon  the  tissues,  aiid  may  be  used  with  safety 
both  in  slight  and  extensive  surgical  operations.  Pliysicians  should 
hav(!  it  by  them,  and  will  find  it  very  serviceable  in  sudden  emergen- 
cies of  bleeding.  It  is  prepared  in  solution  and  in  the  form  of  dry 
salt,  by  Dr.  James  R.  Nichols  &  Co.,  of  this  city.  The  solution  is  the 
most  convenient  and  eligible  form,  and  may  be  applied  as  prepared. 

Powder  of  Iron  (Ferri  Pulvis).  —  This  is  what  is  often  called  iron 
by  hydrogen,  or  Qudvenne's  iron.  It  is  an  impalpaple  powder,  and  of 
an  iron-gray  color.  If  black,  it  is  worthless.  It  is  used  in  anaemia, 
and  in  all  those  conditions  characterized  by  deficiency  of  coloring 
matter  in  the  blood.  The  best  metallic  iron  for  medicinal  use.  Dose, 
from  two  to  six  grains,  several  times  a  day ;  to  be  given  in  the  form 
of  pill. 

Precipitated  Ctirbonrtte  of  Iron  {Ferri  Subcarbonas).  —  This  is  a 
reddish  powder,  insoluble  in  water.  It  is  tonic,  alterative,  and  em- 
menagogue,  and  is  u.sed  in  neuralgia,  chorea,  chlorosis,  anemia,  epi- 
lepsy, scrofula,  etc.  Dose,  five  to  thirty  grains,  three  times  a  day,  to 
be  taken  in  a  little  water. 

Protoxide  of  Iron  {Ferri  Piotoxidum).  —  This  is  of  a  dark  blue 
color,  and  has  a  tendency  to  absorb  oxygen  from  the  air,  which  con- 
verts it  into  the  sesquioxide.  It  is  a  valuable  preparation  of  iron. 
Dose,  from  two  to  six  grains,  three  times  a  day. 

Solution  of  Protoxide  of  Iron. —  The  protoxide  of  iron  being  more 
readily  absorbed  and  assimilated,  and  agreeing  better  with  the  stom- 
ach, than  any  other  preparation  of  this  metal,  has  led  to  a  general  desire 
for  this  stilt  in  some  eligible  form,  protected  from  the  chemical  changes 
to  which  it  is  so  liable.  This  desire  has  been  met  by  Dr.  James  R. 
Nichols  &  Co.  of  this  city,  who,  by  a  new  method  of  chemical  ma- 
nipulation, have  prepared  an  unchangeable  solution  of  it,  in  the  form 
of  an  elegant  syrup,  which  is  permanent  in  form,  pleasant  to  the  taste, 
and  free  from  the  inky  flavor  peculiar  to  iron  preparations.  Dr.  Nich- 
ols, one  of  the  most  reliable  practical  chemists  in  the  country,  has 
conferred  a  benefit  upon  the  profession  by  preparing  this  syrup.  I 
have  had  the  pleasure  of  using  it,  with  peculiar  satisfaction.  Dose, 
from  one  to  two  teaspoonfuls,  three  times  a  day. 

Solution  Protoxide  Iron,  with  Rhubarb  and  Columbo.  —  This  ia  a 
composition  of  protoxide  of  iron  witii  vegetable  tonics ;  a  combina- 
tion long  desired,  but  just  now,  for  the  first  time  effected,  by  Dr. 
James  R.  Nichols  &  Co.  of  this  city.  As  a  remedy  in  many  forma 
of  dys|x*psia,  it  must  prove  of  great  value. 

Solution  l*rotoxide  Iron,  with  <tuinine. — This  has  become  a  remedy 


MEDICINES  AND  THEIR  PREPARATIONS. 


62/5 


•<' 


remedy 


of  established  reputation.  Quinine  combined  with  iron,  particularly 
with  the  protoxide,  must  have  great  advantages  as  a  chalybeate  tonic 
This  is  one  of  the  reliable  preparations  of  Dr.  Nichols.  Each  table- 
spoonful  contains  half  a  grain  of  quinine. 

Solution  Protoxide  Iron,  witli  Iodide  of  PotiiRsn.  —  In  this  prepara- 
tion, the  valuable  alterative  properties  of  i(xlide  of  potassium,  are 
connected  with  iron.  It  is  therefore  altc'-i.tive  and  tome,  and  may  be 
used  in  scrofulous  and  other  weakenct  onditions  of  the  system,  ft 
is  a  HMuedy  of  decided  merit.  Three  grains  of  the  iodide  of  potas- 
sium are  contained  in  each  tablespoonful.  This  is  also  prepared  by 
Dr.  James  R.  Nichols  &  Co. 

Sulplltlte  of  Iron  (Ferri  Sulphas).  —  This  ig  in  the  form  of  transpa- 
rent crystals,  of  a  pale,  bluish-green  color,  and  efflorescent  in  the  air. 
It  has  a  styptic  taste,  and  is  soluble  in  alxiut  twice  its  weight  of 
cold  water,  but  insoluble  in  alcohol.  It  is  astringent  and  tonic.  In 
large  doses,  it  produces  nausea  and  griping  of  the  bowels.  Useful  in 
scrofula,  and  as  an  astringent,  in  passive  hemorrhages,  sweats,  dia- 
betes, chronic  mucous  catarrh,  leucorrhcca,  and  gleet.  As  a  tonic,  it 
is  useful  in  dyspepsia. 

Syrup  of  Iodide  of  Iron .( »Syr«pMS  lodidi  Ferri).  —  This  is  an  ele- 
gant preparation  of  iodine  and  iron,  and  is  given  in  all  debilitated 
conditions  of  the  system,  when  there  is  a  taint  of  scrofula.  ^)ose, 
from  twenty  to  fifty  drops,  well  diluted,  at  the  moment  of  taking,  ith 
water. 

Syrup  of  Iodide  Iron  and  Manganese.  —  This  is  of  a  light  straw 
color,  prepared  from  protosulphate  of  iron,  protosulphate  of  manga- 
nese, and  iodide  of  potassium.  It  is  a  remedy  of  unsurpassed  effi- 
cacy in  antemic,  scrofulous,  syphilitic,  and  cancerous  affections.  It 
i§  considered  superior  to  the  syrup  of  iodide  of  iron.  This  is  another 
of  Dr.  J.  R,  Nichols  &  Co.'s  valuable  preparations.  Dose,  from  ten 
to  sixty  drops. 

Tartrate  of  Iron  and  Potassn  {Ferri  et  Potassa;  Tartras). —  This  is  in 
the  form  of  beautiful  shining  scales,  of  a  dark  ruby  color,  of  a  slightly 
chalybeate  taste,  and  very  soluble  in  water.  It  is  one  of  the  mild- 
est of  the  salts  of  iron,  and  is  considerably  used  in  scrofula,  weak- 
ness of  the  bowels,  general  debility,  etc.  It  is  much  used  of  late,  as 
a  remedy  for  syphilis,  both  externally  and  internally.  The  dose  is 
ten  to  thirty  grains  in  solution. 

Tincture  of  lluriate  of  Iron  {Tinctura  Ferri  Chloridi).  —  This  has 
a  reddish-brown,  yellowish  color,  a  sour  and  very  styptic  taste,  and  an 
odor  like  muriatic  ether.  It  is  one  of  the  most  active  and  certain  pre- 
parations of  iron,  generally  agreeing  with  the  stomach,  and  much 
employed  for  purposes  for  which  iron  is  used.  It  is  useful  in  scrofula, 
gleet,  and  leucorrhcea ;  also  in  hemorrhages  from  the  womb,  kidneys, 
and  bladder,  of  a  passive  character.  Dose,  from  ten  to  thirty  drops, 
gradually  increased  to  one  or  two  drams,  vwo  or  three  times  a  day- 
It  should  be  given  diluted  with  water. 

79 


.  \ 


620 


MEDICINKS  AND  TPKIU  I'UKI'AHATIONS. 


TtlleriillDlte  of  Iron. —  'I'liia  unh  in  in  tho  form  of  n  dark-rod  now- 
dt;r,  liiiviiig  ii  fuiiit  odor,  and  a  tasti;  of  vaUTinnic:  acid.  It  i«  soluble 
in  alcohol,  and  insoluble  in  water.  Given  in  liystoiical  ntfections, 
complicated  with  chlorosis.     Dose,  one  grain,  several  times  a  day. 

IhIii;(Iiiss  [Trhthf/ocoUa).  —  A  gelatinous  substance,  prepare*!  from 
the  bladder  of  fishes.     It  is  soluble  in  alkaline  solutions,  and  diluted  : 
acids.     In  boiling,  it  dissolves,  and  forms  a  jelly  upon  cooling,  in  which 
form  it  is  chiefly  used  as  a  nutritive  diet  for  the  sick. 

Jillap  {f/toDKra  Jalnpa).  —  This  is  a  Mexican  plant.  Its  root  is  an 
active  cathartic,  producing  liquid  8t<K)ls,  more  or  less  griping.  United 
with  cream  of  tartar,  it  becomes  a  hydragogue,  and  is  useful  in  dropsy. 
The  dose  is  from  lifteen  to  thirty  grains. 

Preparations.  —  Fluid  extract,  dose,  a  quarter  to  one  dram;  solid 
extract,  dose,  three  to  eight  grains ;  tincture,  two  ounces  to  the  pint 
diluted  alcohol,  dose,  one  to  two  and  a  half  drama ;  jalapin,  the  active 
principle,  dose,  one  to  two  grains. 

Juniper  {Juniperis  Communis).  —  This  evergreen  shrub  is  a  native 
of  Europe,  and  is  naturalized  in  some  parts  of  this  country.  The 
berries,  which  are  the  part  used,  are  wrinkled,  of  a  dark-purple  color, 
about  the  size  of  a  pea.  They  are  gently  stimulant  and  diuretic,  and 
have  been  used  in  scurvy,  and  inflammation  of  the  bladder,  chiefly  in 
connection  with  more  active  diuretics.  The  oil  of  juniper  obtained 
from  the  berries  is  used  for  similar  purposes.  Five  minims  of  the  oil, 
mixed  with  one  fluid  dram  of  sweet  spirits  of  nitre,  and  given  three 
times  a  day,  is  valuable  in  dropsy.  Dose  of  the  berries,  from  one  to 
two  drams  ;  of  the  oil,  from  five  to  fifteen  drops. 

Kino.  —  This  is  the  hardened  juice  of  an  East  Indian  tree,  Ptero- 
carpus  Marsupiuvi.  There  are  several  varieties  of  it.  It  is  a  })ower- 
ful  and  valuable  astringent,  and  is  much  used  in  diarrhoea,  not  atten- 
ded  with  inflammation.  Opium  is  often  united  with  it,  and  it  is  a 
favorite  addition  to  chalk  mixture.  It  is  also  used  in  chronic  dysen- 
tery, leucorrhoea  and  diabetes.  It  may  be  used  in  the  form  of  jx)wder, 
infusion,  or  tincture.  Dose  of  the  powder,  ten  to  thirty  grains ;  of  the 
tincture,  one  or  two  fluid  drams ;  the  infusion  is  useful  as  an  injection, 
in  leucorrhcea  and  gonorrhoea.  The  powder  is  sometimes  sprinkled 
with  advantage  on  indolent  and  flabby  ulcers. 

Ladies'  Slipper  ( Cypripedium  Pubescens).  —  The  fibrous  roots  are 
the  parts  used  of  this  plant.  It  is  tonic,  nervine,  and  antispasmodic, 
and  is  employed  in  nervous  headache,  and  other  nervous  aflections,  as 
excitability,  hysterics,  neuralgia,  etc. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  solid 
extract,  dose,  five  to  fifteen  grains ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce ;  cypripedin,  the 
active  principle,  dose,  two  to  four  grains.  The  following  is  a  useful 
preparation  for  producing  sleep,  in  wakeful  and  excited  conditions  s 
fluid  extract  ladies'  slip^>er,  one  ounce ;  fluid  extract  pleurisy  root, 
«ne  ounce ;  fluid  extract  skunk  cabbage,  one  ounce ;  fluid  extract 


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Photographic 

Sciences 

Corporation 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

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Series. 


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Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductlons  historique^t 


s 


MEDICINES  AND  THEIR  PREPARATIONS. 


627 


scullcap,  one  ounce  ;  mix  ;  dose,  half  a  drara  to  a  dram,  three  times  a 

day. 

i<'or  sick  and  nervous  headache,  dependent  on  an  acid  stomach,  the 
following  ia  ueeful :  fluid  extract  ladies'  slipper,  half  an  ounce ;  fluid 
extract  catnip,  half  an  ounce;  fluid  extract  scuUcap,  half  an  ounce; 
water,  one  pint ;  mix  ;  dose,  one  and  a  half  to  three  drams. 

Lead  (Plumbum).  —  Lead  acts  upon  the  system  as  a  sedative  and 
astringent.  Internally,  it  is  used  for  the;purpo8e  of  reducing  the  force 
of  the  circulation,  and  for  restraining  improper  bleeding,  and  other 
excessive  discharges.  Externally,  it  is  employed" to  subdue  inflamma- 
tion. It  should  not  be  excessively  used  ;  for,  if  taken  internally  for  a 
long  time,  it  injures  the  nervous  system,  and  brings  on  apoplexy, 
paby,  and  particularly  lead  colic.  Nature  generally  gives  notice  when 
(t  is  doing  mischief,  by  drawing  a  blue  line  around  the  edge  of  the  gum. 
The  preparation  of  lead  chiefly  used  in  medicine  is  the  following: 

Acetate  of  Lead  {Plumbi  Acetas).  —  This  is  known  by  the  name 
of  sugar  of  lead,  and  is  a  white  salt,  crystallized  in  brilliant  needles. 
It  has  first  a  sweetish,  and  then  an  astringent  taste.  In  medicinal 
doses,  it  is  a  powerful  sedative  and  astringent ;  in  large  ones,  an  irri- 
tant poison.  It  is  principally  used,  internally,  for  bleeding  from  the 
hings,  bowels,  and  womb.  The  dose  is  generally  two  grains,  united 
to  half  a  grain  to  a  grain  of  opium,  in  the  form  of  pill.  Externally, 
it  is  employed  in  form  of  solution,  and  applied  to  inflamed  surfaces 
*rith  cloths.  Four  grains  of  sugar  of  lead,  and  four  of  pulverized 
jpium  to  the  pint  of  water,  makes  a  good  lotion  for  various  purpot<e8. 

Lemon  ( Citrus  Limonum).  —  This  is  a  well-known  tropical  fruit, 
the  juice  of  which  has  a  grateful  acid  taste,  which  is  much  used  in 
fevers  and  inflammatory  complaints,  to  form  the  agreeable  drink 
called  lemonade.  The  oil  of  lemon,  obtained  from  the  fresh  rind 
of  the  fruit,  is  ohiefly  used  In  perfumery,  and  to  render  the  taste  of 
medicines  more  agreeable. 

Lettuce  {Lactu^a  Sativa).  —  The  medicinal  properties  of  this  gar- 
den plant  are  contained  in  the  milk.  It  is  given  when  opium  disa- 
grees with  the  patient,  to  allay  cough  and  irritability. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams ; 
Bolid  extract,  dose,  two  to  five  grains.  The  following  is  a  useful  com- 
pound syrup :  fluid  extract  lettuce,  two  ounces ;  fluid  extract  f>oppy, 
four  ounces  ;  simple  syrup)  ten  ounceb  ;  mix  ;  dose,  half  a  dram  to  a 
dram. 

Life  Root  {Senecio  Aureus).  —  This  is  a  perennial  plant,  growing 
on  the  banks  cf  marshy  creeks,  in  the  Northern  and  Western  States, 
and  sometimes  called  Ragwort,  \ioih.  the  root  and  herb  are  diuretic, 
pectoral,  diaphoretic,  and  tonic,  considerably  valued  as  a  remedy  in 
gravel,  and  other  urinary  affections,  particularly  strangury.  It  is  use. 
ml  for  promoting  menstrual  discharges. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  infu* 
sioi^  dose,  one  to  four  ounces ;  senecin,  the  active  principle,  dose. 


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s'/ 


three  to  five  grains.  For  chlorosis,  accompanied  by  absence  of  the  ! 
menses,  the  following  is  a  useful  preparation  :  senecin,  aletrin,  and 
sulphate  of  iron,  four  grains  each.  Mix,  and  divide  into  two  grain 
powders.  Six  grains  each  of  senecin  and  geraniin,  mixed,  and  taken 
in  doses  of  two  to  four  grains,  has  a  good  eft'ect  in  restraining  an 
immoderate  flow  of  the  menses.  In  painful  menstruation  the  follow- 
ing is  a  good  pill :  senecin,  two  grains ;  quinine,  six  grains ;  solid 
extract  belladonna,  three  grains ;  make  into  ten  pills,  and  take  one 
every  three  hours,  till  the  pain  is  subdued. 

Lime  ( Calx).  —  This  is  one  of  the  alkaline  earths,  and  is  an  abun- 
dant natural  production.  It  is  used  in  several  forms  in  medicine,  of 
which  the  following  are  the  chief.  ~ 

Cliloride  of  Lime  ( Calx  Chlorinata).  —  This  is  a  moidt,  grayish- 
white  substance,  having  the  -  Jor  of  chlorine,  and  possessing  powerful 
bleaching  properties.  Externally  used,  it  is  disinfectant,  and,  dis- 
solved in  water,  is  applied  with  advantage  to  ill-conditioned  ulcers, . 
burns,  chilblains,  and  eruptions  of  the  skin,  also  as  a  gargle  in  putrid 
sore  throat,  and  as  a  wash  for  ulcerated  gums,  and  to  purify  the 
breath.  It  has  been  used  with  advantage  in  dysentery,  both  by  mouth 
and  injection,  to  correct  the  fetor  of  the  stools. 

Lime  Water  {Aqua  Calais).  —  This  is  made  by  dissolving  four 
ounces  of  lime  in  a  gallon  of  w^ater,  and  letting  the  solution  stand 
in  a  covered  vessel,  and  pouring  off  the  clear  liquor  when  it  is  wanted 
for  use.  It  is  antacid,  antilithic,  tonic,  and  astringent,  valuable  in  all 
complaints  attended  with  acidity  of  the  stomach.  United  with  milk, 
and  used  as  the  sole  diet,  it  is  sometimes  the  only  remedy  for  chronic 
diarrhoea  of  long  standing.  Dose  of  lime  water,  half  an  ounce  to  \ 
two  ounces. 

Liqnorice  {Glycyrrhiza  Glabra).  —  This  grows  in  the  south  of 
Europe  and  .  sia.  The  root  is  the  part  used.  It  is  demulcent  and 
expectorant  and  is  useful  in  cough,  chronic  broiichitis,  and  irritations 
of  the  mucous  surfaces  generally.  The  pulverized  root,  united  with 
an  equal  amount  of  sulphur,  and  a  little  molasses,  is  a  valuable  pre- 
paration for  coughs.  The  black  extract  may  be  u.sed  for  the  same 
purposes  as  the  root. 

Liverwort  [Hepatica  Americana).  —  An  indigenous  plant,  growing 
in  woodf.,  upon  the  sides  of  hills  and  mountains.  The  leaves  with- 
stand the  cold  of  winter,  and  the  flowers*  appear  early  in  the  spring. 
The  whole  plant  is  medicinal.  It  is  a  mild  demulcent  tonic  and  as- 
tringent, and  has  been  used  in  fevers,  liver  complaints,  bleeding  from 
the  lungs,  and  coughs. 

Preparations.  —  Fluid  extract,  dose,  two  to  three  drams ;  infusion, 
four  ounces  to  the  pint  of  water,  to  be  taken  freely. 

Lobelia  {Lobelia  Injtata). —  This  weed  grows  throughout  the  United 
States ;  both  its  seeds  and  leaves  are  used  in  medicine.  The  plant  is 
emetij,  expectorant,  sedative,  and  antiepasmodic.  As  an  emetic,  it  is 
generally  used  in  combination  with  ovher  articles  for  that  purpdse. 


riimv,vfmmunimm»m 


MEDICINES  AND  THEIR  PREPARATIONS. 


629 


ce  of  the 
3trin,  and 
;wo  grain 
md  taken 
Eiining  an 
lie  foUow- 
ins ;  solid 
tai^e  one 


an  abun- 
dicine,  of 

,  grayiah- 
;  powerful 
and,  dis- 
ed  ulcers, . 
in  putrid 
)urify  the 
by  mouth 

ving  four 
ion  stand 
is  wanted 
Eible  in  all 
jvith  milk, 
)r  chronic 
ounce  to 

south  of 
Icent  and 
irritations 
lited  with 
lable  pre- 
the  same 


growing 
lives  with- 
he  spring. 
a  and  as- 
LJing  from 

infusion, 

he  United 

le  plant  is 

netic,  it  is 

purpose. 


It  is  of  great  advantage  in  spasmodic  asthma,  as  well  as  in  bronchitis, 
croup,  hooping-cough,  and  other  throat  and  chest  affections.  When- 
ever relaxation  is  required  to  subdue  spasm,  or  for  other  purposes, 
lobelia  will  be  found  useful. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant,  ten  to  sixty 
drops ;  as  an  emetic,  one  fourth  of  a  dram  to  a  dram  ;  tincture,  two 
ounces  to  a  pint  of  diluted  alcohol,  dose,  as  an  expectorant,  one  to 
three  drams,  as  an  emetic,  half  an  ounce ;  infusion,  dose,  an  ounce 
every  half  hour  till  vomiting  ensues ;  lobelin,  the  active  principle,  dose, 
half  a  grain  to  a  grain  and  a  half.  The  following  mixture  will  ^' 
found  excellent,  as  an  expectorant  arid  sudorific,  in  spasmodic  croup, 
hooping-cough,  and  asthma,  and  for  subduing  mucous  inflammation 
'bout  the  throat  and  air  passages  :  tincture  of  lobelia,  half  an  ounce; 
tincture  of  bloodroot,  two  ounces ;  oil  of  spearmint,  half  a  dram ; 
empyreumatic  yyrup,  five  ounces ;  dose,  half  a  dram  every  two  hours. 
A  poultice  made  of  lobelia,  elm  bark,  and  weak  lye,  relieves  sprains, 
bruises,  rheumatic  pains,  erysipelatous  inflammations,  and  poison 
from  ivy  or  dogwood. 


Fia.  aoo. 


Fio.  310. 


LADIBS'   BLIFFKIl. 


Lo^ood  {Hfematoxyhn  Campechianurri).  —  This  tree  is  a  native  of 
tropical  America.  The  wood  is  used  in  medicine.  It  is  Ionic  and 
'astringent,  and  is  used  with  advantage  in  diarrhaia,  dysentery,  and  in 
the  relaxed  state  of  the  bowels  after  cholera  infantum.  Used  freely 
with  other  treatment,  it  also  benefits  constitutions  broken  down  by 
disease  or  dissipation. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  five  to  thirty  grains ;  infusion,  half  an  oum-e  to  a  pint 
of  water,  dose,  four  drams  every  three  or  four  hours,  in  diarrhoea. 

Magnesia  {Magnesia  Usla). —  Calcined  magnesia  is  obtained  from 
carbonate  of  magnesia,  by  exposure  to  a  strong  heat.  It  is  a  whit^, 
inodorous,  light  powder,  of  a  feeble  alkaline  taste.  It  i?  antacid  and 
laxative,  and  is  much,  used  in  dyspepsia,  sick  headache,  gout,  and  in 
other  complaints  attended  with  sour  stomacb  and  costiveness ;  like- 
wise a  favorite  remedy  in  complaints  of  children.    Dose,  as  a  laxative, 


\n 


VA 


■will 


from  thirty  to  sixty  grains ;  as  an  antacid,  or  antilithic,  ten  to  thirty 
grains,  once  or  twice  a  day. 

Ciii'boiiilfe  of  IWaftiiesia  {Mag-nesi(e  Carbonas).  —  This  is  prcjiared 
from  sulphate  of  magnesia,  by  carbonate  of  soda.  It  is  antacid,  and 
wiien  it  meets  with  acid  in  the  stomach  and  bowels,  it  is  laxative. 

Sulphate  of  Na^rnesia  (Magnesia  Sulphas).  —  Obtained  from  sea- 
water.  This  is  the  well-known  Epsom  salts  and  is  purgative  and 
diuretic.  Used  in  all  cases  which  require  purgatives.  It  generally 
operates  without  griping,  and,  when  united  with  an  acidulated  infu- 
sion of  roses,  will  remain  on  the  stomach  when  all  other  things  axe 
rejected.  The  less  it  is  diluted,  the  better  and  more  easily  it  operates, 
provided  a  draught  of  warm  water  be  taken  an  hour  afterwards.  It 
may  be  made  to  act  as  a  diuretic,  by  keeping  the  skin  cool,  and  walk* 
ing  about  after  it  has  been  taken. 

Male  ¥emf{Aspidium  Filix  Mas).  —  This  perennial  plant  is  found  in 
both  Europe  and  America,  also  in  Asia  and  northern  Africa.  The 
root,  which  is  the  medicinal  part,  should  be  gathered  during  summer, 
as  the  active  principle  is  more  abundant  at  that  season  than  any 
other.  It  is  also  said  to  deteriorate  by  age,  and  become  nearly  worth- 
less in  two  years.  It  is  slightly  tonic  and  astringent,  but  its  chief 
value  consists  in  its  powftr  to  destroy  and  expel  the  tapeworm. 

Preparations. —  Solid  extract,  dose,  nine  to  fifteen  grains.  The  fol- 
lowing compound  pills  are  adapted  to  the  destruction  of  the  tape- 
worm :  solid  extract  male  fern,  two  scruples ;  gamboge,  fourteen 
grains ;  calomel,  fourteen  grains ;  scammony,  eighteen  grains.  Mix, 
and  divide  into  twenty  pills.     Dose,  two  to  four  pills. 

nnndrake  {Podophyllum  Peltatum).  —  This  is  exclusively  an  Ameri- 
can plant.  The  root  is  the  medicinal  part.  It  is  cathartic,  alterative, 
anthelmintic,  hydragogue,  sialagogue,  and,  in  large  doses,  emetic.  It 
stimulates  and  quickens  the  action  of  the  liver  and  kidneys,  promotes 
expectoration,  and  determines  the  blood  to  the  surface.  Combined 
with  cream  of  tartar,  it  produces  watery  stools,  and  is  useful  in  dropsy. 
It  is  used  in  jaundice,  dysentery,  diarrhoea,  bilious,  remittent,  and  in- 
termittent fevers,  puerperal  fever,  typhoid  fever,  and  all  glandular 
enlargements.  But  it  has  a  more  particular  action  upon  the  liver, 
and  is  es'^ecially  useful  in  derangements  of  that  organ. 

The  severity  of  its  action  seems  to  be  the  only  objection  to  ita  very 
extensive  use.  Its  harshness,  however,  may  be  much  lessened  by  its 
combination  with  castile  soap,  alkalies,  ginger,  or  caulophyllin. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  com- 
pound fluid  extract,  dose,  one  to  two  drams ;  solid  extract,  dose,  three 
to  twelve  grains ;  tincture,  three  and  a  half  ounces  to  one  pint  of 
alcohol,  dose,  one  to  four  drams;  podophyllin,  the  active  principle, 
dose,  as  an  alterative,  one  eighth  to  a  quarter  of  a  grain  ;  as  a  cathar- 
tic, one  to  two  grains. 

Mannat  —  This  is  the  concrete  juice  of  the  tree  called  Ornus 
Europcea,  growing  in  Sicily,  Calabria,  and  Apulia,  as  well  as  of  several 
other  species  of  tree.     Manna  is  a  gentle  laxative,  operating  mildly, 


^m^^ 


MEDICINES  AND  THEIR  PREPARATIONS. 


63'i 


though  sometimes  producing  wind  and  pain.  It  is  considerably  used 
as  a  gentle  phyyic  for  children,  and  women  in  the  family  way.  The 
usual  way  of  prescribing  it  is  in  connection  with  senna,  rhubarb,  mag- 
nesia, or  the  neutral  salts.  Being  sweet,  it  conceals  the  taste  of  these 
remedies,  in  some  measure,  while  it  adds  to  their  purgative  effect 
Dose  of  manna,  for  a  grown  person,  from  one  to  two  ounces ;  for  a 
child,  from  one  to  four  drams,  according  to  age. 

Harsh  Rosemary  ( Stalice  Caroliniana).  —  This  plant  grows  on  the 
coast  from  Maine  to  Georgia.  The  root  of  it  is  the  medicinal  part. 
A  decoction  of  it  is  much  used  in  diarrhcea,  dysentery,  etc.,  also  as  a 
gargle  in  ulcerated  sore  mouth,  and  the  throat  affection  of  scarlet 
fever,  and  as  an  injection  in  gleet,  whites,  and  falling  of  the  womb, 
and  bowel.  Dose  of  the  decoction,  one  or  two  tablespoonfuls,  every 
hour  or  two. 


Fio.  ail. 


Fia.  212. 


wm 


MAMOBAKS. 


KABSRMALLOW. 


Marslunnllow  (AUh(ea  Officinalis).  —  A  perennial  plant,  growing  in 
salt  marshes,  and  pther  moist  places,  in  Europe.  The  root  is  the 
niedicinal  part,  and  its  properties  are  those  of  a  demulcent.  A  decoc- 
tion of  it  is  used  in  irritations  and  inflammations  of  mucous  mem- 
branes, as  in  inflammation  of  the  lungs,  stomach,  bowels,  and  bladder, 
and  some  affections  of  the  kidneys.  The  powdered  root,  and  also  the 
leaves  and  flowers,  are  sometimes  employed  in  the  form  of  poultice. 

Masticll. —  This  is  the  hardened  gum  or  resin  which  flows  from 
incisions  in  the  small  tree  or  shrub  pistacia  lenliscus,  growing  upon 
the  borders  of  the  Mediterranean.  It  is  not  much  used  in  medicine, 
but  is  chiefly  employed  in  manufacturing  a  brilliant  varnish.  I  intro- 
duce it  here  principally  for  the  purpose  of  recommending  the  follow- 
ing use  of  it  in  carious  teeth,  —  particularly  ii.  those  new  parts  of  the 
country  where  dentistry  is  not  much  known.  Dissolve,  in  a  well- 
stopped  bottle,  four  parts  of  mastich  in  one  part  of  sulphuric  ether. 
Saturate  with  this  solution  a  small  piece  of  cotton  of  the  size  of  the 
cavity  in  the  tooth,  and  then,  having  cleansed  and  dried  the  cavity, 
gently  press  the  cotton  into  it.  The  ether  will  soon  evaporate,  and 
leave  the  gum  to  attach  itself  to  the  sides  of  the  tooth,  and  protect 
its  inner  surfaces  from  the  action  of  the  air  and  food. 


<ii'] 


'-'■'•'■•^■•■■''■^-^^■■"'■'-^■"ff  ii[j(  1^ 


■ifr' 


632 


MEDICINES  ANTi  THEIR  PREPARATIONS. 


Hfltico  {Piper  Anfpisti folium).  —  The  leaves  of  this  plant  are  styptic, 
and  somewhat  stimulant  and  tonic.  The  leaves  brought  in  contact 
with  a  bleeding  wound,  have  considerable  power  to  arrest  the  flow  of 
blood. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  tinc- 
ture, four  ounces  to  a  pint  of  diluted  alcohol,  dose,  two  drams  to  an 
ounce ;  infusion,  half  an  ounce  to  a  pint  of  water,  dose,  one  to  two 
ounces. 

Neiulow  Saffron  ( Colchicum  Autumnale).  —  This  is  a  native  of  the 
temperate  parts  of  Europe,  where  it  grows  wild  in  moist  meadows. 
The  roots  and  seeds  are  used.  Colchicum  is  justly  regarded  as  a 
valuable  remedy  in  gout  and  rheumatism,  in  which  it  is  much  and 
chiefly  used.  It  is  thought,  also,  to  act  upon  the  nervous  system, 
aJIaying  pain,  and  producing  other  sedative  effects.  When  not  car- 
ried on  by  the  bowels,  it  produces  sweating,  and  is  occasionally 
diuretic  and  expectorant.  Dose  of  the  dried  root,  from  two  to  eight 
grains. 

Preparations.  —  Fluid  extract  of  root,  dose,  three  to  twelve  drops ; 
fluid  extract  of  seeds,  dose,  five  to  fifteen  drops  ;  tinctuie.  four  ounces 
to  twelve  ounces  diluted  alcohol,  dose,  ten  drops  to  half  a  dram ; 
syrup,  two  ounces  to  fourteen  ounces  simple  syrup,  dose,  one  third  of 
a  dram  to  a  dram ;  wine,  three  ounces  of  root  to  a  pint  of  sherry 
wine,  dose,  thirty  to  forty  drops. 

Monk's  Hood  (Aconite).  ■ —  This  is  anodyne,  sedative,  and  diapho- 
retic. The  ieaves  and  root  are  generally  used  separately.  It  is  use- 
ful in  inflammatory  diseases,  neuralgia,  epilepsy,  paralysis,  gout,  and 
particularly  in  fevers. 

Preparations.  —  Fluid  extract,  dose,  two  to  six  drops  ;  solid  extract, 
dose,  one  quarter  of  a  grain  to  a  grain  ;  tincture,  eight  ounces  of  the 
root  to  a  pint  of  alcohol,  dose,  three  to  eight  drops. 

A  preparation  composed  of  one  dram  of  the  tincture  of  aconite 
root,  and  two  ounces  of  the  tincture  of  black  cohosh,  and  taken  in 
doses  of  one.  teaspoonful  every  four  hours,  has  great  power  in  reliev- 
ing the  various  forms  of  neuralgia,  and  also  chronic  rheumatic  painx, 
particularly  among  old  people. 

For  nervous  headache,  irritability,  restlessness,  and  wakefulness,  the 
following  combination  of  aconite  is  useful : 

Solid  extract  of  aconite,  half  a  dram  ;  solid  extract  of  stramonium, 
four  grains  ;  valerianate  of  quinia,  one  scruple.  Mix,  and  divide  into 
sixty  pills,  of  which  one  is  to  be  taken  every  two,  three,  or  four  hours, 
according  to  symptoms. 

Motherwort  (Leonurus  Cardiaca).  —  This  perennial  plant  is  sup- 
posed to  be  a  native  of  Tartary,  and  introduced  into  this  country. 
It  is  considerably  used  in  domestic  practice,  for  nervous  complaints, 
and  many  chronic  di  orders  attended  with  restlessness,  disturbed 
sleep,  pains  of  the  neives,  and  affections  of  the  liver.  A  warm  infu- 
sion of  the  tops  and  leaves  is  useful  in  restoring  menstrual  suppres- 
uoQ  from  colds. 


MEDICINES  AND  THEIR  PKEPARATI0N8. 


63;{ 


Preparation.  —  Solid  extract,  dose,  three  to  six  grains.  Combined 
with  blue  cohosh  and  skunk  cabbage,  the  solid  extract  ia  a  nervine, 
antispasmodic,  and  cmmenagogue. 


Fra.218. 


Fio.  214. 


MBADOW  BAVVROir. 


MOUNTAIN  LADBSU 


Momitain  Laurel  {Kalmia  Latifolia).  —  The  laurel  is  found  in  most 
parts  of  the  United  States,  on  hills  and  mountains,  flowering  in  June 
and  July,  and  is  very  ornamental.  It  is  sometimes  called  big"  ivy,  or 
calico  bush.  The  narrow-leaf  laurel,  or  sheep  laurel,  kalmia  an^usti- 
folia,  is  also  common,  and  similarly  medicinal.  The  leaves  of  these 
plants  are  used  in  medicine,  and  produce,  when  taken  in  large  doses, 
vertigo,  dimness  of  sight,  etc.  In  medicinal  doses,  they  are  sedative  and 
astringent.  The  saturated  tincture  is  the  best  form  of  administration, 
which  may  be  taken  in  ten  to  twenty-drop  doses,  every  two  or  three 
hours,  in  syphilis,  active  hemorrhages,  hypertrophy  of  the  heart,  and 
jaundice. 

Hollein  ( Verbascum  Thapsus).  —  The  leaves  and  flowers  of  this  bien- 
nial plant  are  antispasmodic,  diuretic,  and  demulcent.  The  infusion 
is  frequently  used  in  domestic  practice,  and  is  useful  in  colds,  coughs, 
bronchitis,  etc. ;  and  may  be  drank  freely.  The  leaves  are  sometimes 
boiled  in  milk,  sweetened,  and  taken  for  bowel  complaints.  The 
leaves,  dipped  in  hot  vinegar  and  water,  are  very  useful,  applied  as  a 
fomentation  in  mumps,  acute  inflammation  of  the  lonsils,  and  malig- 
nant sore  throat ;  a  handful  of  them  may  also  be  placed  in  an  old  tea- 
pot, with  hot  water,  and  the  steam  be  inhaled  through  the  spout,  in 
the  same  complaints. 

Hnstardi  —  The  seeds  of  the  white  mustard,  sinapis  alba,  were,  a 
few  years  ago,  much  recommended  as  a  cure  for  constipation  of  the 
bowels;  and, swallowed  whole,  in  teaspoonful,  or  even,  in  some  obsti- 
nate cases,  in  tablespoonful  doses,  they  aftbrd  a  wholesome  stimulus 
to  the  bowels,  and  accomplish  somekgood.  The  ground-mustard  is  a 
valuable  condiment  to  eat  in  small  quantities,  at  dinner,  in  dyspeptic 
cases.  It  finds  its  most  important  uses,  however,  as  a  prompt  and 
almost  instantaneous  emetic  in  cases  of  poisoning,  and  also  as  a  val- 
uable counter-irritant,  when  applied  externally.  The  volatile  oil  of 
mustard,  one  part,  and  ten  parts  of  sweet  oil,  may  be  applied  to  the 
■kin,  instead  of  the  mustard  poultice,  and  with  similar  results. 


I 


III 


Hil 


i 


f' 


llyiTli.  —  The  tree  bahamoderulron  mi/rrha,  growing  in  Arabia,  eto., 
yields  a  juice  which  hurdena  into  a  gum-resin,  called  myrrh.  This 
pleasant,  aromatic  gum,  is  stimulant,  tonic,  antiseptic,  emmenagorne, 
and  expectorant.  It  is  <!mployed  in  chronic  bronchitis,  consumption, 
chlorosis,  absence  of  the  menses,  etc.  It  is  generally  combined  with 
iron  and  other  tonics,  and  in  amenorrhcea,  is  frequently  combined 
with  aloes.  Loo.lly,  it  is  considerably  used  as  a  wash  to  improve 
spongy  gums,  ulcers  of  the  mouth,  etc.  The  dose  is  from  ten  to  thirty 
grains,  to  be  given  in  pill,  or  in  powder  suspended  in  water.  The 
tiocture  of  myrrh  is  a  useful  external  application. 

Naptha.  —  This  belongs  to  the  class  of  native  inflammable  sub 
stances,  called  bitumens.  It  is  a  transparent,  yellowish  white,  very 
light  and  inflammable  liquid,  and  is  found  abundantly  in  Persia.  Said 
to  have  been  used  with  advantage  in  Asiatic  cholera.  It  is  composed 
exclusively  of  carbon  and  hydrogen.  Dose,  from  ten  to  twenty  drops, 
given  in  half  a  glass  of  wine,  or  mint  water.  During  the  formation 
of  coal  gas,  an  artificial  napthia  is  obtained,  which,  when  purified, 
has  the  property  of  dissolving  India  rubber. 

Medicinally,  it  is  chiefly  used  for  purposes  of  inhalation,  in  affec- 
tions of  the  chest. 

Naphthaline.  —  This  is  obtained  from  a  distillation  of  coal  tar.  It 
is  soluble  in  ether,  alcohol  naphtha,  and  oils,  but  not  in  water.  It  is 
an  excellent  expectorant,  particularly  in  cases  of  impending  suffoca- 
tion of  old  persons,  from  chronic  bronchitis  ;  aLo  in  asthma  and  other 
pectoral  affections.  Being  stimulating,  it  is  improper  in  acute  bron- 
chitis, and  pulmonary  inflammation.  The  dose  is  from  ten  to  thirty 
grains,  given  in  emulsion,  or  syrup,  every  fifteen  minutes,  until  abun- 
dant expectoration  takes  place.  A  scruple  of  napthaline,  mixed  with 
five  drams  of  lard,  makes  a  good  ointment  for  psoriasis,  dry  tetter, 
and  leprosy. 

Nitrate  of  Silver  {Argenti  Niiras).  —  Nitrate  of  silver  is  a  solution 
of  silver  in  nitric  acid,  and  commonly  passes  under  the  name  of  lunar 
caustic.  It  is  both  in  the  form  of  small  cylindrical  rods,  and  of  crys- 
tals, the  latter  being  more  pure  than  the  former. 

As  an  internal  remedy,  nitrate  of  silver  is  tonic  and  antispasmodic, 
and  is  given  chiefly  in  nervous  diseases,  as  epilepsy,  StVitus's  dance, 
and  neuralgia  of  the  heart;  also  in  some  forms  of  dyspepsia,  attended 
with  pain  in  the  stomach,  and  vomiting.  The  dose  is  from  one  fourth 
to  half  a  grain,  in  the  form  of  pill.  It  should  never  be  taken  regu- 
larly as  an  internal  remedy,  more  than  three  months,  as  it  is  apt,  after 
long  use,  to  change  the  skin  to  an  indelible  slate  blue. 

But  nitrate  of  silver  is  most  used  as  an  external  remedy,  in  pharyn- 
gitis, laryngitis,  tracheitis,  and  other  chronic  and  acute  inflammations 
of  mucous  membranes.  For  reducing  these  inflammations,  it  is  very 
nearly  a  specific ;  certainly,  it  is  altogether  the  best  remedy  we  have. 
It  fails  in  some  few  cases ;  but  when  skilfully  used  it  never  does  harm. 
The  solutions  to  be  applied  to  the  throat,  require  to  have  a  strength 
of  from  fifteen  to  a  hundred  and  twenty  grains  to  the  ounce  of  soft 


MEDICINES  AND  THEIR  I'KEPARATIONS. 


eas 


abia,  etc., 
rh.  This 
3nagO(.nie, 
sumption, 
iiied  witli 
combined 
»  improve 
1  to  thirty 
ter.     The 


able  sub- 
hite,  very 
sia.  Said 
composed 
nty  drops, 
formation 
1  purified, 

,  in  affec- 


il  tar.  It 
ter.  It  is 
»  suffoca- 
and  other 
ute  bron- 
1  to  thirty 
itil  abun- 
ixed  with 
Iry  tetter, 

1  solution 

of  lunar 

1  of  crys- 

lasmodic, 
s's  dance, 

attended 
ne  fourth 
wn  regU" 

apt,  after 

1  pharyn- 
nmations 
it  is  very 
we  have, 
aes  harm. 
.  strength 
e  of  soft 


water.    A  solution  containing  one  to  four  or  more  grains  to  the  ounce 
of  water  is  often  used  in  inlliimniations  of  tlic  eye,  gonorrhea,  etc. 

Mitre  {Potassce.  Nilrax).  —  Nitre,  wliich  also  passes  under  the  name 
of  nitrate  of  potassa,  and  saltpetre,  is  both  a  natural  and  artificial 
production.  As  a  medicine,  it  is  refrigerant,  diuretic,  and  diaphoretic, 
and  is  much  ust'd  in  inllammatory  diseas(?s.  It  increases  the  secre- 
tion of  \irine  and  sweat,  and  lessens  the  heat  of  the  body,  and  the  fre- 
quency of  the  pulse.  United  w  th  tartar  emetic  and  calomel,  it  forms 
the  well-known  nitrous  powders,  which  promote  most  of  the  secre- 
tions, particularly  those  of  the  liver  and  skin.  One  of  these  powders, 
constituting  a  dose,  to  be  given  every  two  or  three  hours,  is  composed 
of  eight  grains  of  nitre,  one  fourth  of  a  grain  of  calomel,  and  one 
eighth  of  a  grain  of  tartar  emetic. 

Sweet  Spirit  of  Nitre  (Spirilus  JEtheris  Niirici).  —  Sweet  spirit  of 
nitre  is  diuretic,  diaphoretic,  and  antispasmodic.  It  is  deservedly 
much  esteemed  as  a  medicine,  and  is  extensively  employed  in  febrile 
diseases,  either  alone,  or  in  union  with  tartar  emetic,  or  with  spirit  of 
mindererus.  It  is  often  a  grateful  stimulus  to  the  stomach,  relieving 
na.isea  and  vomiting,  and  promoting  sleep.  It  acts  especially  upon 
the  kidneys,  augmenting  the  secretion  of  urine,  and  is  often  given  in 
conjunction  with  squills,  digitalis,  and  acetate  of  potassa.  The  dose 
is  a  teaspoonful,  given  in  water  every  two  or  three  hours. 

Nutmeg  {Mi/ristica  Moschata).  —  The  nutmeg  is  from  a  tree  grow- 
ing in  the  Molucca  Islands.  It  is  stimulant  and  carminative,  and 
somewhat  used  to  remove  flatulency,  as  well  as  to  render  other  medi- 
cines palatable ;  it  is  most  employed,  however,  to  flavor  drinks,  and 
articles  of  diet.  In  large  doses,  it  is  poisonous,  producing  stupor  and 
delirium. 

Nox  Vomica  {Strychnos  Nax  Vomica).  —  The  tree  which  produeea 
nux  vomica,  grows  in  Bengal,  Malabar,  and  the  coast  oi  Corornandel, 
and  in  other  regions.  The  seeds  are  the  me- 
dicinal part. 

Nux  vomica  is  an  emphatic  excitant  of  the 
brain  and  spinal  cord,  and,  in  large  doses,  is 
an  active  poison  ;  frequently  repeated  in  small 
doses,  it  is  tonic,  diuretic,  and  slightly  laxative. 

Given  in  full  doaes,  it  is  apt  to  produce  mus- 
cular contraction,  as  in  lock-jaw,  together  with 
frequent  starts  and  twitches,  as  if  from  electric 
shocks.  It  is  much  employed  in  treatment  of 
paralysis,  and  is  more  beneficial  in  general  than 
in  partial  palsy. 

Preparations.  —  Fluid  extract,  dose,  two  to 
ten  drops ;  solid  extract,  dose,  half  a  grain  to  two  grains ;  tincture, 
four  ounces  to  the  pint  of  alcohol,  dose,  five  to  fifteen  drops  ;  strych- 
nia, commonly  called  strychnine,  the  active  principle,  dose,  one  six- 
teenth to  one  eighth  of  a  grain. 


V  ', 


Fjo.  216. 


tmX  VOKIOA. 


i 


oil  of  Cajeput  ( Oleum  Cajuputi).  —  This  oil  is  obtained  from  the 


twfia 


636 


MEDICINES  AND  TKEIB  PREPARATIONS. 


-J- 


leaves  of  the  East  Indian  tree  cajuputi.  It  is  diaphoretic  and  anti- 
spasmodic, and  a  powerful  diffuaive  stimulant.  Given  in  cramps  d' 
the  stomach  and  bowels,  colic,  flatulency,  hysterics,  and  chronic  rheu* 
matism.  It  is  considerably  used  as  an  ingredient  in  liniments,  to  bo 
applied  externally  in  rheumatism,  and  neuralgia.  Dose,  from  one  to 
five  drops,  on  sugar. 

Oil  of  Tiirjientine  ( Oleum  Terebinthitue).  —  This  is  genernlly  called 
spirits  of  turpentine,  and  is  obtained  by  distilling  turpentine.  As  ^ 
medicine,  it  is  stimulant,  cathartic,  diuretic,  anthelmintic,  and  astrin- 
gent. li>  large  doses,  it  causes  strangury,  and  other  unpleaHant  sytnp^ 
toms.  The  dose  is  from  ftve  to  thirty  drops,  repeated  every  two  o» 
three  hours.  Fifteen  drops,  taken  every  fifteen  minutes  or  half  lioui. 
powerfully  restrains  bleeding  from  +he  lungs,  and  is,  perhaps,  the  bes^ 
remedy  we  have  for  ihis  frightful  accident 

It  is  also  very  elBcacious  in  checking  other  hemorrhagea.  Exter* 
nally,  it  is  used  considerably  as  an  ingredient  in  liniments  and  rube- 
facients, in  rheumatism,  paralysis,  etc.  Combined  with  linseed  oil,  it 
is  much  used  for  burns  and  scalds.        > 

Olive  Oil  ( Olevm  Olivce).  —  This  cil,  often  called  sweet  oil,  is  ex- 
pressed from  the  fruit  of  the  olive  tree,  Olea  Europea;,  It  is  nutrient 
and  emollient,  and  in  doses  of  one  to  two  fluid  ounces,  laxative.  It 
is  much  employed  as  a  constituent  of  cerates,  liniments,  and  plasters. 

Onion  {Allium  Cepa).  —  The  medicinal  properties  of  the  onion  arc 
much  like  those  of  garlic.  The  juice,  mixed  with  sugar,  is  used  to 
some  extent  as  a  remedy  for  the  coughs  and  colds  of  infants.  Roasted 
onions,  applied  as  a  poultice,  hasten  the  suppuration  of  boils,  tumors, 
etc.     They  are  also  useful,  in  some  cases,  applied  as  drafts  to  the  fet'.t. 

Opiuni, —  This  is  the  hardened  juice  of  the  unripe  seed  of  the  poppy, 
Papaver  Somniferum.  It  is  a  stimulant  narcotic.  A  moderate  dose 
increases  the  fulness  and  frequency  of  the  pulse,  augments  the  warmtU 
of  the  skin,  invigorates  the  muscular  system,  quickens,  the  senses,  ani- 
mates the  spirits,  and  gives  energy  to  the  mental  facultie?.  Its  opera- 
tion is  directed  with  special  force  to  the  brain,  which  it  sornetinii-a 
excites  to  intoxication  and  delirium,  which  excitement  subsides  in  a 
short  time,  and  is  followed  by  a  delightful  calrnneas,  and  placidity  of 
mind,  all  care  and  anxiety  being  banished,  and  the  thoughts  yielded 
to  the  control  of  pleasing  fancies.  At  the  end  of  an  hour  or  more, 
this  reverie  is  succeeded  by  sleep,  which,  at  the  end  of  eight  or  ten 
hours,  passes  off,  and  is  followed  by  headache,  nausea,  tremors,  and 
other  nervous  disturbances.  Large  doses  are  followed  by  shorter 
periods  of  exhilaration  and  excitement,  and  by  more  protracted  sleeps 

Opium  is  used  in  medicine  to  produce  gentle  perspiration,  relieve 
pain,  and  lessen  nervous  excitability  in  all  febrile  and  inflammatory 
diseases ;  also  as  an  antispasmodic  in  hysterics,  colic,  convulsions, 
coughs,  etc.  It  should  not  be  used  in  cases  of  constipation  of  the 
bowels.  A  solution,  composed  of  two  grains  of  opium  to  one  ounce 
of  water,  is  sometimes  a  valuable  injection  in  gonorrhoea  and  spas-i 
modic  stricture.    Dose,  as  a  stimulant,  une  quartei:  to  one  half  a  grain: 


■   -.■W»N-'«CUK*« 


lii 


MEDICINES  AND  THEIR  PREPARATIONS. 


as  a  narcotic,  one  to  two  grains;  in  some  spasmodic  affections,  it  is 
given  in  very  large  doses. 

Jlur|>liiUi  generally  called  morphine^  is  one  of  the  alkaloid  principles 
of  opium.  It  is  used  under  the  various  forms  of  sulphate,  murtale, 
acetate,  and  valerianate  of  morphia, — all  hnving  the  general  properties 
of  opium,  and  are  givi^n  for  similar  purposes,  in  doaes  of  one  eighth 
to  one  quarter  of  a  grain.  One  sixth  of  a  grain  is  equal  to  one  grain 
of  opium. 

Strong  coffee  is  an  excellent  antidote  to  the  poisonous  effects,  both 
of  opium  and  morphia.  A  solution  of  morphia  may  be  made  by 
iidJing  ten  grainn  of  the  salt  to  one  fluid  ounce  and  a  half  of  distilled 
wutiT,  and  half  an  ounce  of  diluted  alcohol,  and  then  adding  two 
drops  of  sulphuric  acid,  if  it  be  tht  sulphate  of  morphia,  or  two  drops 
of  acetic  acid,  if  it  be  the  acetate  of  morphia,  or  two  drops  of  muri» 
tilic  acid,  if  it  be  the  muriate  of  morphia.  The  effects  of  morphia 
may  be  obtained  by  sprin'  ling  some  of  it  on  a  blistered  surface. 

Oraiij^e  Peel  (Aurantii  Cortex).  —  The  orange  is  the  fVuit  of  a  tree 
belonging  to  the  tropical  climates.  Orange  juice  is  a  pleasant  refrig- 
erant, useful  in  fevers,  and  particularly  in  scurvy.  Sick  persons  buck- 
ing the  juice  of  the  orange,  should  be  careful  not  to  swallow  any  of 
the  skinny  portion,  or  the  peel.  The  peel  of  the  orange  is  chiefly 
employed  to  give  a  pleasant  flavor  to  other  medicines,  and  to  prevent 
their  nauseating  properties.  It  is  a  mild  tonic,  carminative,  and  stom- 
achic, and  improves  the  bitter  infusions  and  decoctions  of  gentian, 
quassia,  columbo,  and  peruvian  bark.  Orange  peel  should  never  be 
given  in  substance. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams ; 
tincture,  one  ounce  and  three  quarters  to  a  pint  of  diluted  alcohol, 
chiefly  used  as  an  addition  to  infusions,  etc. ;  syrup,  two  ounces  fluid 
extract  or  tincture  to  a  pint  of  simple  synp,  used  with  water  as  an 
agreeable  drink. 

Orifflnum  (Origamum  Vujgare).  —  A  perennial  herb  growing  in 
Europe  and  this  country.  The  warm  infusion  of  it  causes  perspira- 
tion, and  promotes  the  menstrual  discharge,  when  interrupted  by  a 
cold.  The  oil  of  origanum  is  a  very  useful  ingredient,  in  several 
stimulant  and  rubefacient  liniments. 

Parsley  {Petroselinum  Sativum).  —  The  root  of  this  biennial  plant 
is  aperient  and  diuretic,  and  is  used  in  dropsy,  scarlet  fever,  and  dis- 
eases of  the  kidneys ;  also  in  retention  of  the  urine,  gonorrhcea,  and 
strangury.     The  dose  of  the  infusion  is  from  two  to  four  fluid  ounces,  ^ 
two  or  thr..<3  times  a  day. 

The  bruise  1  leaves  are  applied  with  advantage  to  contusions, 
swelled  -  breasts,  and  enlarged  glands. 

Partridge  Berry  (Mitchella  Repens).  —  This  perennial,  evergreen, 
creeping  herb,  ^rows  in  dry  woods  and  swampy  places  thfoughoi 
the  United  States,  and  has  white,  fragrant  flowers  ii\  June  and  Jul^ 
It  is  parturient,  diuretic,  and  astringent,  and  is  used  in  dropsy,  sup 


jiM-ii^ikie 


638 


MEDICINES  AND  THEIR  PREPARATIONS. 


preasion  of  urine,  and  diarrhcua.  It  acts  as  a  tonic  upon  the  repro- 
ductive organs,  giving  tone  and  vigor  to  the  womb,  and  making  labor 
le'38  tedious.  Dose  of  the  decoction,  from  two  to  four  fluid  ounces, 
two  or  three  times  a  day. 

Peach  {Amygdalus  Persica).  —  The  leaves  of  the  peach  are  sedative 
and  slightly  laxative,  and  are  used  in  inflammations  of  the  stomach 
and  bowels ;  likewise  in  irritable  bladder,  hooping-cough,  sickness  at 
the  stomach,  and  dysentery.  They  are  used  in  the  form  of  cold  infu-' 
sion,  a  tablespoonful  being  a  dose,  to  be  taken  every  hour  or  two.  A 
good  tonic  is  made  by  adding  four  ounces  of  the  biased  kernels  to  a 
quart  of  honey. 

Pennyroyal  (Hedeoma  Pidegioides). —  Pennyroyal  is  a  gently  stim- 
ulant aromatic ;  it  relieves  wind  colic  and  sick  stomach,  and  qualifies 
the  action  of  other  medicines.  Like  most  aromatic  h^rbs,  it  has  the 
property,  when  given  as  a  warm  infusion,  of  promoting  perspiration, 
and  of  exciting  the  menses,  "hen  the  system  is  already  disposed  to 
the  effort.  In  cases  of  recent  suppression,  it  may  be  given  at  bed- 
titne  as  a  warm  tea,  after  bathing  the  feet  in  warm  water.  The  oil 
of  pennyroyal  has  the  properties  of  the  herb. 


Fia.  216. 


Fia.  217. 


FRHimtOTAI.. 


FXHnVIAK  BABK. 


Peppermint  {Mentha  Piperita).  —  The  peppermint  is  a  native  of 
England,  where  it  is  largely  culcivated,  as  it  is  to  some  extent  in  this 
country,  for  the  sake  of  its  essential  oil.  It  is  a  valuable  herb,  having 
a  strong  aromatic  smell,  and  a  pungent,  warming  taste.  It  may  be 
used  in  the  form  of  tea,  which,  when  largely  drank,  imparts  warmth 
to  the  system.  It  is  valuable  in  colds,  flatulent  colic,  hysterica,  spasms, 
cramps  in  the  stomach,  nausea,  and  vomiting,  and  to  disguise  unpleas- 
ant  medicines. 

The  peppermint  furnishes  an  essential  oil,  which,  dissolved  in  alco- 
hol, forms  the  essence  of  peppermint  The  dose  of  this  is  fifteen  to 
thirty  drops,  on  a  lump  of  sugar,  or  in  sweetened  water,  warm  or  cold. 


MEDICINES  AND  THEIR  PREPARATIONa 


63» 


I  the  repro- 
aking  labor 
uid  ounces, 

ire  sedative 
he  stomach 
sickness  at 
f  cold  infu«' 
or  two.  A 
kernels  to  a 

jently  stim- 
id  qualifies 
i,  it  has  the 
erspiration, 
disposed  to 
ren  at  bed- 
r.     The  oil 


native  of 
:ent  in  this 
>rb,  having 
It  may  be 
ts  warmth 
C8,  spasms, 
16  unpleas- 

ed  in  alco- 

fifteen  to 

•ra  or  cold. 


Persimmon  {Diospyros  Vtrginiana).  —  This  is  a  tree  growing  in 
the  Southern  and  Middle  States.  The  bark  and  unripe  fruit  are 
used  in  medicine, — being  astringent  and  tonic.  Persimmon  has  been 
found  useful  in  chronic  diarrhoea,  chronic  dysentery,  hemorrhage  from 
the  womb,  and  fever  and  ague.  It  is  used  in  the  form  of  infusion 
and  syrup,  in  doses  of  a  tablespoonful,  every  two  or  three  hours.  The 
infusion  is  also  used  as  a  wash  and  gargle  in  sore  mouth  and  throat, 
and  as  an  injection  in  whites. 

Peruvian  Bnrk  ( Cinchona).  —  This  valuable  bark  is  derived  from 
several  species  of  the  cinchona  tree,  on  the  western  coast  of  South 
America.  The  remedy  is  said  to  have  been  first  introduced  into 
Europe  in  1640,  by  the  Countess  of  Cinchon,  wife  of  the  Viceroy 
of  Peru,  on  her  return  to  Spain. 

There  are  three  varieties  of  this  bark  :  the  pale,  the  red,  and  the 
yellow.  The  pale  bark  is  least  liable  to  offend  th'  stomach,  and  i* 
perhaps  the  best  as  a  general  tonic ;  but  for  the  treatment  of  fever 
and  ague,  the  red  and  the  yellow  are  both  preferable  to  the  pale,  and 
the  red  is  considered  better  than  the  yellow. 

Cinchona  is  tonic  and  antiperiodic,  and  is  much  used,  and  with 
great  success,  in"  all  periodical  diseases,  as  fever  and  ague,  remittent 
fever,  neuralgia,  and  epidemic  diseases ;  also  in  chronic  diseases  at- 
tended with  debility,  as  scrofula,  dropsy,  and  affections  of  the  skin. 
Dose  of  the  powdered  bark,  as  a  tonic,  from  ten  to  sixty  grains ;  as 
an  antiperiodic,  from  twenty  to  a  hundred  grains. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  com- 
pound fluid  extract,  dose,  half  a  dram  to  a  dram ;  tincture,  four  ounces 
to  one  pint  diluted  alcohol,  dose,  one  to  four  drams ;  infusion,  dose, 
one  to  two  ounces.  A  good  compound  infusion  of  cinchona  is  made 
by  combining  one  ounce  fluid  extract  with  half  an  ounce  of  fluid 
extract  of  snake-root,  two  drams  of  fluid  extract  of  orange  peel,  one 
dram  of  fluid  extract  of  cloves,  one  dram  of  carbonate  of  potassa,  and 
one  pint  of  water.  Dose,  one  to  one  and  a  half  ounces.  The  follow- 
ing is  a  good  nervine  and  tonic  for  persons  of  nervous  temperaments : 
fluid  extract  of  cinchona,  one  ounce ;  fluid  extract  of  valerian,  one 
ounce ;  essence  of  cardamom,  two  drams ;  dose,  one  dram  every  three 
hours. 

Cinclionia  is  a  white  crystalline  substance  obtained  from  the  peru- 
vian  bark.  It  is  sometimes  used  as  a  substitute  for  quinia,  in  doses 
of  from  one  to  four  grains,  three  times  a  day. 

Snlphate  of  Qnlnia  is  snow  white,  and  in  satin-like  crystals,  having 
an  exceedingly  bitter  taste.  It  is  completely  soluble  in  water,  or  alco- 
hol, by  adding  a  few  drops  of  sulphuric  acid.  It  is  the  chief  active 
principle  of  cinchona,  and  has  similar  properties,  namely,  febrifuge, 
tonic,  and  antiperiodic ;  it  is,  however,  less  apt  to  nauseate  and  op- 
press the  stomach.  In  the  treatment  of  intermittent  fevers,  it  has 
almost  entirely  superseded  the  use  of  the  bark. 

Yaleripnate  of  <iainin.  —  This  is  a  combination  of  quinia  and  vale- 
rianic  acid.     It  is  tonic  febrifuge  and  sedative.     It  is  used  for  head- 


.  K- 


mtmiitimtimimUm 


640 


MEDICINES  AND  THEIR  PREPARATIONS. 


?  r 


I' 
k 

'i.'- 


ache  of  a  periodic  character,  and  for  nervous  irritability,  wakefulness, 
restlessness,  etc.     Dose,  from  half  a  grain  to  Iwo  grains. 

Petroliuni.  —  This  is  a  blackish  Liquid  bitumen,  flowing  8pontane> 
ously  from  the  earth  in  Italy,  France,  West  India  Islands,  etc.  As  a 
medicine,  it  is  stimulating,  antispasmodic,  and  sudorific.  It  is  occa- 
sionally administered  in  affections  of  the  chest,  v/hen  not  attended 
with  inflammation.  Externally,  it  is  employed  in  chilblains,  chronic 
rheumatism,  paralysis,  diseases  of  the  joints,  and  affections  of  th« 
skin.  It  is  an  ingredient  in  the  well-known  remedy  called  British 
oil.  The  petrolium  found  in  the  State  of  New  York,  and  called 
Seneca  oil,  is  extensively  used  in  domestic  practice.  The  dose  of 
petrolium  is  from  thirty  drops  to  a  dram. 

Phosplionis.  —  This  is  a  semi-transparent  solid,  and  is  flexible,  and 
has  a  waxy  lustre.  It  is  extracted  from  bones  by  sulphuric  acid.  As 
a  medicine  in  small  doses,  it  acts  as  a  powerful  general  stimulant ;  in 
large  doses,  as  a  violent,  irritant  poison.  When  taken  in  substance 
it  causes  irritation  of  the  stomach,  and  should,  therefore,  always  be 
administered  in  solution  ;  and  even  in  this  form  it  is  objectionable ;  it 
is  better  to  resort  to  the  phosphates,  and  the  hypophosphites.  Phos- 
phorus, being  an  element  in  the  composition  of  the  brain,  has  been 
given,  and  with  advantage,  in  the  various  forms  of  nervous  debility, 
as  consumption,  typhus  fever,  amaurosis,  paralysis,  and  the  general 
breakdown  of  the  vital  powers.  Phosphorus  burns  when  exposed  to 
the  air,  and  should  therefore  be  kept  covered  with  water. 


Fio.  218. 


Fia.aiO. 


FIITK  SOOT. 


PtPBISSBWA. 


Pink  Root  {Spig-elia  Marilundica).  —  This  perennial  herb  grows  in 
rich  soils  in  the  Middle  and  Southern  States.  The  root  is  the  medici- 
nal part.  It  is  a  powerful  anthelmintic,  and  is  but  little  used,  except 
for  expelling  worms. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  and  a 
half;  compound  fluid  extract,  dose,  half  a  dram  to  two  drams;  fluid 


""TTTj 


MEDICINES  AND  THEIR  PREPARATIONS. 


641 


extract  of  pink  root  and  senna,  dose,  half  a  dram  to  u  dram ;  infusion, 
half  an  ounce  to  a  pint  of  water,  dose,  two  to  six  ounces. 

Pipsissewa  {Chimaphila  Umbellata). — This  is  a  small  evergreen 
plant,  growing  in  tlie  United  States,  and  in  Northern  Europe  and 
Asia.  It  18  known  by  the  name  of  princes'  pine.  The  whole  plant  is 
tonic,  diuretic,  and  astringent,  and  has  proved  itself  useful  in  dropsy, 
jreneral  debility,  rheumatism,  chronic  disorders  of  the  kidneys,  blad- 
der, urethra,  etc. 

Preparations.  —  Fluid  extract,  dose,  one  dram  ;  solid  extract,  dose, 
ten  to  twenty  grains  $  infusion,  dose,  two  ounces. 

Plantain  (Planiago  Major). — This  perennial  herb  grows  botn  in 
Europe  and  America.  A  strong  decodtion  of  the  tops  and  the  roots 
is  highly  spoken  of  for  syphilis  and  scrofula ;  the  dose  being  from 
two  to  four  fluid  ounces,  two  or  three  times  a  day.  But  the  bruised 
leaves  are  most  useful,  when  applied  to  wounds,  ulcers,  bites  of 
l)oisonous  insects,  er)  sipelas,  etc. 

Plenrisy  Boot  (^wZepias  Tuherosa.) — This  perennial  plant  is 
abundant  in  the  Southern  States.  The  root,  which  is  the  part  used, 
is  carminative,  tonic,  and  diuretic ;  used  in  pleurisy,  bronchitis, 
iiilflammation  of  the  lungs,  acute  rheumatism,  and  dysentery.  The 
warm  infusion  promotes  diaphoresis,  without  raising  the  temperature 
of  the  body.  United  with  the  warm  infusion  of  wild  yam  root,  it  is 
t'xcellent  for  flatulency  and  wind  colic. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams; 
tincture,  four  ounces  to  a  pint  of  diluted  alcohol,  dose,  three  to  five 
<lrams  ;  infusion,  dose,  one  to  four  ounces  ;  asclepidin,  dose,  one  to  five 
grains.  Asclepidin  and  dioscorein,  united  in  equal  parts,  make  a  valua- 
ble preparation  for  flatulent  and  bilious  colic  ;  dose,  two  to  four  grains. 


FlO.  220. 


Fio.  221. 


FUIUBIST  BOOT. 


POISON  BSXLOCK. 


Poison  Hemlock  (Gonium  Maculatum).  —  This  biennial  plant  is  a 
native  of  Europe  and  Asia,  and  is  naturalized  in  this  country.  The 
h'aves  and  the  seeds  are  used  in  medicine.  Conium  is  narcotic,  ano- 
dyne, antispasmodic,  and  deobstruent ;  used  in  neuralgia,  asthma, 
syphilis,  chronic  rljeuniiitism,  and  various  other  nd'ections. 

«1 


\ 


:  \ '! 


?•/ 


042 


MEDICINES  AND  THEIU  PREPARATIONS. 


Preparations.  —  Fluid  extract,  dose,  five  to  twenty  drops;  solid 
extract,  dose,  half  a  grain  to  two  grains  ;  tincture,  three  ounces  to  a 
pint  of  diluted  alcohol,  dose,  thirty  drops  to  a  dram ;  infusion,  half 
an  ounce  to  a  pint  of  water,  mainly  used  as  a  wash  for  malignant 
ulcers,  etc. 

Poison  Oak  (lihua  Toxicodendron) .  —  The  leaves  are  the  medicinal 
part  of  this  creeping  shrub,  which  'a  common  in  this  country.  The 
form  of  using  this  medicine  is  that  of  a  saturated  tincture,  made  from 
the  fresh  leaves,  and  to  be  ke;;  t  in  well-corked  vials.  It  has  been 
found  useful  'n  paralysis  of  the  bladder  and  rectum,  in  diseases  of  the 
eyes  and  skin,  and  in  chronic  rheumatism.  Dose  of  the  tincture,  from 
live  to  ten  drops,  <^hree  times  a  day.     Large  doses  should  be  avoided. 

Poke  (Phytolacca  Decandra).  —  A  perennial  plant,  growing  in 
nearly  all  parts  of  the  country,  and  called  garget,  pigeon-berry,  and 
scoke.  The  root  is  the  pait  used.  It  is  emetic, 
cathartic,  alterative,  and  slightly  narcotic.  It 
excites  the  whole  glandular  system,  and  is  used 
in  syphilis,  scrofula,  rheumatism,  and  affections 
of  the  skin.  The  root,  buried  in  hot  ashes  until 
soft,  and  then  mashed,  and  applied  as  a  poul- 
tice, is  said,  in  King's  Dispensatory,  to  be  un- 
rivalled in  felons  and  various  tumors.  Dose 
of  the  powdered  root,  as  an  emetic,  twelve 
grains  to  half  a  dram ;  as  an  alt  )rative,  from 


Fitt.  222. 


Sj». 

i 

1 

V 

s 

POKI. 


two  to  six  grams. 

Preparations.  —  Fluid  extract,  dose,  ten  to 
thirty  drops ;  solid  extract,  dose,  one  to  four 
grains ;  tincture,  four  ounces  to  a  pint  of  di- 
luted alcohol,  dose,  half  a  dram  to  a  dram; 
syrup,  two  ounces  to  fourteen  ounces  of  simple  syrup,  dose,  one  to 
two  drams ;  phytolaccin,  the  active  principle,  dose,  one  quarter  to 
one  grain.  For  mercurial  and  syphilitic  pains  in  the  bones,  the  fol- 
lowing pill  is  useful :  solid  extract  of  poke,  two  drams  ;  solid  extract 
of  stillingia,  one  dram ;  solid  extract  of  stramonium,  eight  grain.s. 
Mix,  and  divide  into  sixty  pills,  of  which  one  pill  is  to  ))o  taken 
every  one,  two,  or  three  hours.  .    -^ 

Potassa.  —  This  is  used  in  medicine  under  the  name  of  caustic 
potassa.  It  is  made  by  boiling  a  solution  of  potassa  in  a  clean  iron 
vessel  until  ebullition  ceases,  and  the  potassa  melts,  and  then  pouring 
it  into  cylindrical  moulds ;  when  cold  it  is  to  be  kept  in  well-stopped 
l)ottles.  It  is  a  very  powerful  escharotic,  quickly  destroying  the  flesh 
which  it  touches,  and  extending  its  action  deep  under  the  surface.  It 
differs  in  this  respect  from  nitrite  of  silver,  which  only  acts  upon  the 
surface,  and  is  not,  properly  speaking,  a  caustic 

Caustic  potassa  is  used  for  forming  issues.  The  method  of  using 
it  for  this  purpose  is  to  cut  in  a  piece  of  adhesive  plaster  a  hole  as 
large  as  the  desired  issue,  and  then,  having  stuck  this  upon  the  skin, 


)iw;  solid 
inces  to  a 
ision,  huh' 
malignant 

medicinal 
:vy.  Tiic 
iiade  from 
has  been 
iscs  of  the 
turc,  from 
B  avoided. 

rowing  in 
terrt/,  and 

222. 


se,  one  to 
juarter  to 
s,  the  fol- 
id  extract 
it  grains, 
be  taken 


Df  caustic 
lean  iron 

n  pouring 
-stopped 
the  flesh 

rface.  It 
upon  the 

of  using 
a  hole  as 
the  skin, 


MEDICINES  AND  THEIR  PREPARATIONS. 


043 


to  apply  the  end  of  the  caustic,  i)reviously  moistened,  to  the  opening. 
'  Tliis  application  is  to  be  continued  till  the  life  of  the  part  is  destroyed, 
when  the  caustic  must  be  neutralized  by  vinegar,  or  carefully  washed 
off  with  a  wet  sponge. 
The  following  preparations  of  potassa  are  used  in  medicine  : 

Acetate  of  Potassa  {Potassce  Ape(as).  — This  is  made  by  the  union 
of  acetic  acid  and  cai'bonate  of  potassa,  and  in  consequence  of  its 
extreme  deliquescence  when  exposed  to  the  air,  it  is  kept  in  closely- 
stopped  bottles.  It  is  diuretic,  deobstruent,  and  mildly  cathartic. 
It  is  used  in  febrile  diseases,  several  skin  diseases,  such  as  psoriasis, 
eczema,  and  lepra,  and  particularly  in  dropsical  aflcctions.  Dose,  as 
a  diuretic,  from  twenty  to  thirty  grains  ;  as  an  aperient  from  two  to 
tlu'ee  drams. 

Bicarbonate  of  Potassa  ( Potassae  Bicarhonaa) .  —  This  is  a  solution 
of  carbonalc  of  potassa,  saturated  with  carbonic  acid.  This  acid  is 
diuretic,  antacid,  and  deolwtruent ;  used  in  dropsy,  acidity  of  the 
stomach,  and  glandular  olistructions.  Dose,  ten  to  thirty  grains. 
Twenty  gi'ains  dissolved  in  eight  fluid  ounces  of  water,  and  mixed 
with  four  fluid  drams  of  lemon  juice,  forms  a  good  efliervescing 
draught. 

Bitartrate  of  Potassa  ( Potassce  Bitartras) .  —  This  salt  is  better 
known  as  cream  of  tartar,  and  super  tartrate  qfpotaaaa.  It  is  formed 
from  the  matter  deposited  on  the  bottom  and  sides  of  casks,  during 
the  fermentation  of  sour  wines.  As  a  medicine  it  is  diuretic,  cathar- 
tic, and  refrigerant.  In  small  doses,  it  acts  as  a  cooling  aperient, 
gently  opening  the  bowels  ;  in  large  ones,  as  a  hydragogue  cathartic, 
causing  free,  watery  stools.  This  property,  as  well  as  its  power  of 
acting  upon  the  kiclneys,  causes  it  to  be  much  used  in  dropsical  com- 
plaints. Dissolved  in  boiling  water,  allowed  to  cool,  and  then  sweet- 
ened with  loaf  sugar,  it  forms  a  cooling,  pleasant,  acid  drink.  This 
kind  of  solution,  with  a  little  fresh  lemon  peel  added  to  it,  forms  the 
drink  called  imperial.  Combined  with  sulphur,  it  is  often  used  in 
skin  diseases.  Dose,  as  an  aperient,  a  dram  or  two  ;  As  a  hydragogue 
cathartic,  half  an  ounce  to  an  ounce ;  as  a  diuretic  in  dropsical  com- 
plaints, a  dram  and  a  half  to  two  drams,  several  times  a  day.  Cream 
of  tartar,  j/owdered  rhatany,  and  myrrh,  mixed  in  equal  proportions, 
form  a  good  preparation  for  cleansing  the  teeth. 

Carbonate  of  Potassa  {Potassce  Oarbonaa).  —  Carbonate  of  potassa 
is  punned  pearlash ,  and  is  frequently  called  salt  of  tartar.  The  com- 
mon saleratus  is  a  composition  between  the  carbonate  and  bicarbo- 
nate. Carbonate  of  potassa  has  the  same  medicinal  properties  with 
the  bicarbonate,  and  is  used  for  similar  purposes. 

Chlorate  of  Potassa.  —  This  is  prepared  by  passing  an  excess  of 
chlorine  through  carbonate  of  potassa.  It  is  refrigerant  and  diuretic, 
and  is  given  in  scurvy,  scarlet  fever,  etc. ,  and  as  a  wash  in  canker 
in  the  mouth,  and  various  unhealthy  ulcers,  and  as  an  injection  in 
leucorrhoea  and  gleet. 


!      1 


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wmt^ 


H44 


MEDICINES  AND  THEIR  PREPARATIONS. 


n 


4 


^'Vv- 


Citrate  of  Potassa  (Poloasce  Citras).  — A  grateful,  cooling  diapho- 
retic, long  and  niuc^h  used  in  fevers,  chiefly  in  the  forms  of  the  neutral 
iiiixlure,  and  effervescing  draught. 

Solution  of  Citrate  of  Potassa  {Liquor  PotasacB  Oitratis).  —  This 
is  prepared  by  taking  half  a  pint  of  lemon  juice,  and  adding  l)icar- 
honate  of  potassa  gradually  to  it,  until  it  is  saturated,  tiien  liitering. 
This  passes  under  the  name  of  neutnal  mixture,  saline  mixture,  and 
fjleivescing  draught.  It  is  a  valuable  refrigerant  diaphoretic,  well 
ii(lai)ted  to  the  hot  stage  of  remittent  and  intermittent  fevers,  and 
indeed  to  almost  all  cases  of  fever,  with  a  dry,  hot  skin.  The  dose 
is  a  tablespoonful,  or  half  a  fluid  ounce,  which  should  be  diluted 
wluMi  taken,  and  be  repeated  every  one,  two,  or  three  hours,  accord- 
ing lo  the  necessities  of  the  case. 

Solution  of  Potassa  {Liquor  Potasace).  —  This  is  a  transparent, 
caustic  fluid,  which  requires  to  be  kept  in  green  bottles,  tightly 
corked.  It  is  antitcid,  antilithic,  and  diuretic.  It  is  used  in  some 
affections  of  the  skin,  and  scrofula,  but  more  particularly  for  scalding 
of  the  urcthi'a,  in  gonorrhoea ;  in  this  case,  it  is  well  to  unite  a  few 
lUops  of  laudanum  with  it.  The  dose  is  from  fifteen  to  forty  drops, 
two  or  three  times  a  day,  in  half  a  tumblerful  of  water.  In  dyspeptic 
cases,  attended  with  acidity  of  the  stomach,  it  may  be  associated 
with  some  simple  bitters. 

Sulphate  of  Potassa  ( Potassce  Sulphas) .  —  This  is  a  mild  purgative, 
operating  without  irritation  or  pain.  '  As  an  aperient,  it  should  be 
given  in  doses  of  from  a  scruple  to  a  dram.  Ten  grains  of  rhubarb 
and  one  dram  of  car1)onate  of  potassa,  imited,  and  divided  into  six 
powders,  is  an  excellent  alterative  cathartic  for  children  having  defec- 
tive digestion  and  nutrition,  and  a  tumid  state  of  the  abdomen. 
One  powder  may  be  given  at  a  time,  as  often  as  may  be  necessary 
to  open  the  bowels  gently. 

Tartrate  of  Potassa  (Potassce  Tartras).  — This  often  passes  under 
the  ni\mo  of  soluble  tartar.  It  is  a  mild,  cooling  purgative,  operating, 
as  most  of  the  neutral  salts  do,  without  nuich  pain,  and  i)roducing 
watery  stools.  It  is  useful  in  fevers.  Combining  it  with  senna, 
destroys  its  tendency  to  produce  gi'iping  of  the  bowels.  The  dose 
varies  from  a  dram  to  an  ounce,  according  to  the  effect  desired. 

Potassium.  —  This  is  a  soft,  bluish-^vhite  metal.  Its  union  with 
oxygen,  in  the  proportion  of  one  equivalent  of  each,  forms  potassa  or 
potash.     The  following  preparations  of  it  are  used  in  medicine  : 

Bromide  of  Potassium  {PotassH  Bromidum).  — This  is  a  perma- 
nent, colorless  salt,  having  a  pungent,  saline  taste,  a  little  more  acrid 
than  common  salt,  yet  siniilar  to  it.  As  a  medicine,  it  is  alterative 
and  resolvent,  and  is  used  occasionally  for  secondary  syphilis,  scrofula, 
and  enlarged  spleen.  Dose,  from  three  to  ten  grains,  three  times  a 
day,  in  pill  or  solution.  One  dram  of  the  l)romide  of  potassium, 
rubl)ed  up  with  an  ounce  of  lard,  makes  an  ointment  which  has  been 
used  with  some  good  eflfect  in  goitre,  and  scrofulous  aflfectiona. 


ijr  diapho- 
he  neutral 

).  — This 
ing  bicar- 
liltering. 
vture,  and 
retic,  well 
3 vers,  and 
The  dose 
)e  diluted 
's,  accord- 


insparent, 
8,  tightly 
1  iu  some 
If  scalding 
lite  a  few 
fty  drops, 
dyspeptic 
associated 


purgative, 
should  be 
f  rhubarb 
1  into  six 
ing  defec- 
abdomen. 
necessary 

3ses  under 
operating, 
producing 
th  senna, 
The  dose 
[red. 

mion  with 
potassa  or 
cine  : 

a  penna- 
uore  acrid 

alterative 
,  scrofula, 
e  times  a 
)()tussium, 
I  has  been 
ons. 


MEDICINES  AND  THEIR  PREPARATIONS, 


Fio.  i;23. 


Cyanuret  of  Potassium  {PofassH  Cyanuretum).  —  This  is  emi- 
nently poisonous,  acting  both  as  a  medicine  and  as  a  poison,  like  hy- 
drocyanic acid.  It  has  therefore  been  recommended  as  a  substitute 
for  that  acid.  The  dose  is  one  eighth  of  a  grain,  dissolved  in  half  a 
Huid  ounce  of  water. 

Sulphnrot  of  Potasslnm  {Potasii  Sulphuretum) .  —  This  is  called 
liver  of  sulphur,  and  hep.r,  being  composed  of  sulphur  and  ^)otassium. 
It  ha.s  l)een  used  in  chronic  bronchitis,  arlhrna,  hooping-cough,  and 
rheumatism.  Half  an  ounce  to  an  oan'^d  of  it,  dissolved  in  several 
gallons  of  warm  water,  mrkes  a  valua'ie  sulphur  bath  for  sevoi'al  skin 
diseases,  as  itch,  prurigo,  etc. 

Prickly  Ash  (XcaMoxt/lum  Fraxineum).  —  This  shrub  grows  in 
various  parts  of  the  United  States.  The  leaves  and  capsule!^  have 
a  pleasant,  aromatic  smell.  Its  medicinal  properties 
are  in  the  bark  and  berries.  The  bark  is  stinuilant, 
tonic,  altenitive,  and  sialagogue.  It  is  used  to  rouse 
and  excite  the  system,  when  in  a  languid  state,  and 
for  dei'angements  of  the  liver,  rheumatism,  and  chronic 
syphilis.  It  stimulates  and  strengthens  mucous  mem- 
branes, and  is  a  valual)le  tonic  in  low  typhoid  fever. 
Applied  externally,  it  improves  indolent  and  nialig- 
nant  ulcers.  Dose  of  the  powdered  bark,  from  ten  to 
thirty  grains,  three  times  a  day. 

Preparations.  —  Fluid  extract,  dose,  fifteen  to  forty- 
five  drops ;  tincture,  four  ounces  to  a  pint  of  diluted 
alcohol,  dose,  half  a  dram  to  a  dram  and  a  half;  infu- 
sion, half  an  ounce  to  a  pint  of  water,  dose,  half  an 
ounce  to  two  ounces ;  xanthoxylin,  the  active  princi- 
ple, dose,  two  to  six  grains. 
For  chronic  rheumatism,  the  following  is   a  good  preparation : 
xanthoxylin,  one  dram  ;  cimicifugin,  one  dram  ;  apoeynin,  one  dram  ; 
diluted  alcohol,  one  pint ;  dose,  four  drams,  three  times  a  day. 

Prickly  Ash  Berries  are  carminative,  antispasmodic,  and  stimulant, 
and  have  a  special  direction  to  mucous  membranes.  The  tincture  is 
excellent  in' nervous  diseases,  spasms  of  the  bowels,  flatulency,  and 
diarrhoea-;  and  combined  with  the  tinctui'e  of  poke  berries,  is  very 
serviceable  in  chronic  rheumatism  and  syphilis.  It  is  said  to  have 
been  used  with  great  success,  in  the  West,  in  Asiatic  cholera.  Dose 
of  the  tincture,  from  ten  drops  to  a  fluid  dram,  in  sweetened  water. 
Dose  of  the  oil  of  prickly  ash  berries,  from  two  to  ton  drops,  on  sugar. 


Pbicklt  Amu. 


Prickly  Elder  {Aralia  Spinosd). — This  is  a  tree  which  grows  in 
the  Southern  and  Western  States,  and  is  called  southern  prickly  ash, 
and  (oof hache  tree.  The  bark  is  stimulant,  alterative,  and  diaphoretic. 
The  fresh  bark,  emetic  and  cathartic.  The  tincture  is  serviceable  in 
skin  diseases,  syphilis,  and  chronic  rheumatism.  Dr.  John  King  re- 
ports, that  in  the  cholera  of  1849,  it  was  found  very  serviceable,  where 
cathartics  were  required,  in  the  following  combination :  compound 


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1 

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■I'r'r'it^' 


046 


MEDICINKS  AND  THEIR  PREPARATIONS. 


I 


This  is  the  wood  of  a  tall  f*.'ce  grow- 


powder  of  jalap,  ouo  di'^m  ;  powdered  prickly  elder  ))ark,  one  drain  ; 
coiupDund  p'nv'der  of  rhui>arl),  two  dramu.  These  were  mixed,  and 
given  in  half-teuspoonful  doses,  every  half  hour,  or  hour,  until  the> 
operated.  The  bark  is  uialagogue,  and,  in  small  doses,  powdered,  is 
said  to  relieve  the  dry  and  parched  condition  of  the  throat,  in  many 
diseases. 

Pumpkin  Seeds.  — The  infusion  of  pumpkin  seeds,  made  by  placing 
them  in  water  without  bruising  them,  are  muc  laginous  and  d'uretic, 
and  are  used  in  inflammation  of  the  stomach  el  I  bowels,  scalding  of 
the  urine,  strangury,  etc.  But  this  infusion  is  more  particularly  valu- 
able for  its  power  of  expelling  the  tape-worm.  It  may  be  drank 
freely.  The  oil  of  pumpkin  seeds,  obtained  by  expression,  has  simi- 
lar properties,  and  may  be  taken  in  doses  of  six  to  twelve  drops, 
scvenil  times  a  da3\ 

Qaassla  (Picroena  Eoaceha), 
ing  in  Surinam  and  some  of  the  West  India  Islands.  It  is  an  in- 
tensely bitter  tonic,  febrifuge,  and  anthelmintic,  possessing  in  the 
highest  degree  the  properties  of  the  simple  bitters.  It  invigomtes 
the  digestive  organs,  without  producing  much  excitement  of  the  cir- 
culation. It  is  well  adapted  to  dyspepsia  and  the  debility  of  the 
stomach  which  succeeds  acute  disease,  and  indeed  all  complaints 
where  simple  bittcv  is  required.  Its  generic  title  perpetuates  the  name 
of  the  negro  Quassi,  of  Surinam,  who  first  discovered  its  medicinal 
virtues,  about  the  middle  of  the  last  century,  and  who  became  famous 
for  treating  malignant  fevers  with  it,  as  a  secret  remedy. 

Pi'eparai  10718.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  solid 
extract,  dose,  three  to  five  grains  ;  tincture,  dose,  four  to  eight  drams ; 
infusion,  two  drams  to  a  pint  of  water,  dose,  two  to  four  ounces. 

Qneen  cf  the  Meadow  (Enpatorium  Puipureum) . — This  perennial 
herb  grows  in  low,  swampy  places,  in  many  parts  of  the  country.  It 
is  called  trumpet  weed,  and,  from  its  fine  medicinal  effects  in  com- 
plaints of  the  urinary  organs,  gravel  root.  It  is  an  excellent  diuretic, 
tonic,  and  stimulant.  Used  in  gout,  rheumatism,  hematuria,  chronic 
diseases  of  the  urinary  organs,  strangury,  gravel,  and  dropsical  affec- 
tions. The  decoction  is  the  form  in  which  it  is  most  used  ;  the  dose 
being  two  to  four  ounces,  two  or  three  times  a  day. 

A  preparation  called  eupurpurin  is  also  extracted  from  it,  which,  in 
three-grain  doses,  is  a  powerful  diuretic,  occasioning,  in  some  cases,  it 
is  said,  an  enormous  flow  of  urine. 

(|!aeeii's  Boot  {StilUngia  Sylvaticd).  —  This  perennial  herb  grows 
in  sandy  soils  in  the  Southern  States.  The  root  is  medicinal,  being 
lU  large  doses,  emetic  and  cathartic  ;  in  small  doses,  an  alterative  of 
considerable  value  in  skin  diseases,  rheumatism,  syphilis,  and  scrofula, 
and  in  such  other  complaints  as  require  alteratives. 

Preparations. —  Fluid  extract,  dose,  five  to  fifteen  drops  ;  compound 
fluid  extract,  dose,  half  a  dram  to  a  dram  ;  tincture,  two  ounces  to  a 
pint  of  diluted  alcohol,  dose,  one  to  thi'ee  drams  ;  infusion,  dose,  one 
to  two  ounces.     In  chronic  bronchitis,  and  similar  complaints,  the 


^^rfi 


)no  dram  ; 
lixcd,  uiid 
until  the> 
vdered,  h 
,  iri  many 

l)y  placing 
i  diuretic, 
calding  of 
arly  valu- 
be  drank 
,  has  simi- 
ve  drops, 

ree  grow- 
is  an  in- 
ng  in  the 
ivigorates 
)f  the  cir- 
ity  of  the 
omplaints 
the  name 
medicinal 
ae  famous 

im;  solid 
ht  drams ; 
inces. 
perennial 
ntry.  It 
I  in  com- 
;  diuretic, 
I,  chronic 
ioal  affec- 
the  dose 

which,  in 
e  cases,  it 

srb  grows 

lal,  being 

jrative  of 

scrofula, 

ompound 
mces  to  a 
dose,  one 
aints,  the 


following  syrup  i«  well  rcconimended  :  fluid  extract  of  stillingia,  two 
ounces  ;  fluid  extract  of  bloodroot,  two  ounces  ;  fluid  extract  of  cheny 
bnrk,  two  ounces  ;  bulsain  of  tolu,  one  ounce  and  a  half;  syruf)>  two 
and  a  half  pints.     Dose,  one  to  two  drams. 

Red  Chickweed  (AnagaUisArvensia).  —  An  annual  plant,  common 
in  Europe  and  this  country.  It  has  small  scarlet  flowers  in  June 
and  July.  It  has  been  used  in  nervous  diseases,  as  mania,  delirium, 
epilepsy,  and  particularly  hydrophobia.  Old  and  ill-conditioned 
ulcers  are  improved  I)y  its  use,  in  the  form  of  poultice. 

Bed  Boot  (  Ceanolhus  Americanua).  —  This  shrubby  plant  has  the 
names  of  3^ew  Jersey  tea  and  wild  snow-ball^  and  is  found  in  all 
parts  of  the  United  States.  The  bark  is  antispasmodic,  sedative, 
astringent,  and  expectorant,  and  tastes  and  smells  like  the  {leach  leaf. 
A  decoction  is  useful  in  dysentery,  diarrhoea,  hooping-cough,  and 
chronic  bronchitis,  in  doses  of  a  tablespoonful,  three  times  a  day. 
It  makes,  likewise,  a  very  good  injection  in  leucoiThcea  and  gleet, 
and  gargle  for  ulcerations  of  the  mouth  and  throat. 

Bed  Clover  ( Tin/oUum  Pratense) .  —  The  blossoms  of  this  very 
common  biennial  plant  are  medicinal ,  and  are  highly  recommended 
in  deep,  ragged,  and  cancerous  ulcei's,  as  well  as  in  badly-condi- 
tioned burns.  They  are  soothing  and  detergent,  and  promote  health- 
ful granulation. 

Preparation.  —  Solid  extract,  to  be  used  as  an  external  applicatioa, 
chiefly  in  the  form  of  ointment,  made  by  uniting  four  ounces  of  it 
with  half  a  pound  of  lard. 

Bed  Bose  {Rosa  Gallica).  —  The  petals  of  the  rose  are  slightly 
tonic  and  astringent,  and  are  considerably  employed  in  chronic  inflam- 
mations of  the  eye.  Rose  water,  distilled  from  the  petals,  is  used 
for  similai'  purposes. 

Bed  Saunders  {Pterocarpus  Santalinua) .  —  This  is  a  large  tree 
growing  in  Ceylon,  the  wood  of  which  imparts  a  red  color  to  alco- 
hol, ether,  and  alkaline  solutions,  but  not  to  water.  It  is  almost 
solely  used  for  imparting  color  to  tinctures,  etc.,  having  little  or  no 
medicinal  properties. 

Bosln.  —  This  is  the  solid  resinous  matter  which  remains  aftur  the 
distillation  of  turpentine.  It  is  much  used  as  an  ingredient  in  oint- 
ments and  plasters,  but  is  never  taken  internally.  The  vapor  which 
arises  from  heating  it  upon  some  hot  surface  is  sometimes  inhaled 
with  great  advantage  in  chronic  bronchitis,  and  other  chronic  affec- 
tions of  the  air  tubes. 

Bhatany  (ITrameria  Triandra).  —  This  is  a  native  of  Pei'u,  grow- 
ing in  dry,  sandy  places.  It  is  a  powerful  astringent,  and  a  gentle 
tonic.  It  is  given  with  advantage  in  excessive  menstruation,  vomiting 
of  blood,  chronic  diarrhoea,  leucoiThcea,  and  inability  to  retain  the 
urine  ;  likewise,  as  a  local  application  in  falling  of  the  bowel.  It  ia 
valuable  also  for  nose-bleed,  and  bleeding  gums.  Dose  of  the  powder, 
for  internal  use,  from  ten  to  thirty  grains. 


I'.K 


Preparations.  —  Fluid  oxtract,  dose,  half  a  dram  to  a  dram ;  solid 
extract,  dose,  five  to  twenty  grains  ;  tincture,  three  ounces  to  a  pint 
of  diluted  alcohol,  dose,  three  to  six  drams  ;  infusion,  two  ounces  to 
a  pint  of  water,  dose,  half  an  ounce  to  an  ounce. 

Bhubarb  {Itheum  Palmalum).  — This  root  is  derived  from  several 
species  of  rheum,  and  passes  under  the  various  names  of  European, 
Jiuasian,  CfiineHC,  East  India,  and  Turkey  rhubarb.  The  variety 
called  Russian,  or  Turkey  rhul>ar1>  (for  they  are  the  same),  is  con- 
sidered the  best.  Rhubarb  is  cathartic,  astringent,  and  tonic.  It  is 
much  used  in  mild  cases  of  diarrhoea  and  cholera  mfantinn  ;  likewise, 
as  a  stomachic  and  gentle  tonic  in  dyspepsia,  accompanied  with  a  de- 
bilitated state  of  the  digestive  organs.  It  is  a  valuable  remedy  in  the 
complaints  of  children,  and  is  deservedly  much  used  in  treating  them. 
It  acts  upon  the  muscular  coat  of  the  bowels,  producing  thick  mther 
than  watery  stools.  It  is  therefore  not  adapted  to  the  treatment  of 
dropsical  complaints.  Its  astringency  may  be  increased  by  roasting 
it,  or  diminished,  by  combination  with  soap,  or  an  alkali. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  aro- 
matic fluid  extract,  dose,  half  a  dram  to  a  dram  ;  fluid  extract  of  rhu- 
barl)  and  senna,  dose,  half  a  dram  to  a  dram  ;  solid  extract,  dose,  two 
to  ten  grains  ;  tincture,  an  ounce  and  a  half  of  fluid  extract,  and  half 
an  ounce  of  essence  of  cardamom,  to  a  pint  of  diluted  alcohol,  dose, 
half  an  ounce  to  an  ounce  and  a  half;  infusion,  one  ounce  fluid  ex- 
tract and  two  ounces  spirit  of  cinnamon  to  a  pint  of  water,  dose,  one 
to  three  ounces  ;  syrup,  three  ounces  of  fluid  extract  to  fourteen  of 
syrup,  dose,  two  to  five  drams. 

Rosemary  (Roamarinua  Officinalis).  —  This  evergreen  shrub 
grows  on  the  borders  of  the  Mediterranean,  and  is  cultivated  in  Europe 
and  this  country.  It  is  stimulant,  antispasmodic,  and  emmenagogue. 
It  is  not  used,  in  this  country,  however,  except  to  perfume  ointments, 
tinctures,  and  syrups. 

Round-Leaved  Pyrola  (Pyrola  RotundifoUa). — This  perennial 
shrub  grows  in  various  parts  of  our  country,  aii-l  bears  white  flowers 
in  June.  It  is  called  canker  lettuce,  pear-leaf  winter  green,  etc.  Its 
medicinal  properties  are  those  of  a  tonic,  astringent,  antispasmodic, 
and  diuretic.  Used  in  decoction  for  epilepsy  and  other  nervous  dis- 
orders ;  also  for  gravel,  and  other  diseases  of  the  bladder  and  kidneys. 
The  decoction  may  be  used,  too,  as  a  wash  for  ulcerations  of  the  mouth, 
indolent  ulcers,  and  chronic  ophthalmia.  The  decoction  may  likewise 
be  used  in  making  poultices  for  painful  swellings,  boils,  and  carbun- 
cles.    It  may  be  taken  in  doses  of  from  one  to  six  ounces. 

Rue  {Ruta  Graveolena). — Rue  has  the  medicinal  virtues  of  the 
antispasmodics,  anthelmintics,  and  emmenagogues.  In  large  doees,  it 
is  poisonous.  It  b  useful  in  wind  colic,  worms,  hysterics,  epilepsy, 
etc.  Dose  of  the  leaves,  from  ten  to  twenty  grains ;  of  the  infusion, 
from  one  to  four  ounces. 

Saflh>n  (  Crocus  Sativus) .  —  This  is  a  native  of  Greece  and  Asia 
Minor ;  it  is  also  cultivated  in  France,  England,  and  America,  as  well 


nm ;  solid 

to  a  pint 

ounccy  to 

m  sovcriil 
Curopean, 
0  variety 
I,  J9  con- 
lic.  It  is 
likowiso, 
with  ndc- 
edy  in  the 
ing  thoni. 
ck  rather 
itment  of 
r  roasting 

am  ;  aro- 
ct  of  rhu- 
dose,  two 
,  and  imlf 
lol,  dose, 
fluid  ex- 
dose,  one 
urteen  of 

sn  shrul) 
i>  Europe 
snagogue. 
intmeiits, 

perennial 
te  flowers 
etc.  Its 
>asmodic, 
•vous  dis- 
kidncys. 
le  mouth. 
r  likewise 
i  carbun- 

es  of  the 
;  doses,  it 
epilepsy, 
infusion, 

and  Asia 
a,  as  well 


MEDICINES  AHD  THKIU   F'RKI'ABATIONS. 


.'49 


OH  in  other  countries.  It  has  been  thought  to  be  stinudant  and  anti- 
.sjmHmodic.  in  sumll  doses,  relieving  pain,  and  producing  sleep  ;  in  large 
doMCH,  giving  rise  to  headache,  and  producing  stuiM>r.  In  the  general 
judgment  of  the  profession,  it  is  now  considered,  however,  as  having 
very  little  activity.  It  is  accordingly  not  nuich  used,  except  in  do- 
mestic practice,  where  it  has  some  rc|)utatioi  among  niu'ses  for  its 
power  to  liring  out  meash's,  and  other  eruptions.  It  is  also  thought 
to  lie  bencticial  in  amcnorrluea,  (\  smenorrluca,  chlorosis, and  hysteria. 
It  is  chiefly  used  at  present  to  impart  flavor  and  color  to  tinctures. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  sixty  drops  ;  tinc- 
ture, dose,  half  a  dram  to  a  dram ;  infusion,  one  dram  to  a  i)int  of 
wutcr,  dose,  two  to  three  ounces. 

8age  ( Salvia  Officinalis) .  —  The  tops  and  leaves  of  this  well-known 
garden  plant  are  aromatic,  astringent,  diaphoretic,  and  slightly  tonic. 
The  infusion  is  useful  in  debilitated  conditions  of  the  stomacli,  at- 
tended with  flatulence  ;  it  frequently  relieves  nausea  ;  the  cold  infu- 
sion checks  and  sometimes  entirely  removes  the  night-sweats  of 
liectic.  The  infusion  is  useful  as  a  gargle  in  inflammation  of  the 
throat,  particularly,  if  united  with  a  little  honey  and  alunk.  Dose  of 
the  infusion,  from  one  to  three  fluid  ounces. 

Sarsaparilla  ( Smilax  Officinalis) .  —  Grows  in  swamps  and  hedges 
in  the  Middle  and  Southern  States.  Tiie  root  has  long  been  hekl  in 
esteem  as  an  alterative,  diuretic,  and  demulcent,  being  used  in  scrof- 
ula, chronic  rheumatism,  and  aftections  of  the  skin ;  but  its  most 
extensive  and  useful  application  has  been  found  to  be  in  the  treat- 
ment of  secondary  and  tertiary  syphilis  ;  and  especially  in  the  broken 
condition  of  the  system  which  follows  the  use  of  mercury  in  these 
aflections. 

Preparations.  —  Fluid  extract,  dose,  one  dram ;  fluid  extract  of 
sarsaparilhi  and  dandelion,  dose,  one  dram ;  solid  extract,  dose,  Ave 
to  twenty  grains  ;  infusion,  dose,  two  to  four  ounces. 

Sassafras  (Laurus  Sassafras) .  — This  tree  is  common  in  the  United 
States.  The  bark  of  the  root,  which  is  the  medicinal  part,  is  altera- 
tive, diuretic,  diaphoretic,  and  a  warm  aromatic  stimulant.  It  is 
mainly  used  to  improve  the  flavor  of  other  medicines,  and  also,  as  a 
constituent  of  those  compounds,  which  are  recommended  in  chronic 
rheumatism,  syphiloid  affections,  eruptions  of  the  skin,  and  scurvy. 

Preparations.  — Fluid  extract,  dose,  one  to  two  drams;  tincture, 
six  ounces  to  a  pint  of  alcohol,  dose,  half  an  ounce  to  an  ounce  ;  in- 
fusion, two  ounces  to  a  pint  of  water,  to  be  drank  as  desired. 

Hayin  (Juniper us  Sabina). — An  evergreen  shrub,  growing  in 
Europe  and  North  America.  The  tops  and  leaves  are  diuretic,  dia- 
l)lu)retic,  emmenagogue,  and  anthelmintic.  The  warm  infusion  ])ro- 
inotes  menstruation,  and  destroys  worms.  Care  should  be  taken 
never  to  administer  this  medicine  during  pregnancy,  its  effects  being 
violent  and  dangerous. 

Preparations.  —  Fluid  extract,  dose,  ten  to  thirty  drops  ;  solid  ex- 
tract, dose,  one  to  five  grains :  tincture,  four  ounces  to  a  pint  of 


650 


MBDICINES   AND  THEIR  PREPAUATI0N6 


vta.au. 


diluted  alcohol,  doHo,  hulk'  u  dram  to  a  dram  and  a  half;  infusion, 
half  an  ounce  to  a  pint  of  water,  doHu,  half  an  ounce  to  an  ouncr. 
The  following  mixture  is  uncful  in  amonon-h(Hu  :  Huid  extract  ot 
savin,  half  a  dram;  fluid  extmct  of  ginger,  one  dmni ;  sidphatc  (if 
|K)ta88a,  two  drams.  Mix.  Dose,  half  a  dram,  twice  a  day.  The 
oil  of  savin  has  properties  similar  to  those  of  the  leaves.  Doiit;, 
from  two  to  five  drops,  on  sugar. 

Scammony  {Convolvulus  Scammonia).  — This  plant  is  a  native  df 
Syria,  and  the  neighboring  countries.  The  medicinal  part  is  (he 
hardened  juice  of  the  fresh  root.  It  is  an  energetic  cathartic,  pro- 
<lucing  griping,  and  sometimes  operating  with  decided  harshness,  on 
which  account  it  is  generally  combined  with  other  medi(;ine4  which 
lessen  the  severity  of  its  action.  The  dose  is  from  five  to  twenty 
grains. 

Hcalleap  {Scutellaria Latenjlora). —  An inQlg<^nous  plant, rtowerinj; 
in  July  and  August.  The  whole  herb  is  used.  It  is  a  valuable  ner- 
vine, tonic,  and  antispasmodic ;  while  it  gives 
supjwrt  to  the  nerves,  therefore,  it  imparts  both 
quietness  and  strength  to  the  whole  system,  and 
does  not,  like  other  nervines,  leave  the  patient 
excited  and  irritable.  It  finds  its  use  in  the  treat- 
ment of  neuralgia,  chorea,  convulsions,  lockjaw, 
and  most  other  diseases  of  the  nervous  system. 

Preparations.  —  Fluid  extract,  dose,  half  a 
dnun  to  a  dram ;  compound  fluid  extract,  dose, 
half  a  dmm  to  a  dram ;  tincture,  four  ounces 
to  a  pint  of  diluted  alcohol,  dose,  one  to  two 
<lram8  ;  infusion,  dose,  a  wineglassful,  three  times 
a  day  ;  scutellarin,  the  active  principle,  dose,  two 
to  six  grains. 

8eneka  {Polygala  Senega).  —  An  indigenous 
plant,  commonly  called  snake-root,  the  root  of 
which  is  used  in  medicine.  It  is  a  stimulating  diuretic  and  expecto- 
rant, and  in  large  doses,  an  emetic  and  cailhartic.  It  excites  all  the 
secretions.  It  is  useful  in  chronic  bronchitis,  and  in  other  chronic 
aflTections  of  the  breathing  tubes. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  forty  drops  ;  infu- 
sion, dose,  one  ounce  to  an  ounce  and  a  half;  nyrup,  four  ounces  of 
fluid  extract  to  twelve  ounces  simple  syrup,  dose,  half  a  dram  to  a 
dram.  The  following  is  a  very  good  expectorant  cough  preparation  : 
fluid  extract  of  seneka,  three  drams;  fluid  extract  of  squill,  half  a 
dram  ;  syrup  of  tolu,  two  drams  ;  paregoric,  two  drams  ;  carbonate 
of  ammonia,  twenty  grains ;  water,  four  and  a  half  ounces.  Mix. 
Dose,  one  dram. 

Senna  (  Cassia  Acuti/oUa).  —  Grows  abundantly  in  Upper  Egypt. 
The  leaves  are  the  medicmal  f)art.  It  is  a  mild,  active,  and  certinn 
carthartic,  and  is  much  used  in  corabinutioii  with  other  medicines, 


SCDLLCAr. 


y 


IfKDICINEB  AND  THRIR  PREPARATIONS. 


651 


f;  infuMJon, 

)  an  oiiiuc. 

1  (!Xtnict  (it 

HiilphHto  of 

(lay.     The 

von.        I)(H«.', 

It  n  native  (if 
part  \n  tlic 
tliartic,  pro- 
irshnoss,  on 
iciiK'K  which 
J  to  twenty 

ut,ftowerin<j 
aluable  ner- 

M.  U4. 


md  expecto- 
:cite.s  all  the 
ithcr  chronic 

Irops ;  infu- 
ir  ounces  of 
a.  dram  to  a 
)reparation  : 
(]uill,  half  a 
I ;  carbonate 
nces.     Mix. 

iper  Egypt, 
and  certani 
medicines, 


particularly  opBom  Hnlt«.  The  addition  of  cIovch,  jri»^»M*,  cinnamon, 
and  other  aroujaticH,  removes  all  its  tendency  t(  ^ripin;;,  and  makcn 
it  a  Hafe  and  gentle,  yet  active  purgative,  in  woni  caHcu,  calling  for 
an  evacuation  of  the  ItoweU. 

/^refuiriifwnn.  —  Fluid  extrac^t,  dose,  one  to  two  drams;  fluid  ex- 
tinct of  M'unn  and  jalap,  dose,  half  a  dram  to  a  dram  ;  solid  extract, 
dose,  throo  to  eight  graiuB  ;  tincture,  three  ounces  to  thirteen  ounces 
of  diluted  alcohol,  dose,  half  an  ounce  to  an  oimce  ;  infu»ion,  two 
ounces  to  u  pint  of  water,  dose,  half  an  ounce  to  an  ounce. 

Hhrnbby  Trefoil  ( Ptelea  Trifoliata).  —  This  shrub,  which  grows  in 
the  West,  is  called  wafer-ash,  and  wingaeed.  Tts  bark  and  root  have 
tonic  proiwrties,  and  are  used  in  intermittent  ar«<i  remittent  fevers,  and 
wherever  nature  noedn  a  lift  in  getting  up  from  ->  ^austing  complaints. 
The  medicine,  like  other  tonics,  improves  the  appetite  and  digestion. 
1  )iiH<j  of  the  solid  extmct ,  from  three  to  five  grnina,  three  or  four  times 
a  day  ;  of  the  cold  infusion,  a  tablesixionful,  every  two  or  three  hoiu's. 

The  oleo-resinous  principle  of  the  crude  bark  is  called  ptelein,  and 
is  a  ])owerfui  touic.  Dose  one  or  two  grains,  three  or  four  times  a 
day. 

Fia.  as.  Fio.  ne. 


■BUHE   CABBASB. 


■LtPPCBT    BLM. 


Sknnk  Cabbage  ( Symplocarpus  Foetidua ). — A  perennial  plant ,  grow- 
ing  in  moist  places  throughout  the  United  States  ;  sometimes  called 
V'l  adow  cabbage.  The  root  is  stimulant,  expectorant,  antispasmodic, 
and  slightly  narcotic.  It  is  given  for  pulmonary  and  bronchial  aflfec- 
tions,  epilepsy,  hysterics,  asthma,  hooping-Cv)ugli,  and  irritiible  nerves. 

Preparations.  — Fluid  extract,  dose,  twenty  to  eighty  drops  ;  tinc- 
ture, three  ounces  to  a  pint  of  alcohol,  dose,  half  a  drum  to  a  dram ; 
infusion,  dose,  one  to  two  c  unces  ;  syrup,  two  ounces  of  fluid  extract 
to  eigh.  omices  of  simple  syrup,  dose,  two  to  three  drams.  For 
asthma  and  cough,  and  to  promote  expectomtion,  and  remove  tight- 
ness across  the  chest,  the  lu'lowing  is  a  very  good  compound  prepa- 


i  I 


/i 
< 


Nt 


ima^u 


I- 


fft>- 


652 


MEDICIUES  AND  THEIR  PREPARATIONS. 


ration  :  one  ounce  each  of  the  fluid  oxtmct  of  skunk  ciibbage,  lolielia, 
bloodroot,  pleurisy  root,  and  ginger,  one  pint  of  water,  and  thre« 
pints  of  alcohol.     Dose,  two  to  four  drams. 

Slippery  Elm  (Ulmua  Ftilva).  —  The  inner  bark  of  this  well- 
known  tree  is  nutritive,  demulcent,  emollient,  an-'  slightly  expecto- 
rant and  diuretic.  It  is  valuable  as  a  demulcent  drink  in  inflamma- 
tions of  th*i  lungs,  3tomach,  bowels,  bladder,  and  kidneys;  also,  for 
coughs,  stmngury,  dysentery,  and  the  summer  complaint  of  infants. 
It  makes  a  valuable  i^K)ultice  for  various  purposes. 

Small  Spikenard  (Aralia  Nudicaulis) . —  This  plant  grows  through- 
out the  United  States,  from  Canada  to  the  Carolinas,  in  rocky  woods. 
It  is  called  false  aaraaparilla  and  wild  aarsaparilla.  The  root  is  a 
gentle  stimulant,  diaphoi'etic,  and  alterative.  It  is  used  in  domestic 
practice,  and  by  some  physicians,  in  rheumatism,  syphilis,  and  cuta- 
neous diseases.  The  American  spikenard,  aralia  racemom,  resem- 
bles the  small  spikenard  in  medical  properties.  Either  of  these  roots 
is  valuable  in  chronic  affections  of  the  lungs  and  air  tubes. 

Sofn  (iS5r/»o). — Soap  is  laxative,  antacid,  an  antilithic,  and  is 
much  used  in  combination  with  cathartics,  to  lessen  the  severity  of 
their  action.  In  mesenteric  fever,  advantage  is  derived  from  rul»- 
bing  the  tumid  belly  of  children  with  a  strong  lather  of  soap,  morn- 
ing and  evening ;  and  few  things  are  more  effectual  in  removin" 
hardened  feces  from  the  rectum  in  cases  of  obstinate  costiveness  than 
an  injection  of  soap-suds. 

Sodium.  —  This  is  a  soft  white  metal.  United  Avith  oxygen  in  the 
propoi*^^ion  of  one  equivalent  each,  it  forms  the  alkali,  soda.  The 
ifoUowing  are  the  principal  preparations  of  soda  used  in  medicine  : 

Bicarbonate  of  Soda  (^Sodce  Bicarbonas).  — This  is  a  white,  inodor- 
ous powder,  generally  called  super  carbonate  of  soda.  It  is  antiUMil, 
antilithic,  and  slightly  diuretic.  It  is  chiefly  used  in  preparing  what 
are  called  soda  powders,  and  in  various  preparations  of  medicire, 
when  an  antacl(?  is  required.  Jt  is  also  taken  simply  dissolve;!  in 
water,  for  acidity  of  the  stomach.  The  yeast  powders,  now  .so  nuich 
used, >  are  said  to  be  composed  of  about  i,wo  and  a  half  parts  of  cream 
of  tartar,  and  one  part  each  of  corn  starch  and  ])icarbonate  of  soda. 
Housewives  may  as  well  make  the  combinatio"i  for  theinselves. 

Borate  of  Soda  {Sodas  Boras),  —  This  is  every  where  known  by  the 
name  of  borax.  It  exists  naturally  formed  in  several  parts  of  the 
world,  and  is  likewise  maimfactured.  It  is  a  mild  refrigemut  and 
diuretic ;  also  emmenagogue,  promoting  menstruation,  facilitating 
parturition,  and  favoring  the  expulsion  of  the  after-birth,  by  its  spe- 
cific influence  upon  the  womb.  It  nas  considerable  reputation  in  the 
treatment  of  urinary  diseases,  particularly  those  connected  vf\\^\  an 
excess  of  uric  acid.  The  dose  is  from  twenty  to  forty  grains  in  (Solu- 
tion. Combined  with  rose-water,  honey,  and  various  other  things, 
according  to  circumstances,  Ixjrax  makes  a  valuable  wash  for  inflam- 
matory affections  of  the  mouth  and  throat,  skin  diseases,  etc. 


I)age,  lolielia, 
ir,  and  thie«; 

)f  this  well- 
itly  cxpecto- 
iii  intlamnm- 
ys  ;  also,  for 
it  of  infants. 

ows  throujrli- 
ocky  woods. 
The  root  is  .1 
1  in  vionicstic 
is,  and  ciita- 
nom,  re.sein- 
)f  these  roots 

IS. 

ithic,  and  is 
e  severity  of 
id  from  ruh- 
soap,  niori5- 
in  removin<» 
;iveness  than 


xygen  in  the 
soda.     The 
Medicine : 

i^hite,  inodor- 
It  is  antacid, 
sparing  what 
of  medicire, 
dissolve;!  in 
low  so  nuu-ii 
irts  of  cream 
latc  of  so(hi. 
selves. 

niown  l)y  tiie 
parts  of  the 
rigemnt  and 
facilitating 
,  by  its  spe- 
tation  in  the 
ted  wi\h  an 
ains  in  »^u- 
ther  things, 
ti  for  intlam- 
etc. 


«r 


MEDICINES  AND  THEIR  PREPARATIONS. 


653 


Chloride  of  Sodinm  (Sodii  Chloridum).  —  This  is  the  chejnioal 
name  of  muriate  of  soda,  or  common  salt.  In  small  doses,  it  is  tonic, 
aitemtive,  and  anthelmintic.  It  checks  bleeding  from  the  lungs, 
when  taken  in  teasi)oonful  doses.  The  dose  as  an  aitemtive  is  from 
ten  to  sixty  grains.  As  moderately'  used  in  food  by  most  civilizeO 
people,  it  promotes  digestion  and  improves  tl.e  general  health. 

Sulphate  of  Soda  (Sodce  Sulphas).  —  This  has  a  very  pretty 
name,  but  it  will  not  sound  half  as  well  to  thousands  of  young  pei'- 
sons,  when  they  are  told  that  it  is  the  well-known  glauber's  saltx. 
From  half  an  ounce  to  an  ounce  of  it,  dissolved  in  half  a  tumblerful 
(if  water,  acts  as  a  cathartic ;  a  smaller  dof  as  a  laxative  and  diu- 
ri'tio.  Its  nauseous  and  bitter  taste  may  be  ..^mewhat  concealed  by  a 
little  cream  of  tartar,  or  lemon  juice,  or  a  few  drops  of  sulphuric  acid. 

Sulphite  of  Soda  (/Sodce  Sulphis).  —  This  preparation  is  in  the 
form  of  transparent  crystals,  and  is  very  soluble  in  water.  In  doses 
of  sixty  grains,  this  is  said  to  have  been  used  with  success  in  frothy 
vomitings  ;  it  is  also  well  spoken  of  as  a  remedy  in  acute  rheuma- 
(isin,  and  as  a  wash  in  thrush,  and  some  diseases  of  the  skin. 

Tartrate  of  Potassa  and  Soda  (Sodce  et  Potassce  Tartras).  — This 
is  one  of  the  mildest,  and  most  cooling  purgatives  among  the  salts. 
It  is  known  as  rochelle  salt,  and  generally  agrees  well  with  irritable 
and  delicate  stomachs.  Dose,  from  two  drams  to  an  ounce,  in  a  tum- 
l)lerful  of  Avater.  The  gentle  physic  called  seidlitz  poioders  is  com- 
posed of  two  drams  of  rochelle  salt  and  two  scruples  of  bicarbonate 
of  soda  in  a  blue  paper,  and  thirty-five  gmins  of  tartaric  acid  in  a 
white  paper.  The  contents  of  each  paper  is  dissolved  in  half  a  tum- 
bler of  water  by  itself;  one  solution  is  then  poured  into  the  other, 
and  the  whole  is  drank  during  the  effervescence. 

Solomon's  Seal  (Gonvalaria  MuUiflora).  — This  is  one  of  our  own 
perennial  plants,  and  is  found  in  various  parts  of  the  country.  The 
root  is  tonic,  mucilaginous,  and  astringent.  It  acts  especially  upon 
jnncous  tissues,  and  has  tkerefore  found  its  use  in  chronic  dysentery, 
and  piles,  and  in  chronic  inflammation  of  the  stomach  and  bowels. 
Dose  of  the  decoction,  or  infusion,  from  one  to  four  fluid  ounces,  three 
or  four  times  a  day.  Large  doses  purge  and  vomit.  The  decocti(m, 
applied  locally,  relieves  the  inflammation  caused  by  the  poison  vine. 

Solution  of  Arsenite  of  Potassa  (Liquor  Potassce  Arsenitis).  — 
This  is  known  under  the  names  of  arsenical  solution  and  Fowler's  so- 
lution. It  is  a  transparent  liquid,  having  the  color,  ta.ste,  and  smell 
of  spirits  of  lavender.  It  has  the  geneml  action  upon  the  human 
body  of  the  arsenical  preparations.  It  is  the  preparation  generally 
resorted  to  where  arsenic  is  given  internally,  and  is  used  with  con- 
siderable success  in  intennittent  fever,  leprosy,  and  several  other  skin 
diseases,  St.  Vitus's  dance,  periodical  headache,  and  someotluM-  com- 
l)laints.  The  dose  is  from  three  to  ten  drops,  three  times  a  day,  given 
ill  water ;  generally,  it  is  better  not  to  go  beyond  five  drops.  Some- 
times it  disturbs  the  stomach,  and  binds  the  bowels,  producing  head- 


I' 
41' 
ii 

J 


—         ■■inii^lttiillnrianiiiiliii 


tiSta 


654 


MEDICINES  AND  THEIR  PREPARATIONa 


1"  I 


ache,  dizziness,  und  confusion  of  mind.  When  such  effects  follow 
its  use,  it  must  ho  laid  aside,  and  a  purgative  given.  After  an  inter- 
val of  two  weeks,  it  may  he  resumed  in  smaller  doses.  It  often 
requires  to  he  used  for  several  months. 

Spanish  Flies  {Cantharis  Vesicatoria) . — These  injects  are  of  u 
beautiful,  shining,  golden-green  color.  They  attach  themselves  to 
such  trees,  in  France,  Spain,  and  Italy,  as  the  white  poplar,  elder, 
privet,  and  lilach,  upon  the  leaves  of  which  they  feed.  They  nialvc 
their  appearance  in  swarms  upon  these  trees,  in  May  and  June,  jind 
are  shaken  off  in  the  morning  while  tor"'>id  with  the  cold.  Internally 
administered,  they  are  a  powerful  stimulant,  exercising  a  peculiar  in- 
fluence over  the  urinary  and  genital  organs.  In  large  doses,  they 
excite  violent  inflammation  of  the  alimentary  canal  and  urinary  or- 
gans, strangury,  irritation  of  the  sexual  organs,  headache,  delirium, 
and  convulsions  ;  also  painful  priapism,  vomiting,  bloody  stools,  sali- 
vation, fetid  breath,  hurried  breathing,  and  diflSculty  of  swallowing. 
They  are  given  internally  for  chronic  gonorrhoea,  leucorrhcea,  semi- 
nal weakness,  and  paralysis  of  the  bladder.  Dose  of  the  powder, 
from  half  a  grain  to  two  grains ;  of  the  tincture,  from  twenty  to 
sixty  drops.  Solution  of  potassa,  given  every  hour,  in  thirty-drop 
doses,  is  a  remedy  for  strangury  produced  by  cantharides.  Spanish 
flies  are  used  externally,  in  the  foi-m  of  blistering  plaster  ;  also  in  the 
form  of  tincture,  mixed  with  various  solutions,  to  produce  irritation 
and  redness  of  the  skin. 

Spearmint  (Mentha  Viridis). — This  has  carminative,  diur^^tic, 
and  antisi)asniodic  virtues.  The  warm  infusion  of  it  is  much 
em|)lo_yed  in  domestic  practice,  to  produce  perspiration,  after  taking 
cold,  and  while  suft'ering  from  feverish  symptoms,  from  various 
causes.  The  oil  of  spearmint  has  similar  properties  with  the  herb, 
and  may  be  taken  in  five  to  ten  drop  doses,  on  sugar.  One  ounce 
of  the  oil  of  spearmint,  dissolved  in  a  pint  of  alcohol,  constitutes 
the  essence  of  spearmint. 

Spermaceti  (Cetaceum). — This  is  a  white  crystalline  substance, 
obtained  from  the  head  of  the  spermaceti  whale.  In  household  prac- 
tice, it  is  considerably  used  for  the  coughs  and  colds  of  children, 
being  generally  simmered  with  molasses  or  loaf  sugar.  It  forms  a 
part  of  sevei'al  cerates  and  ointments. 

Spider's  Web  (Tela  Aranece) .  — The  web  of  the  black  or  brown 
spider,  gathered  in  barns,  cellars,  etc.,  is  sometimes  given  in  five  or 
six  grain  doses,  in  pill  form,  and  it  is  said  with  good  effect,  in  peri- 
odical headache,  hysterics,  St.  Vitus's  dance,  asthma,  and  fever  and 
ague.     It  is  likewise  applied  externally  to  check  bleeding. 

Spirit  of  Nitric  Ether  (SpirituH  ^theria  Nitrici) The  general 

reader  will  know  this  article  better  under  the  name  of  aweet  spirits 
of  nitre.  It  is  diuretic,  diaphoretic,  antispasmodic,  and  stimulant,  and 
in  large  doses,. a  narcotic  poison.  It  is  much  used  in  diseases  of  the 
urinary  organs,  either  alone  or  combined  with  sedatives,  and  other 


■DBSBBmMp- 


tafUf^amiieii 


MEDICINES  AND  THEIR   PREPARATIONS. 


655 


!CtS    follow 

r  an  inter- 
It  often 

3  are  of  a 
nselves  to 
Jar,  older, 
riiey  iiKilvc 
June,  and 
Internally 
eculiar  in- 
oses,  they 
irinary  or- 

delirium, 
tools,  sali- 
rallowinjr. 
icea,  8enii- 
9  powder, 
twenty  to 
flirty-drop 
Spanish 
dso  in  the 

irritation 

,  diurv^tic, 
is  much 
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the  herl), 
)ne  ounce 
onstitutes 

ubstance, 

lold  prac- 

children, 

forms  a 

f  • 

or  brown 
in  five  or 
,  in  peri- 
fever  and 


le  genend 
et  spii'ils 
dant,  and 
ses  of  the 
nd  other 


diuretics.     Dose,  from  twenty  drops  to  two  fluid  drams,  to  be  taken 
in  water,  three  or  four  times  a  day. 

Sponge  (Spongia).  — When  burned,  this  is  used  as  an  alterative  in 
scrofula,  scrofulous  tumors,  goitre,  and  obstinate  diseases  of  the  skin. 
It  is  much  employed  by  homoeopathic  physicians,  though  it  has  much 
less  remedial  power  than  iodine.  Dose,  one  to  three  drams,  mixed 
with  honey  or  syrup. 

Sparred  Bye  (Secale  Comutum).  — This  is  a  diseased  product  of 
rye,  known  by  the  name  of  ergot.  This  article  has  a  peculiar  effect 
upon  the  womb,  causing  it  to  contract  Avith  great  energy,  when  give 
in  full  doses.  It  should  never  be  given,  however,  continuously,  fof 
great  length  of  time,  as  it  has  been  known,  when  so  used,  to  product 
dry  gangrene,  typhus  fever,  and  nervous  disorders  connected  with 
convulsions.  Such  were  its  effects  in  certain  provinces  of  France,  in 
consequence  of  the  use  of  rye  bread  contaminated  with  it.  It  is  use- 
ful in  excessive  uterine  hemorrhage,  which  it  arrests  by  causing  the 
womb  to  contract,  and  thus  to  condense  its  tissue,  and  close  up  its 
bleeding  vessels.  It  has  also  l>een  successful  in  bleeding  from  the 
lungs. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  tinc- 
ture, four  ounces  to  a  pint  of  diluLed  alcohol,  dose,  two  and  a  half  to 
five  drams  ;  infusion,  dose,  one  to  two  ounces  ;  wine,  five  ounces  of 
fluid  extract  to  a  pint  of  sherry  wine,  dose,  two  to  four  drams,  in  cases 
of  labor  ;  for  other  purposes,  one  to  two  drams. 

Squill  (Scilla  Maritima) .  — A  perennial  plant  growing  in  countries 
on  the  Mediterranean.  In  large  doses,  it  is  emetic  and  purgative  ;  in 
small  doses,  expectorant  and  diuretic.  It  is  used  in  pulmonary  affec- 
tions to  increase  expectoration,  and  in  dropsical  complaints  to  aug- 
ment the  secretions  of  the  kidneys.  Dose  of  the  dried  root,  one  to 
live  grains,  generally  to  be  united  with  nitre  or  ipecac. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant  and  diuretic, 
two  to  six  drops  ;  as  an  emetic,  twelve  to  twenty-four  drops  ;  comr 
l)ound  fluid  extract,  dose,  ten  to  twenty  drops  ;  tincture,  two  ounces 
to  a  pint  of  diluted  alcohol,  dose,  twenty  to  forty  drops  ;  syrup,  dose, 
a  quarter  to  half  a  dram. 

Star  Grass  (AletrisFarinosa) . — This  plant  is  found  in  dry  soils 
throughout  most  parts  of  the  United  States,  and  called  unicorn  root, 
ague  root,  and  crow  corn.  The  root  is  an  intensely  bitter  tonic,  and 
is  used  to  improve  the  tone  of  the  stomach,  and  for  flatulent  colic  and 
hysterics.  It  is  said  also  to  give  tone  to  the  female  generative  organs, 
affording  a  protection  against  miscarriage.  The  Eclectics  call  it 
one  of  their  best  agents  in  chlorosis,  suppressed  menstruation,  engorge- 
ment and  falling  of  the  womb,  and  painful  menstruation.  Dose  of 
the  powdered  root,  from  five  to  ten  grains,  three  times  a  day. 

Prpparntions.  —  Fluid  extract,  dose,  ten  to  thirty  drops  ;  tincture, 
two  ounces  to  a  pint  of  diluted  alcohol,  dose,  half  a  dram  to  a  dram  ; 
infusion,  two  drams  to  a  pint  of  water,  dose,  one  or  two  ounces ; 


a: 


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«MMiMMIilMrt«i> 


656 


MEDICINES  AND  THEIR  PREPARATIONS. 


W 


m' 


syrup,  dose,  one  to  two  (11*0018 ;  aletridin,  (he  active  principle,  dose, 
one  to  three  grains. 

St.  Ignatins's  Bean  (Faba  Sancti  Ignatii).  — The  seeds  are  the  part 
used,  and  are  the  product  of  the  Ignatia  Amara,  —  a  tree  of  middle 
size,  growing  in  the  Philippine  Islands,  and  is  a  species  of  the  atrich- 
nos.  These  seeds  possess  a  large  amount  of  strychnine,  and  conse- 
quently, in  medicinal  doses,  are  a  powerful  nervine  tonic,  and  are  used 
for  improving  the  digestive  functions,  and  for  rousing  and  strength- 
ening the  whole  system  when  prostrated  by  nervous  complaints. 

Preparations.  — Fluid  extract,  dose,  five  to  ten  drops  ;  solid  extract, 
dose,  half  a  grain  to  a  grain  and  a  half. 

Storax  (Styrax  Officinale).  —  This  is  the  hardened  juice  of  the 
storax,  a  native  of  the  countries  along  the  Meditermnean.  It  is  a 
Htimulant  and  expectorant,  and  is  used  for  chronic  bronchitis,  laryn- 
gitis, and  cough.  The  liquid  storax  is  sometimes  employed  instead 
of  copaiva  in  gonorrhoea  and  gleet.  The  dose  is  from  ten  to  twenty 
grains.    Storax  is  a  constituent  in  the  compound  tincture  of  benzoin. 


Via.  227. 


Fio.  328. 


BTAB  OBA8S. 


sTSAMOimnf. 


stramonium  {Datura  Stramonium).  — This  annual  plant  is  most 
known  in  this  country  by  the  name  of  Jamestown  tqeed;  in  England 
by  that  of  thornapple.  The  leaves  and  seeds  are  medicinal.  Stramo- 
nium is  a  powerful  narcotic  ;  it  is  also  antisimsmodic,  anodyne,  and 
sediitive.  It  is  used  in  various  nervous  aftections,  as  chorea,  epilepsy, 
palsy,  teta.nus,  and  mania.  It  is  much  used  for  relieving  acute  pains, 
etc.     Taken  in  large  doses,  it  is  a  powerful  poison. 

Prp))a rations. — Fluid  extract,  dose,  five  to  twenty  drops  ;  solid 
extrnct,  dose,  half  a  grain  to  a  grain ;  tincture,  two  ounces  to  a  pint 
of  alcohol,  dose,  half  a  dram  to  a  dram  and  a  half,  pnd  to  be  gradu- 
ally increased. 

Snlphnr.  —  This  is  considerably  used  in  medicine,  being  laxative, 
diaphoretic,  and  resolvent.  It  is  chiefly  used  for  piles',  chronic  iheu- 
matism,  gout,  asthma,  and  those  affections  of  the  breathing  organs 


iiple,  dose, 

are  the  part 
e  of  middle 
f  the  strich- 
and  conse- 
nd  are  used 
1  strength- 
)laints. 
did  extnict, 

uice  of  the 
n.  It  is  a 
litis,  laryn- 
r^ed  instead 
t\  to  twenty 
of  benzoin. 


mt  is  most 
in  England 
Stramo- 
odyne,  and 
,  epilepsy, 
icute  pains, 

rops ;  solid 
s  to  a  pint 
be  gradu- 

V, 

-g  laxative, 
ronic  iheu- 
liug  organs 


MEDICINES  AND  THEIR  PREPARATIONS. 


657 


not  attended  with  acute  inflammation.  Externally  and  internally,  it 
is  much  employed  in  skin  diseases,  particularly  the  itch,  for  which  it 
is  a  s|»ecific.  In  these  affections,  it  is  fre(iuently  applied  in  the  form 
of  sulphur  baths.  The  dose  of  sulphur  is  from  one  to  three  drams, 
mixed  with  syrup,  molasses,  or  milk.  When  sublimed,  this  article 
is  called  ^o?oer«  of  sulphur,  which  is  the  form  in  which  it  is  chiefly 
used  in  medicine. 

Sumach  {Rhus  Glabinim) .  —  Found  in  almost  all  parts  of  the  United 
States,  in  old  neglected  fields,  and  by  the  side  of  fences.  The  bark 
and  berries  are  astringent,  tonic,  antiseptic,  and  diuretic,  and  are  used 
in  diarrhoea,  dysentery,  gonorrhoea,  whites,  hectic  fever,  and  scrofula. 
The  berries  make  a  valuable  gargle  in  quinsy,  and  ulcerations  of  the 
mouth  and  throat,  and  also  a  useful  wash  for  ringworm,  tetter,  and 
ulcers.  The  excrescences  which  grow  upon  the  leaves  have  nearly 
lis  nmch  astringency  as  galls,  and  when  pulverized  and  mixed  Avith 
liird,  have  a  similarly  soothing  effect  upon  piles. 

Preparations.  — Fluid  extract,  dose,  one  to  two  dmms  ;  tincture, 
four  ounces  to  thirteen  ounces  of  diluted  alcohol,  dose,  half  an  ounce 
to  an  ounce. 

Sunflower  {Helianihus  Annmis) .  —  The  seeds  and  the  leaves  of  this 
l)lant  are  expectorant  and  diuretic,  and  are  useful  in  several  pulmo- 
nary affections.  The  seeds  yield  a  fixed  oil,  in  which  their  medicinal 
virtues  are  chiefly  found.  In  doses  of  ten  or  twenty  drops,  this  oil 
acts  favorably  upon  inflamed  mucous  surfaces,  and  in  doses  three 
tiine^:  as  large,  it  greatly  augments  the  flow  of  urine. 

Swamp  Dogwood  (  Cornus  iSericea).  — This  is  found'in  damp  places, 
and  along  the  banks  of  rivers,  in  various  parts  of  our  country,  and  is 
known  as  red  ozier,  red  willow,  and  rose  toillow.  The  bark  is  tonic, 
stimulant,  and  astringent,  and  has  been  used  for  similar  purposes  with 
dogwfiod  bark ;  well  spoken  of,  also,  for  dyspepsia,  diarrhoea,  malig- 
nant fevers,  and  as  an  external  application  to  foul  andlU-conditioned 
ulcers.  Dose  of  the  powdered  bark,  from  twenty  to  sixty  grains  ;  of 
the  infusion,  from  two  to  four  fluid  ounces. 

Swamp  Milkweed  (Asclepias  Incamata) This  is  a  native  of  the 

United  States,  and  bears  red  flowers  from  June  to  August.  It  has  the 
name  of  white  Indian  hemp.  The  root  is  emetic,  cathartic,  and  diuretic, 
and  is  useful  in  asthma,  bronchitis,  rheumatism,  syphilis,  and  worms. 

Preparations.  — Fluid  extract,  dose,  twenty  to  fort}'  drops  ;  solid 
extract,  dose,  three  to  five  grains  ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  one  and  a  half  to  three  drams  ;  infusion,  dose, 
three  to  six  drams  ;  syrup,  four  ounces  fluid  extract  to  twelve  ounces 
simple  syrup,  dose,  half  a  dram  to  a  dram  and  a  half. 

Sweet  Fern  (Comptonia  Asplenifolia) ,  —  This  shrub,  growing  in 
stony  pastures  in  New  England  and  Virginia,  is  tonic,  astringent, 
alterative,  and  aromatic,  and  is  used  in  diarrhoea,  dysentery,  cholera 
infantum,  rheumatism,  and  debility  after  fevers.  Dose  of  the  decoc- 
tion, from  one  to  four  fluid  ounces,  three  or  four  times  a  day. 

83 


I  .  *^l 


S 


i''  ! 


1'e 

i 

I 


658 


MEDICINES  AND  THEIR  PREPARATIONS. 


Sweet  Flag  {Acorus  Calamus). — Found  in  damp  places,  in  mo>.t 
parts  of  the  world.  The  root  is  stimulant,  tonic,  and  aromatic  :  use- 
ful in  wind  colic,  weakened  conditions  of  the  stomach,  and  dyspepsia. 
Dose  of  the  root,  from  twenty  to  si  '/rains  ;  of  the  infusion,  from 
two  to  four  fluid  ounces. 

Sweet  Gum  {Liquidamber  Styraci^  ). — This  tree  grows  in  the 
Middle  and  Southern  States.  Being  wounded,  it  yields  a  yellowish- 
white,  honey-like  balsam,  which  hardens  into  a  gum.  This,  melted 
with  equal  parts  of  lard  or  tallow,  forms  an  ointment  which  is  used 
in  some  parts  of  the  country  for  piles,  ringworm  of  the  scalp,  -fever 
gores,  and  other  complaints.  Used  interaally,  it  has  very  nearly  the 
same  eflTects  with  storax. 

Tag  Alder  {Alnus  Rubra). — This  shrub  grows  in  swamps  and 
other  damp  places,  in  northern  United  States.  The  hark  is  altera- 
tive, emetic,  and  astringent.  It  is  used  in  scrofula,  secondary 
syphilis,  herpes,  impetigo,  and  other  skin  diseases. 

Preparations.  — Fluid  extract,  dose,  one  to  two  drams ;  infusion, 
two  ounces  to  a  pint  of  water,  dose,  one  to  two  ounces  ;  alnuin,  the 
active  principle,  dose,  one  to  three  grains. 

Tansy  ( Tanacetum  Vulgare) .  —  Tansy  is  a  perennial  herb,  having 
tonic,  emmenagoguo,  and  diaphoretic  properties ;  the  cold  infusion 
being  tonic,  and  useful  in  dyspepsia,  wind  in  the  stomach,  jaundice, 
and  worms ;  the  warm  infusion,  diaphoretic  and  emmenagogue. 
Dose  of  the  infusion,  from  one  to  four  fluid  ounces,  two  or  three 
times  a  day. 

Tar  {Fix  Liquida) . — The  medicinal  qualities  of  tar  are  like  those  of 
turpentine,  and  it  is  sometimes  used  in  old  chronic  coughs  and  bron- 
chitis. The  vapor  of  boiling  tar  was  once  thought  to  be  very  service- 
able in  bronchial  diseases,  when  inhaled.  Doubtless  it  is  useful  in 
some  cases,  biit  its  virtues  have  been  extolled  above  their  merits. 
In  the  fonn  of  ointment,  it  has  real  eflicacy  in  scald  head  and  tetter. 

ThlmbleT^eed  (Budbeckia  Laciniata).  —  The  whole  of  this  herb  is 
balsamic,  diuretic,  and  tonic,  and  in  the  form  of  decoction,  used 
freely,  is  said  to  liave  been  found  useful  in  some  urinary  complaints, 
as  Bright's  disease,  strangury,  etc. 

Tobacco  {Nicotiana  Tabacum),  — The  leaves  of  tobacco  are  acrid, 
narcotic,  and  poisonous,  and  are  chiefly  used  in  the  form  of  ointment, 
in  skin  diseases,  etc.  Its  poisonous  qualities,  however,  render  it 
dangerous  when  much  used,  even  externally. 

Trailing  A'batns  (Epigcea  Repens).  — This  grows  in  sandy  woods 
and  rocky  soils,  its  flowers  appearing  in  early  spring,  and  exhaling  a 


spicy 


fragrance. 


The  leaves  are  diuretic  and  astringent,  and  are 


very  useful  in  gravel,  and  most  diseases  of  the  urinary  organs,  being 
regarded  in  some  cases  superior  to  Uva  uroi  and  buchu. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams ;  infusion, 
dose,  two  to  four  ounces. 


ces,  in  most 
oinutic :  usc- 
d  (lysiiepisia. 
fusion,  lioui 

;rows  in  the 
a  yellowish- 
rhis,  melted 
liich  is  used 
scalp,  .fever 
•y  nearly  the 

swamps  and 
•k  is  altera- 
,   secondary 

9 ;  infusion, 
alnuin,  the 

lerb,  having 
old  infusion 
ih,  jaundice, 
imenagogue. 
wo  or  three 

like  those  of 
IS  and  bron- 
^ery  service- 
is  useful  in 
heir  merits, 
and  tetter. 

'  this  herb  is 
oction,  used 
complaints, 

so  are  acrid, 
of  ointment, 
r,  render  it 

andy  woods 
i  exhaling  u 
nt,  and  are 
gans,  Ijeing 

infusion, 


Tapioca  {Janipha  Manihot).  —  This  plant  grows  in  tijc  West  Indies 
nndBi-azil.  It  is  cultivated  chiefly  on  account  of  the  root,  which  is 
largely  used  as  an  article  of  food,  particularly  for  the  sick,  or  nither, 
for  those  recovering  from  sickness.  The  starch  which  it  contains  js 
separated  by  washing,  scraping,  grating,  and  grinding,  and  is  in  the 
form  of  hard,  white,  rough  grains.  It  is  prepared  for  use  by  boiling ; 
and,  in  debility  and  low  forms  of  disease,  may  have  the  addition  of 
wine,  nutmeg,  or  other  aromatics. 

Tulip  Tree  {Liriodendron  Tulipifera).  — This  is  a  largo  and  elegant 
tree  growing  in  many  parts  of  the  country,  and  called/jop/arand  wlute 
poplar.  The  bark  of  the  root  is  aromatic,  stimulant,  and  tonic,  and 
in  wann  infusion,  diaphoretic.  It  is  used  in  fever  and  ague,  chronic 
rheumatism,  and  chronic  diseases  of  the  stomach  and  bowels.  Dose 
of  the  powdered  bark,  from  a  scruple  to  two  drams  ;  of  the  infusion, 
from  one  to  two  fluid  ounces. 

Turkey  Com  ( CorijdaUs  Formosa) .  — This  perennial  plant  is  called 
wild-turkey  pea,  and  stagger-weed,  and  gi-ows  in  rich  soils  in  the 
Southern  and  Western  States.  The  tuber,  which  is  the  medicinal 
part,  should  only  be  collected  while  the  plant  is  in  flower.  It  is  tonic, 
diuretic,  and  alterative.  It  is  much  valued  as  a  remedy  in  syphilis 
and  scrofula. 

Preparations.  —  Fluid  extract,  dose,  ten  to  forty  drops  ;  tinctui-e, 
three  ounces  to  a  pint  of  diluted  alcohol,  dose,  half  a  dram  to  two 
drams  ;  corydalin,  the  active  principle,  dose,  half  a  grain  to  a  grain. 
A  valuable  alterative  for  syphilis  is  made  by  uniting  eight  grains  of 
corydalin  with  ttn  grains  of  hydrastin,  and  dividing  into  twelve  pow- 
ders.    Dose,  one  powder,  three  or  four  times  a  day. 

Turiueric  (  Curcuma  Lonya  .  —  This  is  a  native  of  the  East  Indies 
and  Cochin  China.  The  root  is  a  stimulant  aromatic  and  tonic,  some- 
what like  ginger,  employed  in  debilitated  states  of  the  stomach,  etc. 

Preparations.  —  Fluid  extract,  dose,  two  or  three  drams  ;  tincture, 
two  ounces  to  twelve  ounces  of  diluted  alcohol,  dose,  one  and  a  half 
to  two  ounces  ;  infusion,  dose,  two  to  four  ounces. 

Yalerian  (  Val&Hana  Officinalis).  —  This  is  a  European  plant,  flow- 
ering in  June  or  July.  The  root  is  tonic,  nervine,  and  antispasmodic, 
and  is  much  used  in  cases  of  irregular  nervous  action,  particularly 
morbid  nervous  vigilance,  or  hypochpndria,  epilepsy,  lowness  of 
spirits,  and  nervous  headache. 

Preparations.  —  Fluid  extract,  dose,  half  a  di'am  to  a  dram  and  a 
half;  solid  extract,  dose  three  to  ten  grains  ;  tincture,  four  ounces  to 
a  pint  of  diluted  alcohol,  dose,  two  to  four  drams  ;  infusion,  half  an 
ounce  to  a  pint  of  water,  dose,  two  to  four  ounces  ;  syrup,  four  ounces 
of  fluid  extract  to  a  pint  of  simple  syrup,  dose,  two  to  four  dnuus. 

Vervain  (  Verbena  Hastata),  — A  perennial  plant,  common  in  the 
United  States.  The  root  is  tonic,  emetic,  expectorant,  and  sudorific. 
It  is  used  in  intermittent  fevers,  colds,  and  obstructed  menr*  "^'on, 
in  the  form  of  warm  infusion.     The  cold  infusion  is  a  good  t         in 


fi,; 


i,1: 


a-: 


,>. 


660 


MEDICIXES  AND  THEIR   PREPARATION'S. 


loss  of  npiMstite,  debility,  etc.  Dose  of  the  powdered  root,  one  or  two 
scruples;  of  the  infusion,  from  two  to  four  ounces,  three  or  four 
times  a  day. 

Tinegar  (Acelum).  — This  is  refrigei'ant,  diuretic,  astringent,  and 
tonic  ;  used  in  fevers  and  inflammatory  complaints,  likewise  m  scurvy 
Hod  typhus,  as  an  antiseptic.  It  has  I)eon  found  useful  in  dysentery 
iind  scarlet  fever,  saturated  with  common  salt.  Externally,  it  is  ap- 
1  >!ied  to  bruises,  inflammations,  sprains,  and  swellings.  It  sometimes 
ii.'is  n  good  eflect  as  a  gargle  in  putrid  sore  throat,  etc.,  and  as  a  cool- 
ui^  wash  in  headache  dunng  fevers. 


Fio.  : 


Fia.  2S0. 


TnaiKIA   tKAU-BOOT. 


FiS.  231. 


Yirginia  Siiake*root  (  Aristolochia  Serpentaria) .  —  This  is  a  peren- 
nial herb  of  the  Middle  and  Southern  States.  The  root  is  stimulant, 
tonic,  and  diaphoretic.  It  is  used  in  typhoid  feve/s,  when  the  sys- 
tem needs  suppoil,  but  cannot  bear  active  stimulation. 
Combined  with  jjeruvian  bark,  it  is  also  used  in  intei*- 
niittent  fevers.  The  cold  infusion  is  employed  in  some 
foniis  of  dyspepsia ;  likewise  as  a  gargle  in  malignant 
sore  throat. 

P'-eparatioTis.  —  Fluid  extract,  dose,  one  quarter  to 
.  lialf  a  dram ;  tincture,  three  ounces  to  a  pint  of  diluted 
iiloohol,  dose,  one  to  two  drams :  infusion  half  an  ounce 
to  a  pint  of  water,  dose,  one  to  two  ounces,  in  low  forms 
of  fever.  The  following  is  a  good  compound  tincture ; 
Imlf  an  ounce  each  of  fluid  extract  of  snake-root;  fluid 
extract  of  ipecac,  fluid  extract  of  safii-on,  fluid  extract 
of  ladies'  slipiier,  together  with  half  an  ounce  of  cam- 
phor, and  one  and  a  half  pints  of  diluted  alcohol ;  dose, 
u  dram  to  a  dram  and  a  lialf. 

Water  Horehonnd. — Thit3  article  has  been  described 
\xm\er  Bugle  Weed,  but  the  cut  was  forgotten.      See  Bugle   Weed 
^Lycopus  Virginicus). 


,  one  or  two 
reo  or  four 

'ingent,  and 
He  in  scurvy 
1  dysentery 
ly,  it  is  ap- 
t  sometimes 
id  as  a  cool- 


DOT. 


1  IS  a  peren- 
)  stimulant, 
an  the  sy«- 


Fio.  231. 


WATsn 

H0BBH6QMD 


iugle  Weed 


Water  Pepper  {Polygonum  Pundatum).  —  This  annual  plant  is 
called  uni'irt-weed,  and  grows  throughout  our  country,  in  low  grounds, 
and  along  ditfhcs  and  brooks.  It  has  a  pimgent,0)iting  taste,  and  is 
stimulant,  diuretic,  emmenagogue,  antiseijtio,  and  vesicant.  It  is 
used  in  coughs,  colds,  gravel,  and  womb  complaints. 

Prepamtions. — Fluid  extract,  dose,  ten  to  sixty  drops;  solid 
extract,  dose,  two  to  three  grains  ;  tincture,  four  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  a  dram  to  two  drams ;  infusion,  half  an 
ounce  to  a  pint  of  water,  dose,  half  an  ounce  to  an  ounce. 

Wahoo  ( Enonymiis  Atropuipureus) .  —  A  small  shrub  growing  in 
woods  in  many  pans  of  the  United  States.  The  bark  of  the  root  is 
!i  bitter  tonic,  laxative,  alterative,  diuretic,  and  expectorant,  and  is 
advantageously  used  in  pulmonary  nfl'ections,  dropsy,  constipation, 
torpidity  of  the  liver,  dyspepsia,  and  intermittent  fevers. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams  ;  tincture, 
four  ounces  to  twelve  ounces  of  diluted  alcohol,  dose,  half  an  ounce 
to  an  ounce. 

Wax.  —  The  yellow  and  white  wax  are  chiefly  used  as  ingredients 
of  plasters  and  ointments. 

White  Hellebore  (  Veratrum  Album).  —  This  is  an  European  pe- 
rennial plant,  the  root  of  which  is  a  violent  emetic  and  purgative,  and 
in  large  doses  is  poisonous ;  not  often  used,  except  externally,  in  the 
form  of  ointment  or  decoction,  for  the  cure  of  itch,  and  some  other 
skin  diseases. 

White  Oak  (Quercua  Alba).  —  The  inner  bark  of  the  white  oak  is 
astringent,  tonic,  and  antiseptic,  and  has  been  used  in  intermittent 
fever,  chronic  diarrhoea,  chronic  mucous  discharges,  and  passive  hem- 
orrhages. As  a  wash  applied  externally,  it  sometimes  arrests  night- 
sweats,  and  as  ar  astringent  gargle  and  injection,  its  use  is  common 
for  relaxed  palate,  sjiongy  gums,  leucorrhoea,  falling  of  the  bowel,  etc. 

Preparationtt.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  ten  to  twenty  grains  ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce. 

White  Pond  Lily  (N'ymphoBa  Odorafa).  —  This  grows  in  ponds  and 
marshes  in  many  parts  of  our  country.  The  root  is  demulcent,  ano- 
dyne, astringent  and  alterative  ;  used  in  dysentery,  diarrhoea,  gonor- 
rhoea, whites,  and  scrofula.  An  infusion  is  sometimes  used  as  a 
gargle  in  ulcers -of  the  mouth  and  throat,  and  as  an  injection  in  leu- 
corrhoea.    Dose  of  the  infusion,  from  two  to  four  fluid  ounces. 

Wild  Cherry  ( Prwnus  Viginiana).  —  This  tree  grows  extensively 
in  the  American  forests,  flourishing  where  the  soil  is  fertile  and  the 
climate  temperate.  The  inner  bark  is  tonic  and  stimulant  to  the  di- 
gestive organs,  and  sedative^  to  the  nerves  and  the  circulation.  It  is 
much  used  in  consumption,  scrofula,  and  dyspepsia. 

Preparations.  —  Fluid  extract,  dose,  two  to  four  drams,  compound 
fluid  extract,  dose,  half  a  dmm  to  two  drams ;  infusion,  half  an  ounce 


/    m 


:r 


to  11  pint  of  water,  do»e,  two  ounces ;  ftyrui),  three  ounces  of  fluid 
extrnct  to  thirteen  ounces  of  simNio  syrup,  dose,  two  drams  to  an 
ounce. 

Wild  Cocomli'T  (Momordica  Ela(erium).  —  This,  sometimes  called 
ftqnirUmj  cucumber,  is  tt  native  of  the  south  of  Europe,  and  is  culti- 
vated in  Great  Britain.  It  is  a  powerful  hydragogue  cathartic,  and 
in  large  doses,  causes  nausea  and  vomiting.  On  account  of  the 
watery  stools  it  produces,  it  is  much  used  in  dropsical  complaints, 
though  the  severity  of  its  action  forbids  its  being  used  alone.  Dose, 
a  (|uarter  to  half  a  grain,  rei>eatcd  every  hour  till  it  operates ;  of 
elaterin,  from  a  sixteenth  to  a  twentieth  of  u  grain,  given  in  solution. 

Wild  Ginger  {Amrum  Canadense) .  —  This  is  known  by  the  names 
of  colCs-foot  and  Canada  anake-root,  and  is  common  in  all  parts  of 
the  country.  The  root  is  tonic,  stimulant,  aromatic,  expectorant,  and 
diaphoretic.  It  is  used  in  pains  of  the  stomach,  colic,  etc.  Dose  of 
the  powder,  half  a  dnim  ;  of  the  tincture,  half  a  dram  to  two  drams. 

Kio.  292. 


WILD  INOISO. 


WITCH  lUJSBL. 


Wild  Indigo  {Bapiista  Tinctoria).  —  This  perennial  shmbis  found 
in  most  parts  of  the  country.  The  bark  of  the  root  is  purgative, 
emetic,  stimulant,  astringent,  and  antiseptic.  It  is  chiefly  used  for 
its  antiseptic  properties.  For  exteroal  use  it  is  valuable  as  a  wash 
or  gargle  for  various  ulcers,  ixercurial  sore  mouth,  and  scrofulous 
and  .><yphilitic  ophthalmia. 

Preparations.  —  Fluid  extract,  dose,  n  quarter  to  half  a  dram  ; 
tincture,  two  ounces  to  a  pint  o*'  diluted  alcohol,  dose,  two  to  four 
drams;  iufusion,  dose,  half  an  (,„.ice ;  baptisin,  the  active  principle, 
a  (|Uiirter  to  half  a  grain  ;  gargle,  four  ounces  of  fluid  extract  to 
twelve  ounces  of  water,  to  be  used  as  occasion  rccpiires 

Wild  Yam  (DioKcorea  VUlosa).  — A  perennial  vine,  found  mostly 
at  liie  South.  The  root  is  anti^^pasmodic,  and  is  successfully  used- in 
liilous  colic.  It  is  suid  to  bring  relief  in  the  most  violent  cases  of 
this  complaint.  It  allays  nausea  and  s[msms  during  pregnancy.  It  is 
given  in  the  form  of  decoction,  two  or  three  fluid  ounces  every  thirty 


MEDICINES   AND  THEIR  PREPARATIONS. 


663 


!«  of  fluid 
ini8  to  un 

men  called 
d  is  culti- 
lartic,  and 
int  of  the 
)mplaint8, 
e.  Dose, 
erates ;  of 

I  solution. 

the  names 

II  parts  of 
orant,  and 

Dose  of 
wo  drams. 


Lib  is  found 
purgative, 
y  used  for 
as  a  wash 
scrofulous 

f  a  dram ; 

wo  to  four 
principle, 
extract  to 

md  mostly 
lly  used^in 
it  cases  of 
ncy.  It  is 
very  thirty 


or  forty  iuiinitet>.     Dose  of  the  tincture,  from  a  *|uarttM-  of  a  dram  to 
a  dnini ;  of  dioscorein,  the  active  principle,  one  to  four  gniins. 

Willow  (Silex  Alba). — The  wiUow  is  conuuon  in  Kuropo  and 
America.  Its  l)ark  is  tonic  and  astringent ;  an<l  is  used,  occasionally, 
as  a  suhstitute  for  peruvian  hark,  in  interniiltent  fever.  It  is  also 
employed  in  the  treatment  of  chronic  diarrh(i>a  and  dysentery.  l.)o»o 
of  iho  |M)wdered  hark,  one  dram;  of  the  decm'tion,  one  to  two  fluid 
ounces.  Salicin,  the  active  principle,  is  given,  sometimes,  in  place 
of  (|uinine  ;  dose,  from  two  to  ten  grains. 

Wintergreen  ( OauUheria  Procumbens) .  —  This  evergreen  grows  in 
mountainous,  barren  regions,  throughout  our  country.  The  leaves  are 
au  agreeable  stimulant,  aromatic,  and  astringent.  Used  for  chronic 
diarrhoea,  and  as  an  cmmenagogue.  The  oil  and  essence  are  useful 
in  flatulent  colic  ;  dose  of  the  oil, ..from  five  to  ten  drops,  on  sugar  ; 
of  the  essence,  thirty  to  forty  drops.  Much  used  to  flavor  other 
medicines. 

Witch  ilazel  {Uamamelia  Virginica). — This  derives  its  name  from 
ils  having  fruit  and  flowers  together  on  the  »amo  tree.  It  is  found  in 
most  parts  of  our  country.  The  bark  and  leaves  are  ionic,  astringent, 
and  sedative.  It  is  used  in  bleeding  from  the  lungs  and  stomach,  and 
in  diarrhoea,  dysentery,  and  excessive  mucous  discharges.  It  is  also 
used  in  incipient  consumption,  and  for  sore  mouth,  etc. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams;  infusion, 
dose,  four  drams  ;  syrup,  four  ounces  of  fluid  extract  to  twelve  ounces 
of  simple  syrup,  dose,  one  to  two  drams. 

Flu.  va. 


Fia.  884. 

1 '                                          ■ 

i; 

s^ 

1 

*                • 

1 

■<  ■ 

n 

WOLrBBAHI. 


WORMWOOD. 


Wolfsbane  {^Aconilum  Napelltis).  — This  hasalready  been  described, 
xmder  its  other  common  name,  which  is  Monkshood;  but  as  the  cut 
we  had  prepared  to  accompany  it  was  omitted,  we  give  it  a  place 
here,  refeiTing  the  reader  to  monkshoml  for  its  description. 


■m 


^'S^SSiSi 


664 


MKDICINK8  AND  THEIR   PRKPAIIATION8. 


WomiHewl  (ChenopoJium  Anthelminticum) . — Thin  peronninl  U 
called  Jeruaalfin  oak\  uiul  is  foiuxl  in  wuHtu  pUcoH  all  ovor  the  Unitod 
8tatc8.  An  oil  is  uxtnictcd  IVoiii  tliu  hcmxIh,  which,  in  (Umoh  of  rroin 
four  to  eight  (lr(>|)u,  niornin<<  and  (Honing,  for  a  child,  dcHtroys  woniir,. 
A  Htrong  infuHion  of  the  topis  hu«t  u  Himilur  utfoct.  The  remedy  Mhould 
l)u  U8od  four  or  tivo  days,  and  i>e  followed  by  a  purge. 

Wormwood  ( Artemima  AMnthium).  —  The  tops  nnd  \r  wes  of  this 
])ercnnial  are  tonic  and  anthelmintic  ;  used  in  intermittt  nt  fever.  Jaun- 
dice, and  worms.  It  restores  the  appetite  in  u  weakened  stnte  of  llic 
digestive  organs,  and  is  also  useful  in  amcnorrha'n.  it  is  excellent 
applied  as  a  tincture,  or  in  the  form  of  fomentation,  to  bruises,  spntins, 
and  local  intlunnnations. 

Prei>araiion9.  —  Fluid  extract,  doso,  one  third  to  two  thirds  of  ii 
dram  ;  solid  extract,  d(»so,  three  to  tive  grains  ;  tincture,  two  ouucch 
to  fourteen  ounces  of  diluted  alcohol,  dose,  two  to  four  dmms  ;  syrup, 
two  ounces  tluid  extract  to  six  ounces  of  simple  syrup,  dose,  one  to 
two  dnuns. 

Yarrow  {Achillea  Millefolium).  — A  perennial  herb,  common  to 
the  Old  World  and  New,  and  growing  in  old  fields  and  along  fences. 
It  is  tonic,  astringent,  and  alterative,  an  1  has  been  used  in  infcr- 
mittent  fever,  bleeding  from  the  lungs,  excessive  menstruutioii, 
wind  colic,  and  chronic  dysentery.  Dose  of  the  infusion,  a  winu- 
glassful,  three  or  four  times  a  day. 

Yeast  (Cerevtmce  Fermentum) .  —  Yeast  is  slightly  tonic  and  slini- 
utating,  and  has  been  used  with  advantage  in  typhoid  fever ;  also  in 
scarlet  fever,  and  in  all  diseases  where  there  is  adisi)osition  to  putrid- 
ity. The  dose  is  from  one  to  two  fluid  ounces,  every  two  or  three 
hours.  It  makes  an  excellent  antiseptic  poultice,  for  unhealthy  und 
fetid  ulcers,  especially  if  combined  with  powdered  slippery  elm  bark, 
and  charcofl'. 

Yellow  Do?k  {Rumex   Criapm).  —  The  root  of  this       ''»•  ^■ 
pcrenniel  nlant  'i  alterative,  tonic,  diuretic,  and  deter- 
gent, and  is  regarded  an  very  valuable  in  the  treatment 
of  scrofula    syphilis,  leprosy,  scurvy,  and  other  skin 
diseases. 

Preparations.  —  Fluid  extract,  dose,  one  to  two 
dnuns  ;  solid  extract,  dose,  four  to  eight  grains  ;  syrup, 
four  ounces  of  fluid  extract  to  twelve  ounces  of  simple 
syrup,  dos*?,  half  an  ounce  to  an  ounce ;  rumin,  the 
active  prmciple,  dose,  two  to  four  gi-ains. 

Yellow  Jes'mmlne  (Gelseminum  /Sempervirens) . — 
This  al)ounds  in  the  Southern  States,  where  it  is  culti- 
vated as  an  ornamental  vine.  The  root  is  a  powerful 
febrifuge,  narcotic,  end  relaxant,  controlling  and  sul»- 
4uing  ifever,  quieting  nei-vous  irritability  and  excitement,  equalizing 
the  circulation,  promoting  perspiration,  and  rectifying  the  secretions. 
It  is  much  used  by  the  Eclectics  of  the  Western  States,  but  the  genend 


TCLLOV  DOCK. 


_J 


v'S^'C'  jV*  ,  y  .■*;  ?fia"i^»¥'^vit 


»a2S«S6SS!- 


roniiinl  h 
lu!  Tnitod 
H  of  fVoju 
/>*  worm.,. 
<lynhoultl 

k'esof  this 
ver,  Jiiuu- 
nto  of'tlit^ 
excel  Uiiit 
I.  Mprains, 

ird»  of  11 
fo  ounces 
s ;  Hynip, 
0,  uno  to 

mmon  to 
'^  fences, 
in  infci- 
itruutiou, 
u  wiuo- 

iml  sliui- 
;  also  in 
o  putritl- 
or  three 
ilthy  and 
Ini  bark, 

la.  336. 


AV  DOCK. 

lualiznipr 
cretions. 
5  general 


judgment  of  the  profesHion  is,  that  it  i«  too  jKUVcrful  a  remedy  to  bo 
safe.  My  own  opinion  Ih,  that  the  American  iielleboro  is  e(]ually 
ctlectivo  with  the  yellow  jesHaniino,  and  that  it8  geneml  uho  involves 
far  loss  danger. 

Preparationa.  —  Fluid  extract,  dose,  t  wo  to  twenty  drops  ;  tincture, 
four  ounces  to  n  pint  of  alcohol,  dose,  fifteen  to  sixty  drops,  and  in- 
crease ;  gclHeminin,  the  active  principle,  dodc,  half  a  gmin  to  a  grain 
and  a  half. 

Yellow  Ladies'  Slipper  ( CypripediumPuheacenn). — This  perennial 
plant  is  called  American  valerian,  nerve  root,  etc.  The  fibrous  roots 
are  tonic,  nervine,  nntirtpaHnuHlic,  and  diaphoretic,  and  are  used  in 
nervous  headache,  nervous  excitability,  hysterics,  neuralgia,  and  St. 
Vitus'8  dance.     Dose  of  the  jmwder,  from  ten  to  thirty  grains. 

Preparationa.  — Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  five  to  fifteen  grains  ;  tincture,  two  ounces  to  a  i)int  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce  ;  syrup,  four  ounces 
of  fluid  extract  to  fourteen  ounces  of  simple  syrup,  dose,  two  to  four 
drams  ;  cypripedin,  the  active  principle,  dose,  two  to  four  grains. 

Yellow  Parillft  (^Meniapermum  Canadenae).  — This  is  a  perennial 
j)lant,  growing  in  woods,  and  near  streams,  throughout  the  country. 
The  root  has  the  properties  of  n  tonic,  laxative,  alterative,  and  diu- 
retic. It  is  valued  in  the  treatment  of  scrofula,  syphilis,  skin  diseases, 
gout,  rheumatism,  dyspepsia,  genend  debility,  and  chronic  inHamnin- 
tion  of  the  stomach  and  bowels.  Dose  of  the  decoction,  from  two  to 
four  fluid  ounces,  three  times  a  day  ;  of  the  solid  extract,  from  ttvo  to 
four  grains. 

Zinc.  —  Several  preparations  of  this  metal  are  used  in  medicine,  as 
follows : 

Acetate  of  Zinc.  —  This  is  used  as  an  external  remedy  only,  gener- 
ally as  an  astringent  wash  for  inflammations  of  the  eye,  and  as  an 
mjection  in  gonorrhoea,  but  onlyafter  the  acute  stage  of  these  diseases 
has  past.  The  strength  of  these  solutions  generally  should  be  one  or 
two  grains  to  a  fluid  ounce  of  soft  water. 

Chlorjde  of  Zinc  ("Zinc/  Chloridum). —  This  is  a  powerful  escharo- 
tic,  ond  IS  employed  as  an  external  application  to  cancers  and  ol;sti- 
natc  idcers.  A  weak  solution  of  it  is  occasionally  employed  in  old 
chronic  gleet,  also  in  whites,  and  purulent  discharge  from  the  neck 
of  the  womb.     ' 

Iodide  of  Zinc  (Zinci  lodidnm).  — This  is  in  the  form  of  Avhite 
needles,  and  is  tonic  and  astringent.  It  is  not  much  used,  except 
externally,  being  applied  in  a  solution  of  twent}'  gi-ains  to  a  fluid 
oimce  of  water,  to  enlargo:!  tonsils,  bymeansof  a  camel's-hair  pencil, 
or  a  piece  of  sjwnge  tied  to  the  end  of  a  stick. 

Oxide  of  Zinc  {Zinci  Oxidum).  —  This  is  an  inodorous,  white  pow- 
der, insoluble  in  water  and  alcohol.  It  is  tonic  and  antispasmodic, 
and  is  given  in  chorea,  epilepsy,  hooping-cough,  and  other  similar 


i  i 


G66 


MEDICINKS  AND  THEIR  PREPARA  TIONS. 


I 


diseases ;  liut  it  is  more  especially  employed  to  arrest  the  night- 
sweats  of  consumption,  for  which  purpose,  we  have  at  present  no 
other  article  of  equal  efficacy.  It  is  sprinkled  externally  upon  ex- 
coriated surfaces,  and  is  used  in  ointments.  Dose  from  two  to  eight 
grains,  in  the  form  of  pill. 

Precipitated  Carbonate  of  Zinc  ( Zinci  Garbonas  Pi<zdpitalas) .  — 
This  is  employed  for  the  same  purpose  as  prepared  calamine,  being 
adapted  only  to  external  use. 

Prepared  Calamine  ( Calamina  Prceparaia).  —  This  is  in  the  form 
of  a  pinkish  or  flesh-coloi-ed  powder,  of  an  earthy  apt^earance.  It  i?* 
employed  only  as  an  external  application,  being  dusted  on  excoria- 
tions and  supei*ficial  ulcerations,  as  a  mild  astringent.  It  should  be  a 
very  fine  powder.  « 

Snlpliatd  of  Zinc  {Zinci  Sulphas).  —  Thiii$  is  a  colorless,  transpar- 
ent salt,  crystallizing  usually  in  small,  four-sided  prisms.  It  is  tonic 
and  astringent,  and  in  lar^e  doses,  a  prompt  emetic.  Used  as  a  ionic 
incases  of  debility  attended  with  in'itation.  In  obstinate  intermit- 
tents,  it  is  sometimes  conjoined  with  sulphate  of  quinia;  it  is  chieHy 
employed,  however,  in  such  spasmodic  diseases  as  epilepsy,  chorea, 
and  hooping-cough.  As  an  astringent,  it  is  used  externally,  being 
applied  in  solution  to  bleeding  surfaces,  as  a  wash  in  ophthalmia,  and 
as  an  injection  in  whites  and  chronic  gonorrhoea, 

Yalerianate  of  Zinc  (Zinci  Valerianas).  — This  is  in  white,  pearly 
scales,  with  a  faint  odor  of  valerianic  acid.  It  is  tonic  and  antispas- 
modic, and  is  used  in  the  various  nervous  affections  .which  accompany 
chlorosis.  Dose,  one  or  two  grains,  several  times  a  day,  in  the  form 
of  pill. 

Preparations.    Fharmaoy. 

The  preparation  of  medicines  for  use,  constitutes  the  art  of  phar- 
macy. It  is  the  peculiar  business  of  the  apothecary.  It  will  not  be 
mecessary  in  these  pages  to  describe  his  art,  in  all  particulars,  but 
merely  as  many  of  the  prei^arations  which  it  is  his  duty  to  prepare  as 
are  really  needed  in  the  treatment  of  disease.  In  doing  this,  I  shall 
classify  the  preparations  alphabetically,  and  begin  with 

Cerates. 

These  substances  have  a  degree  of  hardness  midway  between  oint- 
ments and  plasters.  They  may  be  spread  upon  leather  or  linen,  with- 
out the  use  of  heat,  and  they  do  not  melt  and  run  when  applied  to  the 
skin.  They  are  made  of  wax,  or  spermaceti,  combined  with  lard  or 
oil.  The  articles  are  melted  together  by  a  very  gentle  heat,  and  dur- 
ing the  process  of  cooling,  the  whole  should  be  well  stirred. 

Calahiine  Cerate.  —  Prepared  calamine  and  yellow  wax,  each  three 
ounces;  lard,  one  pound.  Melt  the  lard  and  wax  togethei .  When 
tlie  mixture  begins  to  thicken,  on  cooling,  gi-adually  stir  in  the  cala- 
mine. 


i  the  night- 
present  no 
ly  upon  (!x- 
,wo  to  eight 

ipitatas).  — 
mine,  being 

in  the  form 
mce.  It  is 
on  excoriu- 
:  should  be  a 

m,  transpnr- 
It  is  tonic 
ed  as  H  tonic 
ite  intennit- 
it  is  chiefly 
psy,  chorea, 
nallv,  being 
thalmia,  and 

i^hite,  pearly 

nd  antispas- 

i  acoompany 

in  the  form 


irt  of  phar- 
will  not  be 
iculars,  but 
3  prepare  as 
this,  I  shall 


tween  oint- 
linen,  with- 
>plied  to  the 
vith  lard  or 
at,  and  dur- 
ed. 

each  three 
lei .  When 
in  the  cala- 


MEDIC1NE8  AND  THEIR  PREPARATIONS. 


66^ 


This  is  called  Turner's  cerate,  and  is  useful  foi  burns,  excoria- 
tions, superficial  ulcers,  and  sores. 

Goulard's  Cerate. — Take  of  solution  of  subacetate  of  lead,  two 
fluid  ounces  and  a  half;  white  wax,  four  ounces ;  olive  oil,  nine  fluid 
ounces;  camphor,  half  a  dram.  Mix  the  wax,  previously  melU'd, 
with  eight  fluid  ounces  of  the  oil ;  remove  from  the  fire,  and  when  tae 
mixture  l)e^ins  to  thicken,  gradually  pour  in  the  solution  of  subacetate 
of  lead,  stin'ing  constantly,  with  a  wooden  spatula,  till  it  becomes 
cool.     Then  add  the  camphor,  dissolved  in  the  remainder  of  the  oil. 

This  is  the  cei'ate  of  tubacetale  of  lead,  and  is  used  for  excoriations, 
inflamed  burns,  sctdds,  and  chilblains,  and  for  eruptions  of  the  skin. 
Excellent  for  blistered  surfaces,  indisposed  to  heal. 

Half  an  ounce  of  this  preparation  united  with  half  an  ounce  of 
simple  cerate,  and  one  dram  each  of  calomel  and  powdered  opium, 
makes  a  very  valuable  remedy  for  various  eruptions  of  the  skin,  of  a 
local  natv  re. 

Resin  Cerate.  —  Take  of  resin,  five  ounces  ;  lard,  eight  ounces ; 
yellow  wax,  two  ounces.  Melt  together  with  a  gentle  heat,  and  stir 
till  cool. 

This  is  known  as  baailicon  ointment,  and  is  used  as  a  gentle  stimu- 
lant to  blistered  surfaces,  indolent  ulcers,  burns,  scalds,  and  chilblains. 

Compound  Resin  Cerate  — Take  of  resin,  suet,  and  yellow  wax, 
each  a  pound  ;  turpentine,  half  a  pound  ;  flax-seed  oil,  half  a  pint. 
Melt  together,  strain  through  linen,  and  stir  till  cool. 

This,  under  the  name  of  Deshler's  salve,  is  popularly  used  for  sim- 
ilar purposes  with  the  resin  cerate. 

Savfne  Cerate. — Take  powdered  savine,  two  ounces;  resin  ce- 
rate, a  pound.     Mix  the  savine  M'ith  the  cerate,  previously  softened. 
Used  as  a  dressing  for  perpetual  blisters. 

Simple  Cerate.  —  Lard,  eight  ounces ;  white  wax,  four  ounces. 
Melt  together,  f,nd  stir  till  cool. 

Used  for  dressing  blisters,  wounds,  etc.,  where  it  is  desirable  sim- 
ply  o  preserve  the  moisture  of  the  part,  and  to  exclude  the  air. 

Spanish  Flies  Cerate,  known  as  blistering  plaster.  Take  finely 
povvd>ired  Spanish  flies,  a  pound  ;  yellow  wax  and  resin,  each  seven 
ounces ;  lard,  ten  ounces.  To  the  wax,  resin,  and  lard,  previously 
melted  togetiier  and  strained,  add  the  Spanish  flies,  and,  by  means  of 
the  most  gentle  heat,  keep  the  mixture  in  a  fluid  state  for  half  an 
hour,  stirring  occasionally,  then  remove  the  heat,  and  stir  till  cool. 

This  can  lie  easily  spread  without  the  aid  of  heat,  and  is  used  for 
the  puriMjseof  drawing  blisters.  It  is  now,  however,  superceded  in  a 
great  degree  by  various  preparations,  composed  for  the  most  part  of 
cuntharidiu,  either  dissolved  in  oil,  and  applied  to  the  skin  by  means 
of  a  }>iece  of  pai)er  saturated  with  it,  or  incorporated  with  wax,  and 
spread  in  a  very  thin  layer  upon  fine  waxed  cloth,  silk,  or  paper,  con- 
stituting the  blistering  cloth,  blistering  paper,  etc. 


V  i 


668 


MEDICINES  AND  THEIR  PREPARATIONS. 


Confections,  Conserves,  and  iLlactuaries. 

These  are  soft  solida,  in  which  medicinal  articles  are  incoiporated 
with  sugar,  syrup,  honey,  or  some  other  saccharine  matter,  for  the  pur- 
pose both  of  preserving  the  mass,  and  of  rendering  the  medicine  more 
palatable  and  convenient  for  use. 

Ammatic  Confection.  — Take  of  aromatic  powder,  five  and  a  half 
ounces;  powdered  saffron,  half  an  ounce;  syrup  of  orange  peel,  six 
ounces  ;  clarified  honey,  two  ounces.  Rub  the  aromatic  powder  with 
the  saffron ;  then  add  the  syrup  and  honey,  and  l>eat  the  whole  to- 
gether, in  a  mortar,  till  they  are  thoroughly  mixed. 

Given  in  debilitated  states  of  the  stomach,  as  a  vehicle  for  other 
medicines.     Dose,  from  ten  gi-ains  to  a  dram. 

Compound  Confection  of  Catechn.  — Take  of  compound  powder  of 
catechu,  five  ounces ;  simple  syrup,  five  fluid  ounces.  Add  the  syrup 
gradually  to  the  powder,  and  mix  them  well. 

To  be  given  in  diarrhoea  and  chronic  dysentery,  in  the  dose  of  half 
a  dram  to  a  dram. 

Confection  of  Senna,  otherwise  called  lenitive  electuary/.  Take  of 
senna,  eight  ounces;  coriander  seeds,  four  ounces;  bruised  liquorice 
root,  three  ounces  :  figs,  a  pound  ;  pulp  of  primes,  pulp  of  tamarinds, 
pulp  of  purging  cassia,  each,  half  a  pound ;  refined  sugar,  two  pounds 
and  a  half;  water,  four  pints.  Rub  the  senna  and  coriander  together 
jmd  separate  ten  ounces  of  the  powder  with  a  sieve.  Boil  the  residue 
with  the  liquorice  root  and  figs,  in  the  water,  to  one  half;  then  proi^s 
out  the  liquor,  and  strain.  Evaporate  the  strained  liquor,  by  the  mo.st 
gentle  heat,  to  a  pint  and  a  half;  then  add  the  sugar  and  form  n 
syrup.  Lastly,  rub  the  pulps  with  the  syrup,  added  graduall}',  and, 
having  thrown  in  the  sifted  powder^  beat  all  together  till  well  mixed. 

This  is  a  pleasant  and  admu-able  laxative,  being  well  adapted  to 
the  habitual  costiveness  .;f  pregnant  women,  and  those  affected  with 
piles  ;  for  this  latter  puvjM)'5e,  it  is  still  better  combined  with  cream  of 
tartar  and  sulphur,  as  desci'ibed  in  No.  6  of  the  prescriptions,  at  the 
end  of  the  book. 

Deooctions. 

Tbtese  are  solutions  of  vegetable  medicines,  obtained  by  boilinjr 
them  in  water.  They  diflfer  from  infusions,  in  being  subjected  to 
a  greater  degree  of  heat,  the  water  during  their  preparation  being 
kept  up  to  the  boiling  point.  The  process  should  be  conducted  in  a 
covered  vessel,  and  the  boiling  must  not  be  continued  for  a  very  long 
time.  Medicines,  whose  active  principle  is  volatile,  are  not  proper  for 
decoctions,  the  active  principle  being  driven  oft*  by  heat  and  lost. 

The  usual  proportion  of  vegetable  substances  used  in  making  de- 
coctions is  one  ounce  to  a  pint  of  water,  and  the  dose  of  the  decoc- 
tion, from  one  to  four  ounces. 


-^S&SA 


"■^33- 


)8. 

coiporated 
"or  the  pur- 
iciue  more 

and  a  half 
peel,  six 
)wder  with 
whole  to- 

s  for  other 

powder  of 
J  the  syrup 

ose  of  half 

Take  of 
id  liquorice 
tamarinds, 
;wo  pounds 
er  together 
the  residue 
then  pi'or^s 
>y  the  most 
nd  fonn  a 
uully,  and, 
i^ell  mixfd. 
adapted  to 
fected  witli 
;h  cream  of 
!>ns,  at  the 


by  boilinjr 
ihjected  to 
tion  being 
ucted  in  a 
I  very  long 
proper  for 
id  lost, 
laking  de- 
the  decoe- 


EsBenoes. 

« 

These  are  generally  prepared  by  dissolving  one  ounce  of  the  essen- 
tial oils  of  plants  in  one  pint  of  alcohol.  The  oils  of  lemon,  pepper- 
mint, sassafras,  etc.,  are  made  in  this  way,  and  their  properties,  of 
course,  are  similar  to  the  oils  from  which  they  are  prepared.  They 
are  generally  taken  in  a  little  sweetened  water,  in  doses  of  ten  drops 
to  a  teaspoonful. 

ExtraotSf 

These  are  soft  solids,  obtained  by  evaporating  the  tinctures,  or 
solutions,  of  vegetable  substances.  The  active  principles  of  dried 
vegetables  can  only  be  extracted  by  some  liquid ;  this,  for  preparing 
extracts,,  is  either  water,  or  alcohol,  qr  a  mixture  of  the  two.  Those 
obtained  by  the  use  of  water  are  called  aqueous,  or  watery  extracts; 
those  by  means  of  alcohol,  alcoholic  extracts;  and  those  by  both  alco- 
hol and  water,  hydro-alcoholic  extracts. 

Extracts  are  generally  prepared  on  a  large  scale,  by  persons  who 
make  a  business  of  it.  Like  other  articles,  many  of  these  prepara- 
tions get  into  the  market  which  are  inferior  in  quality,  and  even 
worthless.  Without  disparaging  the  prejjarations  of  other  raanufac- 
turers,  I  would  mention  those  prepared  by  the  large  manufacturing 
house  of  Tilden  &  Co.,  at  New  Lebanon,  New  York,  as  worthy  of 
public  confidence.  Most  of  their  solid  extracts,  with  the  proper  doses, 
are  mentioned  in  previous  pages,  under  the  several  articles  from  which 
they  are  made. 

rinid  EztraotB. 

These  are  concentrations,  into  a  small  bulk,  in  liquid  form,  of  the 
active  principles  of  medicinal  substances.  They  are  a  valuable  class 
of  remedies,  being  in  some  cases  preferable  to  tinctures,  having  less 
alcohol ;  and  better  than  extracts  or  decoctions,  because  not  so  often 
injured  by  heat  In  their  preparation,  and  not  requiring  to  be  taken  in 
large  doses.  Great  skill  Is  required  in  their  preparation,  and  they 
should  alwa3'8  be  obtained  from  those  who  have  the  reputation  of 
making  reliable  articles.  None  that  I  am  acquainted  with,  better 
deserve  confidence  than  those  of  Tilden  &  Co. 

Fomentations. 

Fomentation  is  a  sort  of  pjirtial  or  local  hot  bath,  and  consists 
either  in  the  application  of  cloths  dipped  in  hot  water,  or  some  hot 
iiK'diciited  decoction,  and  applied  to  the  affected  i)ai't,  or,  of  bitter  or 
anodyne  herbs  steeped  in  vinegar  or  water,  and  then,  while  hot,  en- 
closed in  a  muslin  b|ig,  and  laid  upon  the  diseased  place.  In  either 
case,  whether  the  cloths  wet  in  a  decoction  of  the  herbs,  or  the  herbs! 
themselves,  slightly  steeped,  be  applied  in  a  bag,  Iho  a[)plication  should 


670 


MEDICINES  AND  THEIR  PREPARATI©N8. 


^u 


•f  ■ 


he  as  hot  as  can  he  borne,  and  not  so  moist  as  to  wet  the  bed  or 
clothes  of  the  patient. 

Fomentations  act  hy  their  warmth  and  moistui'e  chiefly;  and 
sliglitly,  in  some  cases,  hy  their  medicinal  virtues.  Their  object  is 
to  lessen  pain  and  inflammation,  by  vdaxing  the  parts,  and  relieving 
tension  and  spasm.  They  may  be  epared  from  equal  parts  of  hops, 
tansy,  and  wormwood,  or  from  equal  parts  of  hops,  lobelia,  and  stra- 
monium, etc.,  etc. 

Infusions. 

For  a  description  of  simple  infusions,  see  page  588.  Those  made 
of  one  article  only  are  suflSciently  referred  to  in  previous  pages.  It 
will  only  be  necessary  here  to  insert  such  compound  infusions  as  are 
deemed  important. 

Compound  Inflision  of  Catechn.  —  Take  of  powdered  catechu,  half 
an  ounce  ,  bruised  cinnamon,  a  dram  ;  boiling  water,  a  pint ;  macer- 
ate for  an  hour  in  a  covered  vessel,  and  strain.  An  elegant  mode  of 
administering  catechu.  Dose,  from  one  to  three  fluid  ounces,  three  or 
four  times  a  day. 

Compound  Inflision  of  Gentian.  —  Vake  of  bruised  gentian,  half  an 
ounce  ;  dried  orange  peel  and  coriander  seeds,  bruised,  each  a  dram  ; 
diluted  alcohol,  four  fluid  ounces ;  cold  water,  twelve  fluid  ounces. 
Fii-st,  pour  on  the  diluted  alcohol,  then,  three  hours  afterward,  the 
water.  Let  the  whole  stand  twelve  hours,  and  strain.  An  excellent 
form  for  using  gentian.  Dose,  one  fluid  ounce,  three  or  four  times  a 
day. 

Compound  Infusion  of  Geranium.  —  Take  of  geranium  root,  sweet 
bugle  leaves,  golden  seal  root,  witch-hazel  l)ark,  each,  in  coarse  powder, 
one  ounce  ;  boiling  water,  four  pints.  Mix,  and  allow  all  to  stand  in 
a  covered  vessel,  two  hours  applying  a  gentle  heat ;  then  strain.  Two 
dram.*  of  alum  may  or  may  not  be  added. 

Used  in  chronic  diarrhoea  and  dysentery,  in  one  or  two  tablespoon- 
ful  doses,  every  two  or  three  hours ;  also  as  an  injection  in  gleet, 
whites,  falling  of  the  bowel,  etc. ;  and  as  a  gargle  in  ulcerations  of 
the  mouth  and  throat. 

Compound  Inflision  of  Parsley.  —  Take  of  parsley  roots  and  seeds, 
and  suhcarhonate  of  iron,  each,  two  ounces ;  horseradish  root,  one 
ounce;  squill,  juniper  berries,  white  mustard  seed,  mandrake  root, 
and  queen  of  the  meadow  root,  each,  half  an  ounce  ;  coarsely  )>ruise 
these  articles,  and  place  them  in  boiling  cider,  and  expose  them,  for 
twenty-four  houi-s,  to  a  very  gentle  heat,  in  a  covered  earthen  vessel. 
The  cider  should  he  sparkling  and  tart.  Let  the  articles  stand  in  the 
cider. 

Useful  in  dropsy.  Dose,  one  or  two  fluid  ounces,  three  or  four 
times  a  day. 

Compound  Infusion  of  Senna.  — Take  of  senna  and  manna,  each, 
one  ounce  ;  jalap,  cream  of  taitar,  and  caraway  seeds,  bruised,  each. 


;ho  bed  or 

iefly ;  and 
*  object  i.s 
rl  relieving 
•ts  of  hops, 
I,  and  stra- 


hose  made 
pages.  It 
ons  as  Hre 

techu,  half 
it;  inacer- 
nt  mode  of 
58,  three  or 

an,  half  an 
^h  a  dram ; 
id  ounces, 
rward,  the 
1  excellent 
)ur  times  a 

'oot,  sweet 
50  powder, 
to  stand  in 
ain.    Two 

iblespoon- 

in  gleet, 

irations  of 

md  seeds, 
root,  one 

*ake  root, 

ely  bruise 
them,  for 

en  vessel. 

and  in  the 

»e  or  four 

ma,  each, 
sed,  each, 


MEDICINES  AND  THEIR  PREPARATIONS. 


671 


two  drams  ;  boiling  water,  one  piLt.  Add  all  the  ingredients  to  the 
water,  in  a  covered  vessel,  and  let  them  stand  twelve  hours.  Then 
add  four  ounces  of  elixir  salutis. 

This  is  a  valuable,  and  not  disagreeable,  gentle  physic  for  various 
purposes.     Dose,  from  one  to  four  ounces. 

Compound  Influion  of  Trailing  Arbutus.  —  Take  of  queen  of  the 
meadow  root,  dwarf  elder  bark,  marshmallow  root,  and  trailing  arlm- 
tus,  each,  co'vsely  bruised,  half  an  ounce ;  add  to  them,  one  pint 
of  boiling  wmor,  and  one  pint  of  Holland  gin,  and  steep  by  the  tiro 
four  hours,  in  a  closely  covered  vessel.  Strain,  and  sweeten  with 
honey. 

Excellent  for  gravel,  suppression  of  urine,  scalding  of  urine,  and 
various  other  disorders  of  the  urinary  organs.  Dose,  from  an  ounce 
to  a  wineglassful,  with  more  or  less  frequency,  according  to  the  ur- 
gency of  the  case. 

Injeotlons. —  Clysters. 

• 

These  are  preparations  to  be  introduced  into  the  lower  bowel  by 
means  of  a  syrinj^e.  A  sufficient  number  of  them  are  given  among 
the  recipes  at  the  end  of  the  book.  It  is  not  necessary  to  repeat 
them  here. 

Liniments. 

These  are  liquid  preparations,  generally  a  little  thicker  than  water, 
and  thinner  than  oils,  intended  only  to  be  applied  to  inflamed,  pain- 
ful, or  swelled  parts.  They  are  designed  to  soothe,  or  quiet,  or  stim- 
ulate, or  make  fed  the  part  to  which  they  are  applied  ;  and  are  rubbed 
on  with  the  hand,  or  a  piece  of  flannel  or  cotton,  and  frequently  in 
connection  with  heat,  by  sitting  or  standing  before  a  fire. 

A  large  number  of  liniments  are  given  under  the  head  of  recipes 
at  the  end  of  the  book.     To  those,  I  add  a  few  valuable  ones  here. 

Camphor  Liniment.  — Take  six  drams  of  camph-  '  dissolve  it 

in  one  fluid  >ounce  of  chloroform,  and  add  to  this  «.  ,d  ounce  of 

olive  oil. 

For  sprains,  neuralgia,  rheumatism,  etc. 

Compound  Camplior  Liniment.  —  Take  two  ounces  and  a  half  of 
camphor,  a  fluid  dram  of  oil  of  lavender,  seventeen  fluid  ounces  of 
alcohol,  and  three  fluid  ounces  of  strong  solution  of  ammonia.  Dis- 
solve the  camphor  and  the  oil  in  the  alcohol ;  then  add  the  t^mmonia, 
and  shake  till  they  ai-e  mixed. 

To  be  used  as  a  rubefacient  and  anodyne  for  local  pains,  particu- 
larly rheumatism. 

Compound  Liniment  of  Ammonia.  —  Take  five  fluid  ounces  of 
strong  water  of  ammonia,  two  fluid  ounces  of  tincture  of  camphor, 
and  one  fluid  ounce  of  spirit  of  rosemary.     Mix  them  well  together. 


This  18  similar  to  Dr.  OranvilWs  counter-irritant  lotion ;  nnd  is  used 
ns  u  prompt  and  i)owerful  rul)efacient,  or  even  vesicatory,  in  neural- 
gin,  rheumatism,  gout,  spasms,  and  inflammations'. 

CrotonOil  Liniment. — Take  one  fluid  ounce  of  croton  oil,  and 
seven  fluid  ounces  of  oil  of  turpentine.  Mix,  and  shake  them  well 
together.  ' 

A  good  rubefacient  and  pustulating  preparation  to  apply  to  the 
chest  and  other  parts. 

Liniment  of  Opium.  —  Take  six  ounces  of  castile  soap,  an  ounce 
and  a  half  of  opium,  three  ounces  of  camphor,  six  fluid  drums  of  oil 
of  rosemary,  and  two  pints  of  alcohol.  Macerate  the  soap  and  opium 
•n  the  spirit  for  three  days  ;  then  filter,  and  add  the  oil  and  camphor, 
nnd  shake  briskly. 

This  is  a  useful  anodyne  and  rubefacient  liniment  for  bruises, 
sprains  and  pains  of  a  rheumatic  and  gouty  nature. 

Liniment  of  SpaniHli  Flies.  — Take  an  ounce  of  powdered  Spanish 
Hies,  and  half  a  pint  of  oil  of  turpentine.  Mix,  and  apply  gentle  heat 
to  them,  in  a  covered  vessel,  for  three  hours.     Thou  stram. 

Employed  with  advantage,  externally,  in  the  sinking  stage  of  ty- 
phoid fevers.  If  so  powerful  as  to  be  in  danger  of  causing  blistering, 
it  may  be  weakened  by  adding  flax-seed  or  olive  oil. 

Liniment  of  Turpentine.  — Take  half  a  pint  of  oil  of  turpentine, 
and,  a  pound  of  resin  cerate.  Melt  the  cerate,  and  add  the  oil  to  it, 
mixing  them  well. 

This  is  a  valuable  remedy  for  scalds  and  bums,  and  should  be 
applied  soon  after  the  accident,  and  be  discontinued  when  the  inflam- 
mation excited  by  the  fire  is  removed;  The  l)urned  or  scalded  surface 
should  be  covered  Avith  lint  wet  with  the  liniment. 

Opodeldoc. —  Take  three  ounces  of  white  bar  soap,  sliced,  an  ounce 
of  camphor,  a  fluid  dram  each  of  oil  of  rosemary  and  oil  of  origa- 
niini,  and  a  pint  of  alcohol.  Digest  the  soap  in  the  alcohol  by  means 
of  :i  gentle  heat,  until  it  is  dissolved  ;  then  'add  the  camphor  and  oils, 
and  when  they  are  dissolved,  pour  the  whole  into  broad-mouthed 
vials. 

This  is  the  camphorated  sotip  Unimeni,  and  is  used  as  an  anodyne 
application  to  sprains,  bruises,  and  painful  tumors,  etc. 


Medic    3d  Waters. 

Those  preparations  consisting  of  water  impregnated  with  some 
medicinal  substance  are  called  medicated  wa-'v,'s.  They  are  prepared 
from  volatile  oils  by  triturating  in  a  mortar  a  dram  ot  the  oil,  more 
or  less,  with  a  small  quantity  ot  carbonate  of  magnesia,  and  then  very 
gradually  pouring  on  one  quait  of  water,  while  the  trituration  is  con- 
tinued. Jit  last,  the  preparation  is  filtered  through  paper.  The  quan- 
tity of  oil,  magnesia,  and  water,  used  for  each  preparation,  is  as  fol- 
lows : 


ind  IS  used 
ill  ueuraU 

>n  oil,  and 
them  well 

ply  to  the 

I  an  ounce 
inis  of  oil 
and  opium 
I  camphoi', 

r  bruises, 

3d  Spanish 

gentle  heat 

1. 

age  of  ty- 

blistering, 

urpentine, 
e  oil  to  it, 

should  bo 
the  intlani- 
led  surface 


an  ounce 
of  origa- 
by  means 
and  oils, 
-mouthed 

1  anodyne 


I- 
( 

vith  some 

prepared 

oil,  more 

then  very 

ion  is  con- 

The  quau- 

is  as  fol- 


MKDICINKS  AND  TIIEIR  PREPARATIONS. 


673 


Oil  of  bitter  almonds,  sixteen  minims;  carbonate  of  magnesin,  a 
c'ram;  water,  one  quart. 

Oil  of  cinnamon,  half  a  fluid  dram ;  carbonate  of  magnesia,  a  dram: 
water,  one  quart. 

Twenty  miiiinis  of  oil  of  roses,  a  dmm  of  carbonate  of  magnesia, 
tnd  one  quart  of  water. 

Oil  of  feiuK'l,  half  a  fluid  dram;  carbonate  of  magnesia,  a  dram; 
V/ater,  a  quart. 

Peppermint  Water,  Spearmint  Water,  and  Pennyroyal  Water,  are 
all  prepared  from  the  same  quantities  of  their  several  oi's,  as  Cinna- 
mon Water. 

The  dose  of  these  waters  is  half  a  fluid  ounce  to  two  fluid  ounces, 
except  the  bitter  almond  water,  which  is  one  or  two  fluid  drims. 

C'iUiiphor  Water.  —  Take  two  drams  of  camphor,  forty  minims  of 
alcohol,  four  tlrams  of  carbonate  of  magnesia,  and  one  quart  of  water. 
Rub  the  camphor  first  with  the  alcohol,  afterwards  with  the  carbonate 
of  magnesia,  and  lastly,  with  the  water,  gradually  added.  Then  filter 
through  paper. 

Medicated  Wines. 

Wines  are  i7sed  in  making  certain  preparations,  because  the  alco- 
hol they  contain  will  extract  from  plants,  etc,  some  medicinal  proper- 
ties which  water  will  not,  and  at  the  same  time  is  less  stimulating 
thbij  the  tinctures,  etc.,  made  from  alcoholic  spirits. 

Compound  Wine  of  Comfrey  {Restorative  Wine  Bitters).  —  Take 
one  ounce,  each,  bruised,  of  comfrey,  Solomon's  seal,  and  spikenard; 
and  half  an  ounce,  each,  bruised,  of  chamomile  flowers,  Colombo,  and 
gentian.  Cover  these  with  boiling  water,  and  let  them  stand  twenty- 
four  hours,  in  a  covered  vessel.  Then  add  two  quarts  of  sherry  wine. 
Macerate  fourteen  days,  express  and  strain. 

Valuable  in  leucorrhoea  and  other  female  complaints.  Dose,  from 
half  a  fluid  ounce  to  two  fluid  ounces,  three  or  four  times  a  day. 

Compound  Wine  of  Golden  Seal.  —  Take  one  dram,  each,  bruised, 
of  golden  seal  root,  tulip  tree  bark,  and  bitter  root,  half  a  dram  of 
pulverized  cayenne,  and  two  quarts  of  sherry  wine.  Macerate  foi 
fourteen  days,  with  occasional  shaking;  then  express  and  stiain. 

This  is  a  pleasant  bitter  tonic  in  dyspepsia,  etc.  Dose,  from  half  a 
fluid  ounce  to  two  fluid  ounces,  three  times  a  day. 

Wine  of  Ipecacuanha.  —  Take  two  ounces  of  bruised  ipecac,  and 
one  quart  of  sherry  wine.  Macerate  fourteen  days,  with  occasional 
shaking.     Then  express  and  filter  through  paper. 

This  is  a  valuable  emetic  preparation,  —  especially  for  children. 
Dose,  as  an  emetic,  for  an  adult,  one  fluid  ounce  ;  as  an  expectorant, 
from  ten  to  thirty  minims ;  for  a  child  two  years  old,  as  an  emetrt, 
one  fluid  dram,  repeated  every  fifteeu  minutes  till  it  operates. 

85, 


^'A 


\ 


674 


MEDICINRS  AND  THEIR  PREPARATIONS. 


vV 


Mixtures. 

TiiRSE  are  preparatioiiR  in  which  medicinal  substances  which  can- 
not bu  dissolved  in  water  are  suspended  in  it  by  means  of  some  viscid 
inattiT,  like  sugar,  or  gum  arable.  Their  object  is  to  conceal  the  taste, 
prevent  the  sickening  effect,  and  make  it  more  easy  to  take  disagreea- 
ble medicines.  To  make  a  perfect  mixture  requires  skill.  Generally, 
the  medicine  to  be  suspended  should  be  triturated  in  a  mortar  with 
the  sugar,  gum  arable,  etc.,  before  the  water  is  added. 

Ainiond  Nixtnre.  —  Take  half  an  ounce  of  sweet  almonds,  half  a 
dram  of  powdered  gum  arable,  two  drams  of  sugar,  and  eight  fluid 
ounces  of  water.  Soak  the  almonds  in  the  water,  and  having  removed 
their  external  coat,  beat  them  with  the  gum  arabic  and  sugar  in  a 
mortar,  till  they  are  thoroughly  mixed  ;  then  rub  the  mixture,  gradu- 
ally adding  the  water,  and  lastly,  strain. 

This  is  an  agreeable,  nutritive  demulcent,  in  bronchial,  dysenteric, 
and  urinary  affections.  It  must  be  used  freely,  the  dose  being  from 
two  to  eight  fluid  ounces. 

Cliulk  IMixtnre.  —  Take  half  an  ounce  of  prepared  chalk,  two  drams 
each  of  refined  sugar  and  powdered  gum  arabic,  and  four  fluid  ounces 
each  of  cinnamon-water  and  water.  Rub  them  together  till  they  are 
thoroughly  mixed. 

This  is  much  used  in  looseness  of  the  bowels,  accompanied  with 
acidity,  particularly  among  children.  If  an  increase  of  its  astringency 
be  required,  add  laudanum,  or  kino,  or  catechu.  ' 

Compound  mixture  of  Iron.  —  Take  a  drum  of  myrrh,  twenty-five 
grains  of  carbonate  .of  potassa,  one  scruple  of  powdered  sulphate  of 
iron,  half  a  fluid  ounce  of  spirit  of  lavender,  one  dram  of  refined  sugar, 
and  seven  and  a  half  fluid  ounces  of  rose  water.  Rub  the  myrrh  in 
a  mortar,  gradually  adding  the  rose  water,  then  mix  with  these  the 
spirit  of  lavender,  sugar,  and  carbonate  of  potassa,  and  lastly,  the 
sulphate  of  iron.  Pour  the  whole  into  a  glass  bottle,  and  keep  it 
well  stopped. 

This  is  about  the  same  thing  ?8  Orijit/i's  myrrh  mixture,  and  is 
considerably  used  in  chlorosis,  and  '<ther  affections  requiring  the  use 
of  iron. 

Brandy  Kixture. — Take  four  fluid  ounces  each  of  brandy  and  cin- 
namon water,  the  yolks  of  two  eggs,  hv'  in  ounce  of  refined  sugar, 
and  three  drops  of  oil  of  cinnamon.     ]Vi.a.  them. 

A  useful  stimulant  and  nutritive  draught,  to  be  used  in  the  sinking 
etage  of  low  forms  of  fever. 

Extrnct  of  Rhubarb  and  Potassa  {Neutralizing'  Extract).  —  Take 
two  pounds  of  the  best  rhubarb,  one  pound  each  of  cinnamon  and 
golden  seal.  Grind  or  coarsely  bruise  the  articles,  and  mix  them; 
macerate  them  for  two  days  in  one  gallon  of  the  best  fourth  proof 
brandy.     Then  express  the  tincture  with  strong  pressure,  and  add  to 


irhich  can- 
ame  viscid 
I  the  taste, 
disagreea- 
Generally, 
lortar  with 

nds,  half  a 
eight  fluid 
ig  removed 
sugar  in  a 
ure,  gradu- 

dysenteric, 
being  from 


,  two  drama 
iuid  ounces 
till  they  are 

panied  with 
astringency 

twenty-five 
sulphate  of 
fined  sugar, 
le  myrrh  in 
these  the 
lastly,  the 
nd  keep  it 

lure,  and  is 
ring  the  use 

idy  and  cin- 
tfined  sugar, 

the  sinking 


icl).  —-  Take 
namon  and 
mix  them; 

fourth  procf 
,  and  add  to 


MEDICINES  AND  THEIR  PREPARATIONS. 


675 


It  one  fluid  dram  of  oil  of  peppermint,  previously  dissolved  in  a  little 
alcohol.  Break  up  the  compressed  residue  from  the  press,  and  place 
it  in  a  perculator,  and  gradually  run  warm  water  through  it,  until  the 
strt'ngtii  is  exhausted.  Evaporate  this  solution  to  four  pints,  and 
while  the  liquor  is  still  hot,  dissolve  in  it  two  pounds  of  bicarix)nate 
of  pota»t»a,  and  three  pounds  of  refined  sugar.  Continue  the  evapo- 
ration, if  necessary,  until,  when  added  to  the  tincture  first  obtained, 
it  will  make  a  gallon  and  a  half,  then  mix  the  two  solutions  togethf^r. 
This  is  a  useful  preparation  for  diarrhoea,  dysentery,  cholera  morbus, 
summer  complaints  of  children,  acidity  of  the  stomach,  heartburn,  etc. 
Dose,  one  fluid  dram. 

Mettiiner's  Aperient  —  Take  one  ounce  and  a  half  of  pulverized 
aloes,  four  ounces  of  bicarbonate  of  soda,  two  fluid  ounces  of  com- 
pound S|nrit8  of  lavender,  and  two  quarts  of  water.  Place  the  whole 
in  a  jar,  or  jug,  and  let  them  stand  fourteen  days,  shaking  well  bnce 
a  day.     Then  pour  off"  from  the  dregs.     It  improves  by  age. 

This  preparation  was  made  by  Professor  Mettauer,  and  was  held 
in  so  high  esteem  by  him,  that  when  he  sent  it  to  the  London  Lancet, 
he  requested  that  he  might  have  the  credit  of  compounding  it.  It  is 
one  of  the  best  known  aperients  for  costiveness,  —  particularly  when 
connw'ted  with  bilious  dyspepsia.  For  that  class  of  bilious  persons 
who  overeat,  and  have  acid  stomachs,  it  has  great  value.  In  bilious 
cases,  the  nitro-muriatic  acid,  taken  before  meals  (the  aperient  after 
meals)  may  be  usefully  associated  with  it.  In  the  constipation  of 
hysteria  and  hypochondriasis,  the  fluid  extract  of  valerian  may  be 
added  to  it.     Dose,  from  two  drams  to  two  ounces. 

Saline  Mixtare  ( WJiite  Liqvid  Physic).  —  Take  half  a  pound  of 
sulphate  of  soda,  and  one  and  a  half  pints  of  water.  Mix,  and  dis- 
solve the  soda ;  then  add  two  fluid  ounces  of  nitro-muriatic  acid,  and 
one  dram  and  eight  grains  of  powdered  alum. 

Used  to  allay  nausea  and  vomiting,  and  as  a  cooling  purgative ; 
also  for  colic,  diseases  of  the  liver,  diarrhoea,  dysentery,  intermittent 
fevers,  etc. 

This  is  one  of  the  remedies  of  the  Eclectic  school  of  physicians, 
and  is  held  by  them  in  high  esteem.  Dose,  a  tablespoonful  in  a  gill 
of  water,  to  be  repeated  every  hour  or  two,  until  it  causes  one  or  two 
svacuations  from  the  bowels. 

Ointments. 

Ointments  are  composed  of  fatty  substances,  about  the  consistence 
of  butter,  impregnated  with  medicine.  All  gritty  matter  should  be 
excluded  from  them.  To  prevent  the  rancidity  to  which  they  are 
liable,  a  little  glycerin  is  now  frequently  added. 

Ointment  of  Acetate  of  Lead.  —  Take  two  ounces  of  white  wax, 
and  four  ounces  of  lard ;  melt  them  together,  and  add  two  and  a  half 
drams  of  finely  powdered  acetate  of.  lead ;  stir  constantly  till  cold. 
This  is  useful  for  burns  scalds,  ulcere,  and  excoriations. 


! 

i: 


MRDICIMES  AND  THEIR  PREPARATIONS. 


^'^/ 


Ointment  of  Baybeiry.  —  Take  half  a  pound  each  of  tallow,  white 
turpentine,  and  bayberry,  and  four  ounces  of  olive  oil ;  melt  together 
and  strain. 

Good  for  scrofulous  and  Indolent  ulcers. 

Ointment  of  BelludonnM.  —  Take  a  dram  of  extract  of  belladonna 
und  an  ounce  of  lard  ;  mix  them. 
A  useful  anodyne  application  for  painful  tumors,  neuralgia,  etc. 

Ointment  of  Creosote.  —  Take  half  a  fluid  dram  of  creosote,  and  an 
ounce  of  lard  ;  mix  them. 

A  useful  application  for  syphilitic,  scrofulous,  and  cancerous  ulcers. 

Coui|iounil  Ointment  of  Gulls. — Take  six  drams  of  finely  powdered 
galls,  six  ounces  of  lard,  and  a  dram  and  a  half  of  pulverized  opium; 
rub  them  together.  - 

A  valuable  preparation  in  irritable  piles. 

Ointment  of  Red  Iodide  of  Hercnry.  —  Take  one  dram  of  red  iodide 
of  mercury,  and  seven  drams  of  ointment  of  white  wax:  incorporate 
them  thoroughly  together  by  trituration  in  a  mortar. 

Used  as  a  dressing  for  indolent  scrofulous  ulcers. 

Ointment  of  Nitrate  of  Mercury.  —  Take  one  omice  of  mercury, 
eleven  fluid  ounces  of  nitric  acid,  nine  fluid  ounces  of  fresh  neats-foot 
oil,  three  ounces  of  lard.  Dissolve  the  mercury  in  tho  acid,  then  heat 
the  oil  and  lard  together  in  an  earthen  vessel  to  200°  F. ;  then  add 
the  mercurial  solution,  and  stir  with  a  wooden  spatula,  constantly,  as 
long  as  efiervescence  continues,  and  afterward  occasionally  till  the 
ointment  stiffens. 

milder  Ointment  of  Nitrate  of  Mercury.  —  Take  an  ounce  of  oint- 
ment of  nitrate  of  mercury,  and  seven  ounces  of  lard ;  rub  them  to- 
gether. 

The  first  of  the  above  two  preparations  is  the  citrine  ointment,  and  is 
much  and  advantageously  employed  as  an  external  application  in 
porrigo,  impetigo,  psoriasis,  and  pityriasis.  It  is  nearly  a  specific  for 
inflammation  of  the  eyelids  connected  with  the  formation  of  scaly 
matter  about  the  lashes.  The  second  of  these  two  preparations  is 
merely  a  dilution  of  the  first 

Ointment  of  Oxide  of  Zinc.  —  Take  half  an  ounce  of  oxide  of  zinc, 
and  three  ounces  of  lard  ;  rub  them  together. 

This  is  a  mild  astringent  application  in  chronic  opthalmia,  erup- 
tions of  the  skin,  sore  nipples,  and  other  excoriations. 

Ointment  of  Poison  Hemlock. — Take  one  dram  of  extract  of  poison 
hemlock  (Tilden  &  Co.'s  preparation),  and  one  ounce  of  lard;  rub 
them  together. 

An  anodyne  application  for  painful  swellings,  ulcers,  and  piles. 

Ointment  of  Poke.  —  Tako  a  dram  of  the  extract  of  poke,  and  one 
ounce. of  lard  ;  mix  them. 
For  malignant  ulcers,  scald  head,  itch.  etc. 


How,  white 
clt  together 


belladonna 

gia,  etc. 
iote,  and  an 

;rou8  ulcers. 

y  powdered 
ized  opium ; 

if  red  iodide 
incorporate 


if  mercury, 
ih  neats-foot 
id,  then  heat 
'. ;  then  add 
nstantly,  as 
lally  till  the 

lice  of  oint- 
ib  thena  to- 

[merUi  and  is 
plication  in 
specific  for 

ion  of  scaly 
)arations  ia 

xide  of  zinc, 
almia,  erup- 


ict  of  poison 
rub 


ct  of  poi 
}f  lard; 


id  piles. 
)ke,  and  one 


Ointment  of  Stnimonium.  —  Take  one  dram  of  the  extract  of  stra- 
monium leaves,  and  one  ounce  of  lard ;  rub  the  extract  with  a  little 
water  till  it  is  uniformly  soft,  and  then  with  the  lard. 

Used  as  an  external  application  in  irritable  ulcers,  painful  piles,  and 
skin  eruptions. 

Sim|ile  Ointment  —  Take  a  pound  of  white  wax,  and  four  pounds 
of  lard ;  melt  them  together  with  a  gentle  heat,  and  stir  constantly 
till  cold. 

Ointment  of  Rose  Water.  —  Take  a  fluid  ounce  of  rose  water,  two 
fluid  ounci  s  of  oil  of  almondis,  half  an  ounce  of  sperinaci^ti,  one  (iruin 
of  white  wax ;  melt  togetner,  by  means  of  a  water-bath,  the  oil,  sper- 
maceti, and  wax  ;  then  add  the  rose  water,  and  stir  the  mixture  con- 
stantly till  cold. 

This  is  the  well  known  preparation  called  cold  cream.,  and  is  used 
with  much  advantage  for  chapped  lips  and  hands,  excoriations,  etc. 

Spermaceti  Ointment.  —  Take  five  ounces  of  spermaceti,  fouiteen 
of  white  wax,  aiid  a  pint  of  olive  oil ;  melt  them  together  over  a  slow 
fire,  and  stir  constantlv  till  cold. 

A  mild  dressing  for  blisters,  wounds,  and  excoriated  surfaces. 

Tar  Ointment  —  Take  a  pound  each  of  tar  and  suet ;  melt  the 
suet  with  a  gentle  h^ai,  and  add  the  tar  to  it ;  then  stir  constantly  till 
they  are  cold. 

A  useful  stimulating  application  to  various  scaly  and  scabby  erup- 
tions, particularly  leprosy  and  scald  head. 

Ointment  of  White  Hellebore. — Take  one  ounce  of  powdered  white 
hellebore  root,  four  ounces  of  lard,  and  twelve  drops  of  oil  of  lemons ; 
rub  them  thoroughly  together. 

A  useful  ointment  for  the  cure  of  itch. 

Ointment  of  Wild  Indiipo.  —Take  one  pound  of  powdered  wild 
indigo  root,  moisten  it  Lhoroughly  with  alcohol,  and  let  it  stand 
twenty-four  hours ;  then  put  it  in  a  percolator,  and  add  alcohol  as 
long  as  the  liquid  wliich  passes  contains  the  taste  of  the  root.  Distil- 
the  alcohol  from  this  filtered  tincture  until  half  a  gallon  of  tincture  is 
obtained.  Melt  one  pound  of  fresh  butter,  without  salt,  add  the 
above  tincture,  and  carefully  evaporate  the  rest  of  the  alcohol ;  stir 
constantly  till  cold,  aft«r  the  alcohol  has  nearly  passed  off. 

This  is  one  of  the  preparations  of  the  Eclectics,  and  is  a  cleansing, 
detergent,  antiseptic,  and  discutient  ointment,  useful  in  scrofulous, 
erysipelatous,  and  malignant  ulcers,  eruptions  of  the  skin,  etc. 

Pile  Ointment  —  Take  three  handfuls  each  of  witch  nazel  bark, 
white  oak  bark,  and  sweet  appletree  bark  ;  bruise  or  grind  them,  and 
add  to  them  three  pints  of  water ;  boil  down  to  one  pint,  and  strain  ; 
add  to  this  liquid  half  a  pound  of  lard,  and  simmer  till  the  water  all 
disappears,  stirring  continually  both  before  and  after  removing  from 
the  fire  till  it  cools. 

This  forms  a  brick-colored  anodyne,  astringent  ointment,  admira- 
bly adapted  to  the  cure  of  pile  tumors. 


k 

J! 


678 


MEDICINR»  AND  THKIR  PRKPARATI0N8. 


It'   ^ 
» t 


Conipouud  Letid  Olntnifitt.  —  Taki;  two  and  n  half  (lounda  of  olivo 
oil,  four  ounceH  cacrli  of  (jvoHwax  and  unsalted  butter,  and  half  a 
pound  uf  white  turpentine  ;  melt  them  together,  ntrain,  and  then  heat 
to  nearly  the  boiling  point ;  then  gradually  add  one  pound  of  red 
lead,  Htirring  conutantty  till  the  mixture  becomea  black  or  brown ; 
then  remove  from  the  fire,  and  when  it  is  partly  cool,  add  to  it  a 
mixture  of  twelve  ounces  of  honey,  and  half  a  pound  of  powdered 
camphor. 

TliiH  is  a  very  healing  ointment,  and  is  much  used  for  ulcers,  burns 
wounds,  and  ukin  diseases. 

Cuiii|N»iiiiii  Salphnr  Ointment.  —  Take  one  ounce  of  sulphur,  one 
dram  each  of  ammoniated  mercury  and  benzoic  acid,  one  lluid  dratii 
each  of  sulphuric  acid  and  oil  of  bergamot,  two  drams  of  nitrate  of 

[Kitassa,  and  half  a  pound  of  lard.     First,  melt  the  lard  with  a  gtMitIc 
leat,  then  add  the  other  ingredients,  stirring  constantly  till  they  are 
cold. 

A  sovereign  remedy  for  itch. 

Pills. 

Pills  are  small  masses  of  medicinal  substances,  in  globular  shape, 
and  of  a  size  convenient  for  swallowing.  Each  pill  generally  weighs 
from  three  to  five  grains.  Those  medicines  which  cannot  be  disHolved 
in  water,  and  are  particularly  unpleasant  to  the  taste,  are  usually 
given  in  the  form  of  pill.  Bngar*coated,  as  now  very  extensively 
prepared  by  Tilden  &  Co.,  from  every  important  medicine,  and  in  a 
great  variety  of  combination,  they  will  doubtless  becotne  a  very  pop- 
ular form  of  taking  medicine.  Physicians  cannot  do  better  than  to 
use  the  pills  of  the  abovenamed  extensive  manufacturing  house. 

The  method  of  making  pills  is  as  follows :  If  the  substance  to  bo 
worked  into  pills  be  a  solid  extract,  add  a  few  drops  of  water  to  it, 
and  rub  it  to  the  right  consistence ;  if  it  be  a  resin,  add  to  it  a  few 
drops  of  alcohol;  if  it  be  a  soft  or  liquid  substance,  rub  up  with  it 
some  inert  substance,  or  crumb  of  bread,  or  wheat  flour,  or  starch,  or 
pulverized  gum  arable ;  if  it  be  a  powder,  mix  it  with  some  soft 
substance,  as  confection,  soap,  or  syrup,  molasses,  honey,  or  mucilage 
df  gum  arable.  The  materials  must  be  well  mixed  and  rubbed  into 
a  uniform  mass,  which  should  be  rolled  v  oatula  or  case  knife, 

into  a  cylinder  of  just  the  same  size  t>-  .t.     This  is  to  be  di- 

vided equally  into  the  number  of  ired,  each  of  which  is 

rolled  into  a  spherical  form  betw(  .iiumb  and  finger,  or  upon 

the  palm  of  one  hand  by  the  indej.  c  of  the  other. 

So  many  valuable  pills  are  prescrioea  among  the  "  Recipes,"  that  it 
Is  Qot  necessary  here  to  add  to  their  number. 


Plasters. 

PiiASTERs  are  composed  of  wax,  resins,  gums,  fats,  and  oils,  and 
rometimes  medicinal  substances,  and  are  spread  upon  linen,  musliri, 


^^ 


inds  of  olivo 
niul  half  a 
1(1  then  heat 
3und  of  r«'(l 
;  or  brown ; 
add  to  it  a 
)f  powdered 

ilcera,  burns. 


mlnhur,  one 
L>  tluid  drani 
)f  nitrate  of 
'ith  11  gentle 
till  they  are 


bnlar  shape, 
rally  weighs 
be  disHolved 
are  usually 
extensively 
le,  and  in  a 
a  very  pop- 
ter  than  to 
louse. 

itance  to  bo 
water  to  it, 

to  it  a  few 

up  with  it 

)r  starch,  or 

some  soft 
or  mucilage 
rubbed  into 
case  knife, 
is  to  be  di- 
>f  which  is 
;er,  or  upon 


pes,"  that  it 


id  oils,  and 
len,  muslifi, 


MEDICINKS  AND  TIIKIR  PRKI'ARATIONS. 


cm 


or  leather,  —  moAlly  the  latter.  When  cold  they  are  har<l ;  but  when 
brou<{lit  to  the  warmth  of  the  human  body,  they  ho  far  soften  iis  to 
adhi;re  firmly  to  the  skin,  but  do  not  "run"  so  as  to  spread  outward, 
and  soil  the  under-cloth«'s.  They  are  intended  generally  to  excite  and 
irrital(!  the  skin;  sometimes  as  mecrhaniea!  supporters;  (iiid  sometimes 
tt»  allect  the  system  by  having  their  medicinal  matters  absorbcid. 

R«ilii(ioiliiil  IMtister. —  Take  three  ounces  of  resin  plaster,  and  an 
ounce  and  a  half  of  extract  of  belladonna,  add  the  ex  .act  to  the 
plaster  previously  melted  by  a  gentle  heat,  and  mix. 

A  useful  anodyne  application  in  neuralgia,  rheumatic  pains,  and 
dystnenorrhcEa. 

Coinpouiul  €ii|isicuiii  IMtister. —  Melt  togetlier  half  a  pound  of  resin, 
and  two  ounces  of  beeswax  ;  to  this  add  one  pint  of  spirit  in  which 
two  ounces  of  powdered  cayenne,  enclosed  loosely  in  a  linen  bag,  has 
been  digested  one  hour  by  a  gentle  heat ;  evaporate  the  spirit  by  a 
moderate  heat,  and  add  one  ounce  of  powdered  camphor,  and  one 
fluid  dram  and  a  half  of  oil  of  sassafras ;  stir  constantly  till  cold. 

This  may  be  used  whenever  a  stimulating  plaster  is  recpiired. 

Coiiipouiiil  Giilhiiiiiiin  PliKSter.  —  Take  two  ounces  of  galbanum, 
three  ounces  of  burgundy  pitch,  half  an  ounce  of  resin,  half  an  ounce 
of  yellow  wax,  and  four  ounces  of  lead  plaster ;  melt  them  all  to- 
gether, over  a  gentle  f're. 

This  ia,a  valuable  strengthening  plaster,  and  may  be  used  for  weak- 
ness of  various  parts,  as  well  as  for  scrofulous  enlargement  of  glands 
and  joints. 

Coiiipouiid  Lend  IMnstcr.  —  Take  one  pound  of  lead  plaster;  mett 
it  by  a  moderate  heat,  and  then  add  two  fluid  ounces  each  of  linseed 
oil  and  tincture  of  opium,  six  fluid  ounces  of  oil  of  turpentine,  and 
two  thirds  of  a  pound  of  oil  of  origanum ;  stir  together  till  cold. 

Used  for  burns,  scalds,  chilblains,  etc. 

Compound  llesiii  Plaster. —  Take  three  pounds  of  resin,  four  ounces 
each  of  beeswax  and  hemlock  gum ;  melt  the  articles  together,  then 
remove  from  the  fire,  and,  when  nearly  cold,  add  gradually  one  fluid 
ounce  each  of  oil  of  hemlock,  oil  of  sassafras,  and  olive  oil,  with  half 
an  ounce  of  camphor  dissolved  in  them,  and  half  a  fluid  ounce  of  oil 
of  turpentine.  Pour  the  whole  into  cold  water,  and  work  in  the 
hands  till  cold,  forming  it  into  rolls. 

This  is  an  excellent  strengthening  plaster,  useful  for  rheumatism, 
enlarged  joints,  glands,  and  wherever  a  weakened  part  needs  gentle 
stimulation  and  support 

Spiced  Plaster.  —  Take  one  ounce  each  of  powdered  ginger,  cloves, 
cinnamon,  and  black  pepper;  one  dram  of  pulverized  cayenne;  half 
a  fluid  ounce  of  tincture  of  ginger;  and  a  sufficient  quantity  of  honey. 
Mix  the  powders,  and  then  add  the  tincture  and  honey,  to  form  a  stiff 
poultice. 

This  is  applied  with  great  advantage  over  the  stomach  in  cases  of 
nausea  and  vomiting. 


I 


80 


MEDICINES  AND  THEIR  PREPARATIONS. 


Cum|N)Uu:l  Tar  IMnster.  —  Boil  three  pounds  of  tar  half  an  hour, 
Ihcii  add  one  pound  and  a  half  of  burgundy  pitch,  one  pound  of  white 
gijia  turpentine  (after  having  melted  them  together  and  strained). 
Sfir  together,  then  remove  from  the  fire,  and  add  ten  ounces  each  of 
finely  powdered  mandrake  root,  bloodroot,  poke  root,  and  Indian  tur- 
nip; mix  thoroughly  together. 

'riiis  is  an  irritant,  rubefacient,  suppurative  plaster,  and  is  consider- 
ably used  by  the  Eclectics,  to  produce  counter-irritation  and  revulsion 
in  neuralgia,  rheumatism,  and  other  painful  affections,  as  well  as  in 
chronic  inllammation  of  internal  organs.  To  be  spread  thinly  on  soft 
leather,  and  renewed  daily  on  me  same  leather.  Four  days  are  re- 
quired to  produce  suppuration.  If  it  produce  great  pain  or  inflam- 
mation, remove  it,  and  apply  mutton  tallow,  or  I'lm  poultice. 

Lead  Plaster.  —  Take  one  pound  and  a  quarter  of  very  finely  pow- 
dered semivitrified  oxide  of  lead,  one  quart  of  ve  oil,  and  half  a 
pint  of  water.  Boil  togetly^r  over  a  gentle  fire,  stiiring  constantly  till 
the  oil  and  litharge  unite  and  form  a  plaster.  If  lhi3  water  nearly  all 
evaporates  before  the  process  iS  couipleted,  add  a  little  boiling  water. 

A  useful  plaster  for  ulcers,  burns,  excoriated  surfaces,  etc. 

Red  Oxide  of  Lead  Plaf  ler. —  Melt  together  one  quart  of  olive  oil, 
and  one  ounce  each  of  bejswax  and  resin  ;  lu-at  tj  the  boiling  point, 
and  then  add  gradually  thi'ee  quarters  of  a  pound  of  powdered  red  lead. 
Stir  constantly,  and  when  the  oil  has  taken  up  the  lead,  the  mixture 
will  be  brown  or  shining  black ;  then  remove  from  the  fire,  and  when 
nearly  cold,  add  four  scruples  of  powdered  camphor,  and  stir  together. 
It  should  not  be  removed  from  the  fire  until  it  has  acquired  a  proper 
consistence  for  spreading,  which  may  be  easily  ascertained  by  allow- 
ing a  portion  of  it  to  cool  on  a  knife. 

This  is  a  valuable  plaster  for  scrofulous  and  syphilitic  ulcers,  also 
for  burns,  scalds,  and  several  skin  diseases. 


Poultices. — Cataplasms. 

Bre^d  and  Water  Poultice.  —  Put  the  needed  nnantity  of  boilins 
water  in  a  basin ;  throw  in  crumbled  white  bread,  or  cracker,  and 
cover  with  a  plate.  When  the  bre^d  or  cracker  lias  soakeO  up  all  it 
will,  drr/m  oil'  +he  remaininff  water.  Spread  one  third  yf  oi:  inch 
thick,  r  nd  apply 

Flaxseed  Poultices.  —  Put  boiling  water  in  a  basin,  and  stir  in  flax- 
seed mtal  to make  a  thick  paste.     Spread ^n  linen,  and  apply. 

Yeast  Poultice.  —  Mix  half  a  pint  of  yeast  with  one  pound  of  flax- 
seed ineai.     Stir  carefully  while  heating. 

Carrot  PouWicei  —  Boil  the  proper  quantity  of  carrots  till  they  are 
quite  soft.  Strain  off  the  water,  mash  them  to  a  puip,  and  add  a  little 
-lard  or  sweet  oil  to  prevent  them  from  getting  hard,  then  spread.  A 
good  application  for  malignant  and  ofi'ensive  sores. 


MEDfCINES  AND  THEIR  PREPARATIONS. 


6H1 


'  an  hour, 
d  of  white 
strained), 
es  each  of 
ndian  tur- 

i  conaider- 
l  revulsion 
well  as  in 
Illy  on  soft 
lys  are  re- 
or  inflatn- 


inely  pow- 
iiid  half  a 
stantly  till 
'  nearly  all 
ng  water. 


f  olive  oil, 
ling  pointy 
<1  red  lead, 
le  mixture 

and  when 
r  together, 
d  a  proper 

by  allow- 

ilcers,  alao 


of  boiling 
icker,  and 
•}  up  all  it 
if  OP  inch 


tir  in  f.ax- 
id  of  fiax- 


1  they  are 
idd  a  little 
pread.     A 


Out  Meal  Poultice. — Place  hot  water  in  a  basin,  and  stir  in  oat  meal 
slowly,  while  it  boils,  till  the  poultice  is  of  the  right  thickness ;  that 
id,  till  it  will  not  run  on  ihe  rag  on  which  it  is  spread. 

Inrlitin  Meal  Poultice.  —  Made  the  same  as  oat  meal  poultice. 

Arrow  Root  Poultice.  —  Mix  two  or  more  tablespoonfuls  of  arrow- 
root with  a  little  cold  water,  in  a  basin,  till  it  is  all  united  with  the 
water.  Then  add  boiling  water,  and  stir,  till  the  whole  becomes  a 
thick  paste. 

Sliiipery  Elm  Poultice.  —  Stir  ground  slippery  elm  bark  info  hot 
water,  and  let  it  swell.     This  is  a  very  soothing  poultice  for  irritable 

sores. 

Oiliou  Poultice.  -7-  Made  in  the  same  way  as  the  carrot  poultice. 
This  is  quite  stimulating,  and  induces  indolent  sores  to  matarate 
more  freely.     It  is  excellent  for  slow  boils. 

Cliarcoal  Poultice.  —  Take  either  the  bread  and  milk,  or  the  Indian 
meal  poultice,  and  stir  into  it  one  quarter  its  bulk  of  finely  pulverized 
charcoal.     Excellent  for  thoroughly  cleansing  a  foul  sore  or  ulcer. 

Auodyne  Poultice.  —  Take  half  an  ounce  of  the  extract  either  of 
foxglove,  or  henbane,  or  stramonium,  or  conium,  or  belladonna,  and 
mix  with  it  half  a  pint  of  tepid  water.  Then  stir  in  as  much  flax- 
seed meal  as  will  make  a  poultice  of  the  right  thickness.  Always  be 
careful  not  to  apply  this  poultice  where  there  is  nmch  skin  oil',  lest 
the  extract  used  be  so  much  absorbed  as  to  produce  poisonous  effects. 
These  poultices  allay  the  pain  of  cancerous  and  other  sores. 

Lobelia  Poultice. —  Powdered  lobelia  and  ground  slippery  elm  bark, 
each,  one  ounce.  Stir  these  into  hot  weak  lye,  to  make  a  poultice. 
For  wounds,  fistula,  whitlow,  boils,  erysipelas,  and  stings  of  insects. 

Poke  Itoot  Poultice.  —  Roast  a  sufficient  quantity  of  fresh  poke 
root  in  hot  ashes.  When  it  is  quite  soft,  pound  it,  and  make  a  poul- 
tice. To  be  applied  to  tumors  to  scatter  them,  or  hasten  their  suppu- 
ration.    To  be  removed  every  four  hours. 

Mustiird  Poultice.  —  Stir  up  a  tablespoonful  of  ground  mustard 
Tith  a  little  water,  to  the  consistence  of  paste.  Spread  upon  linen 
or  brown  paper,  and  cover  with  thin  muslin,  that  the  mustard  may 
'lot  Htick  to  the  skin  when  the  poultice  ia  removed. 

Powders. 

A  SINGLE  substance  used  as  a  powder  is  called  a  simple  pow<.  2r; 
two  or  more  united,  a  compound  powder.  Under  the  above  head,  i~ 
shall  describe  only  compound  powders.  In  preparing  compound 
powders,  the  substances,  if  of  different  degrees  of  hardness,  should 
generally  be  pulverized  separately.  Many  powders  require  to  be  ex- 
cluded from  the  light,  which  may  be  done  by  covering  .the  bottles  io 
which  they  are  kept  with  black  varnish. 


/ 


.  I 


;:; 


11  ■ 


682 


MEDICINES  AND  THEIR  PREPARATIONS. 


Aromntic  Powder.  —  Take  two  ounces  each  of  cinnamon  and  gin- 
ger, and  an  ounce  each  of  cardamom  deprived  of  the  capaulect,  and 
grated  nutmeg.  Rub  them  together  into  a  very  fine  powder,  and 
keep  in  well-stopped  bottles. 

The  powder  is  stimulant  and  carminative,  and  in  cases  of  weak- 
ened digestion,  may  be  given  in  ten  to  thirty-grain  doaea. 

Conipoimd  Powder  of  Aloes  and  Canella.  —  Take  a  )K)und  ot  aloes, 
and  three  ounces  of  canella.  Rub  them  separately  to  a  fine  powder, 
tind  mix  them. 

This  is  the  preparation  known  as  hiera  picra,  or  simply  picra.  It 
may  be  used  for  amenorrhoea,  or  generally  as  a  bitter  to  correct  coa- 
tiveness,  and  improve  the  appetite. 

Compound  Powder  of  Catechu.  —  Take  two  ounces  each  of  catechu 
and  kino,  and  half  an  ounce  each  of  cinnamon  and  nutmeg.  Reduce 
all  to  a  fine  powder,  mix,  and  pass  them  through  a  fine  sieve. 

For  chronic  diarrhoea,  dysentery,  etc.  Dose,  from  fifteen  to  thirty 
grains. 

Compound  Powder  of  Chalk.  —  Take  half  a  pound  of  prepared 
chalk,  four  ounces  of  cinnamon,  three  ounces  each  of  tormentil  and 
gum  arable,  and  half  an  ounce  of  long  pepper.  Rub  them  separately 
into  a  very  fine  powder,  and  mix. 

This  powder  is  warm,  stimulant,  astringent,  and  antacid,  and  is 
well  fitted  for  diarrhoea,  not  connected  with  infiammation. 

Compound  Powder  of  Chalk  with  Opium.  —  Take  six  ounces  and  a 
half  of  compound  powder  of  chalk,  and  four  scruples  of  powdered 
opium.     Mix  them. 

The  opium  in  this  preparation  increases  the  efficacy  of  the  com- 
pound powder  of  chalk  in  diarrhoea.  Dose  for  an  adult,  ten  to  twenty 
grains,  and  repeated  after  each  discharge. 

Compound  Powder  of  Golden  Seal.  —  Take  two  drams  each  of 
powdered  golden  seal,  blue  cohosh,  and  helonias,  and  mix  them. 

Useful  in  dyspepsia,  and  chronic  inflammation  of  the  mucous  mem- 
brane of  the  stomach,  etc.  Dose,  half  a  teaspoonful  to  a  teaspoonful, 
three  or  four  times  a  day. 

Compound  Powder  of  Hydrastin.  —  Take  half  a  dram  each,  in 
powder,  of  hydrastin,  leptandrin,  rhubarb,  and  myricin.  Mix  tho- 
roughly, and  divide  into  thirty-two  powders. 

This  is  tonic  and  laxative,  and  is  useful  in  dyspepsia,  jaundice^ 
chronic  inflammation  of  the  bowels,  and  during  recovery  from  ex- 
hausting complaints.  One  powder  may  be  taken  often  enough  to 
produce  one  movement  of  the  bowels  a  day. 

Inhaling;  Powder.  —  Take  one  dram  of  crystals  of  nitrate  of  silver, 
and  two  and  a  half  drams  of  lycopodium.  Work  the  lycopodium 
into  a  very  stiff'  paste,  with  a  little  warm  water,  in  which  the  nitrate 
is  dissolved.  Spread  this  thin  in  a  shallow  dish,  cover  it  so  as  to  shut 
out  the  light,  and  set  it  where  it  will  dry ;  when  thoroughly  dry,  pul- 
verize. 


MEDICINES  AND  THEIR  PREPARATIONS. 


683 


mon  and  gin- 
capsules,  and 
;  powder,  and 

^ases  of  weak- 

9. 

►ound  of  aloes, 
a  fine  powder, 

iply  pier  a.     It 

0  correct  cos- 

ich  of  catechu 
neg.     Reduce 
sieve. 
;teen  to  thirty 

1  of  prepared 
tormentil  and 
em  separately 

itacid,  and  is 
n. 

ounces  and  a 
of  powdered 

V  of  the  corn- 
ten  to  twenty 

ima   each  of 
X  them, 
nucous  mem- 
L  teaspoonful, 

am   each,  in 
Mix  (ho- 

iia,  jaundice^ 
ery  from  ex- 
n  enough  to 

ate  of  silver, 
lycopodium 
1  the  nitrate 
so  as  to  shut 
fhly  dry,  pul- 


I  have  used  this  powder  with  great  advantage  in  many  cases  of 
bronchitis,  by  directing  three  or  four  grains  of  it  to  be  inhaled  once  a 
day,  in  an  instrument  I  had  constructed  for  that  purpose.  This  is  the 
only  really  valuable  catarrh  ^wuff  ever  used.  A  pinch  of  it  taken  once 
a  day  (never  oftener)  for  nasal  catarrh,  will  often  do  excellent  service. 

Compoand  Powder  of  Ipecacuanhat  —  Take  a  dram  each  of  pow- 
dered ipecacuanha  and  opium,  and  one  ounce  of  sulphate  of  potassa. 
Rub  them  together  into  a  fine  powder. 

This  is  the  well  known  Dover's  powder.  It  is  an  admirable  ano- 
dyne and  diaphoretic,  and  is  much  used  in  inflammatory  complaints, 
particularly  rheumatism  and  pneumonia,  complicated  with  low,  ty- 
phoid symptoms.     Dose,  fronri  five  to  fifteen  grains. 

Compound  Powder  of  Jalap.  —  Take  half  an  ounce  of  pulverized 
jalap  and  senna,  one  ounce  of  pulverircd  bitart.rate  of  potassa,  half  a 
dram  of  pulverized  ginger,  and  tjn  grains  of  pulverized  cayenne. 
Mix  thoroughly. 

This  is  a  valuable  purgative  medicine,  and  may  be  used  in  most 
cases  where  a  simple  cathartic  is  required.  Dose,  half  a  teaspoonful 
to  a  tablespoon  ful. 

Compound  Powder  of  Kino.  —  Take  fifteen  drams  of  kino,  half  an 
ounce  of  cinnamon,  and  a  dram  of  dried  opium.  Rub  them  sepa- 
rately to  a  very  fine  powder,  and  mix  them. 

This  is  anodyne  and  astringent,  and  is  useful  in  diarrhoea,  etc. 

Compound  Powder  of  Rbubarb.  —  Take  four  ounces  of  powdered 
rhubarb,  one  pound  of  magnesia,  and  two  ounces  of  finely  powdered 
ginger.     Mix  thoroughly,  and  preserve  in  well-stopped  bottles. 

An  excellent  laxative  and  antacid,  and  well  adapted  to  the  bowel 
complaints  of  children. 

Compound  Powder  of  Rhubarb  and  Potassa  {Neutralizing  Powder). 
—  Take  half  an  ounce  each  of  powdered  rhubarb,  bicarbonate  of 
potassa,  and  peppermint  leaves.     Mix  thoroughly. 

Valuable  in  diarrhoea,  cholera  morbus,  dysentery,  summer  com. 
plaint  of  children,  sour  stomach,  heartburn,  etc. 

Worm  Powder.  —  Take  one  ounce  each  of  powdered  white  Indian 
hemp  root  (asclepias  incarnata),  mandrake,  pink  root,  and  bitter  root; 
two  ounces  of  powdered  balmony,  and  four  scruples  of  powdered 
aloes.     Mix  thoroughly. 

A  very  good  remedy  for  all  kiads  of  worms.  A  teaspoonful  of  the 
powder  may  be  mixed  with  a  gill  of  molasses,  and  a  teaspoonful  of 
this  given  tc  a  child  every  hour  or  two  till  it  operates.  After  this, 
give  a  teaspoonful  three  times  a  day,  for  a  few  days. 

Syrups. 

A  STRONG  solution  of  sugar  and  water  is  a  simple  syrup.  When 
the  water  is  first  charged  with  some  medicinal  substance,  and  sugar 


I 


684 


MEDICINES  AND  THEIU  PREPARATIONS. 


is  added  lo  this,  we  have  a  medicated  syrvp.     Refined  sugar  should 
always  be  preferred,  in  preparing  medicated  syrups. 

Simple  Syrup.  —  Take  two  a»  1  a  half  pounds  of  refined  sugar,  and 
a  pint  of  water  J  dissolve  tiie  sugar  in  the  water  by  heat,  remove  any 
scum  that  may  arise,  and  ntrain  while  hot. 

Synip  of  Almouds.  —  Take  a  pound  of  sweet  almonds,  four  ounces 
of  bitter  almonds,  three  pints  of  water,  and  six  pounds  of  refined 
sugar.  Blanch  the  almonds,  then  rub  them  in  a  mortar  to  very  fine 
paste,  and  add,  during  the  trituration,  three  fluid  ounces  of  the  water, 
and  one  pound  of  the  sugar.  Mix  the  paste  thoroughly  with  the 
remainder  of  the  water.  Strain  with  strong  expression,  add  the  rfr 
mainder  of  tlie  sugar  to  the  strained  liquor,  and  dissolve  by  a  gentle 
heat.  Strain  through  fine  linen,  and  after  it  is  cool,  put  it  into  "bottles, 
thoroughly  stopped,  and  keep  in  a  cool  place- 

TliiH  is  demulcent,  nutritive,  and  sedative,  and  is  sometimes  added 
to  cough  mixtures,  etc. 

Syi'iip  of  Citric  Acid.  —  Take  two  drams  of  powdered  citric  acid, 
four  minims  of  oil  of  lemons,  and  two  pints  of  syrup.  With  one  fluid 
ounce  of  the  syrup,  rub  the  citric  acid  and  oil  of  lemons,  then  add 
the  remainder  of  the  syrup,  and  dissolve  by  a  gentle  heat. 

This  is  much  employed  as  an  agreeable  and  cooling  addition  to 
drinks,  especially  to  carbonic  acid  water.  Tartaric  acid,  being  cheaper 
than  citric  acid,  is  often  substituted  for  it,  and  the  preparation  thus 
made  is  nmch  sold  under  the  name  of  lemon  syrup. 

Syrup  of  Garlic.  —  Take  six  ounces  of  fresh  garlic,  sliced  and 
bruised,  one  pint  of  diluted  acetic  acid,  and  two  pounds  of  refined 
sugar.  Macerate  the  garlic  in  ten  fluid  ounces  of  the  diluted  acetic 
acid,  in  a  glass  vessel,  four  days,  and  express  the  liquor.  Then  mix 
the  rest  with  what  remains  of  the  acid,  a'nd  again  express,  till  sutfi- 
cient  has  passed  to  make  the  whole  when  filtered  measure  a  pint. 
Then  pour  the  filtered  liquor  on  the  sugar  in  a  bottle,  and  shake  till 
it  is  dissolved. 

Excellent  in  the  bronchial  affections  of  children.  Dose,  a  teaspoon- 
fui,  for  a  child  a  year  old. 

Syrup  of  Glllfcr.  —  Add  two  fluid  ounces  of  tincture  of  ginger  to 
a  quart  of  simple  syrup;  evaporate  the  alcohol  by  a  gentle  heat. 

This  is  carminative  and  stimulant,  and  gives  tone  to  the  debilitated 
stomach,  removing  wind,  etc  It  is  added  to  other  njedicines  to  im- 
prove their  flavor. 

Compound  Syrup  of  Hypopliospliites.  —  Take  256  grains  of  hypo- 
phosphite  of  lime,  192  grains  of  hypophosphite  of  soda  128  grams 
of  hypophosphite  of  potassa,  96  grains  of  recently  precipitated  hypo- 
phosphite  of  iron,  240  grains  of  hypophosphorous  acid  solution,  12 
ounces  of  white  sugar,  half  an  ounce  of  extract  of  vanilla,  and  a 
BuflScient  quantity  of  water.  Dissolve  the  salts  of  lime,  soda,  and 
potassa, <in  six  ounces  of  water;  put  the  iron  salt  into  a  mortar,  and 
gradually  add  solution  of  hypophosphorous  acid  till  it  is  dissolved : 


sugar  should 

ed  sugar,  and 
;,  remove  any 

3,  four  ounces 
ds  of  refined 
ir  to  very  fine 
of  the  water, 
hly  with  the 
I,  add  the  re* 
e  by  a  gentle 
t  into  "bottles, 

etirnes  added 

d  citric  acid, 

i^ith  one  fluid 

)ns,  then  add 

t. 

J  addition  to 

)eing  cheaper 

paration  thus 

3,  sliced  and 
ids  of  refined 
iiluted  acetic 
'.  Then  mix 
resa,  till  sutfi- 
asure  a  pint, 
md  shake  till 

i,  a  teaspoon- 

of  ginger  to 
tie  heat, 
le  debilitated 
icines  to  im- 

ins  of  hypo- 
a,  128  grains 
>italed  hypo- 
solution,  12 
inilla,  and  a 
e,  noda,  and 
,  mortar,  and 
is  dissolved: 


MEDICINES  AND  THEIR  PREPARATIONS. 


685 


to  this  add  the  solution  of  the  other  salts,  after  it  has  been  rendered 
BJiglitly  acidulous  with  the  same  acid,  and  then  water,  till  the  whole 
measures  nine  fluid  ounces.  Dissolve  this  in  sugar,  with  heat,  and 
flavor  with  the  vanilla.  Without  flavoring,  this  syrup  is  not  unpleas- 
ant, being  slightly  saline,  and  not  at  all  ferruginous.  Any  other 
flavoring  may  be  used,  as  orange  peel,  orange  flower,  or  ginger.  It 
is  also  suggested  to  physicians  that  glycerine  may  be  used,  wholly  or 
partially,  in  place  of  sugar,  when  indicated,  six  ounces  and  a  half  of 
glycerine  being  substituted  for  twelve  ounces  of  sugar. 

This  syrup  has  been  nmch  used  of  late  as  a  new  remedy  for  con- 
sumption, on  the  authority  of  Dr.  Churchill.  It  is  elegantly  maiui- 
fuctured  by  Di.  Jamei  R.  Nichols  &  Co.,  of  this  city.  Dose,  a  tea- 
epoonful,  three  times  a  day  before  meals. 

Synip  of  Ipecacuanha.  —  Take  one  ounce  of  ipecacuanha,  in  coarse 
powder,  one  pint  of  diluted  alcohol,  two  pounds  and  a  half  of  sugar, 
and  one  pint  of  water.  Macerate  the  ipecacuanha  in  the  alcohol 
fourteen  days,  and  filter;  evaporate  the  filtered  liquor  to  six  fluid 
ounces,  filter  again,  and  add  water  to  make  the  liquor  measure  a  pint; 
thfii  add  the  sugar,  and  proceed  as  directed  for  syrup. 

This  is  chieliy  used  in  complaints  of  children.  Dose,  as  an  emetic, 
for  an  adnit,  uvo  fluid  ounces;  for  a  child  a  year  or  two  old,  one  or 
iwo  tlnid  drams.  As  an  expectorant,  for  an  adult,  two  fluid  drams; 
'or  a  cliiki,  five  to  twenty  minims. 

Syrup  of  Lrnutus.  —  Take  a  pint  of  strained  lemon  juice,  two 
pounds  and  a  half  of  refined  sugar,  and  two  and  a  half  fluid  ounces 
of  rectified  spirit;  boil  the  juice  ten  minutes,  and  strain;  then  add 
the  sugar,  and  dissolve.  After  the  syrup  has  cooled,  mix  the  spirit 
with  it. 

A  cooling  and  grateful  addition  to  drinks  in  fevers,  and  serves  to 
cover  the  taste  of  salts  and  other  purgatives. 

Aromatic  Syrup  of  Rhubarb.  —  Take  two  ounces  and  a  half  of 
bruised  rhubarb,  half  an  ounce  each  of  bruised  cloves  and  cinnamon, 
two  drams  of  bruised  nutmeg,  two  pints  of  diluted  alcohol,  and  six 
pints  of  syrup.  Macerate  the  rhubarb  and  aromatics  in  the  alcohol 
for  fourteen  days,  and  strain;  then,  by  a  gentle  heat,  evaporate  th'- 
liquor  to  a  pint,  and,  while  hot,  mix  it  with  the  syrup  previous- 
heated. 

This  is  a  warm  cordial  laxative,  admirably  fitted  for  the  bowel 
complaints  of  infants.  Dose,  a  fluid  dram,  repeated  every  two  hours 
till  it  operates. 

Syrup  of  Seneka.  —  Take  four  ounces  of  fluid  extract  of  seneka,  and 
one  pint  of  water ;  mix,  and  dissolve  in  the  liquid  one  pound  of  refined 
sugar,  and  proceed  as  directed  for  syrup. 

This  is  a  stimulating  expectorant,  used  in  colds,  coughs,  etc.,  after 
inflammatory  symptoms  have  subsided.  Dose,  for  an  adult,  one  or 
two  teaspo.ir/fuls,  as  often  as  necessary. 

Syrup  of  Squill.  —  To  one  pint  of  vinegar  of  squill,  add  two  pounds 
of  refined  sugar,  and  proceed  as  directed  for  syrup. 


It.  ia  a  useful  expectorant  for  coughs  and  bronchial  afTectioud  of 
infants  and  children.     Dose,  half  a  dram  to  a  dram. 

Syrup  of  Tola.  —  Take  two  fluid  ounces  of  tincture  of  tolu,  and 
one  pint  of  simple  syrup ;  mix,  and  gently  heat  the  mixture  to  evapo- 
rate the  alcohol. 

This  is  chiefly  ust  d  to  flavor  other  preparations. 

Synip  of  Wilrt-Clienry  Bark.  —  Place  two  pounds  and  a  half  of 
coarsely  powdered  wild-cherry  bark  in  a  percolator,  and  pass  through 
it  one  gallon  of  water.  Strain  this,  and  dissolve  in  it  by  heat  sixteen 
pounds  of  refined  sugar. 

This  makes  an  elegant  tonic  and  sedative  preparation,  and  is  mixed 
with  various  other  articles  in  prescribing  for  dyspepsia,  consumption, 
etc. 

Coiii|N)iiim1  Syrnp  of  Partridge  Berry.  —  Take  half  a  pound  of  par- 
tridge-berry, and  two  ounces  each  of  helonias,  blue  cohosh,  and  high 
cranberry  bark  ;  add  to  them  one  quart  of  brandy,  and  macerate  four 
days.  Press  oiit  the  brandy ;  and  place  the  herbs  in  three  quarts  of 
boiling  water,  and  boil  down  to  two  and  a  half  pints.  Straio^  add  one 
pound  of  sugar,  and  evaporate  to  two  and  a  half  pints.  Remove  from 
the  fire,  and  when  nearly  cold,  add  the  brandy  previously  pressed  out 

This  is  considerably  used  by  the  Eclectic  physicians,  under  the 
name  of  vwther's  cordial;  and  may  be  usefully  employed  by  all  phy- 
sicians in  suppression  of  the  menses,  painful  menstruation,  profuse 
menstruation,  and  habitual  abortions.  Dose  from  one  to  two  ounces, 
two  or  three  times  a  day. 

Compound  Syrup  of  Phosphates  {Oiemical  Food). — Take  ten  drams 
of  protosulphate  of  iron,  twelve  drams  of  phosphate  of  soda,  twelve 
drams  of  phosphate  of  lime,  twenty  drams  of  phosphoric  acid  (glacial), 
two  scruples  of  carbonate  of  soda,  one  dram  of  carbonate  of  potassa, 
sufficient  quantity  of  muriatic  acid,  sufficient  quantity  of  water  of 
ammonia,  two  drams  of  powdered  cochineal,  sufficient  water  to  make 
twenty  fluid  ounces,  three  pounds  of  sugar,  and  fifteen  drops  of  oil 
of  orange.  Dissolve  the  sulphate  of  iron  in  two  fluid  ounces  of  boil- 
ing water,  and  the  phosphate  of  soda  in  four  fluid  ounces  of  boiling 
water.  Mix  the  solutions,  and  wash  the  precipitated  phosphate  of 
iron  till  the  washings  are  tasteless. 

Dissolve  the  phosphate  of  lime  in  four  fluid  ounces  of  boiling  water, 
with  sufficient  muriatic^  acid  to  make  a  clear  solution,  precipitate'  it 
with  water  of  ammonia,  and  wash  the  precipitate. 

To  the  freshly  pi  cipitat«d  phosphates,  as  thus  prepared,  add  the 
phosphoric  acid,  previously  dissolved  in  the  water.  When  clear,  add 
the  carbonates  of  soda  and  potassa,  and  afterwards  sufficient  muriatic 
acid  to  dissolve  the  precipitate. 

Now  add  the  cochineal  mixed  with  the  sugar,  apply  heat,  and  when 
the  syrup  is  formed,  strain  and  flavor  it 

This  is  an  elegant  syrup,  agreeable  both  to  the  eye  and  taste,  and 
has  been  extensively  sold  and  used  as  a  nutritive  tonic,  in  chronic  de- 
bility, in  cases  of  broken  down  constitution,  wasting  of  the  flesh,  etc. 


aflectioad  of 

of  tolu,  and 
are  to  evapo- 


id  a  half  of 

pass  til  rough 

heat  sixteen 

and  is  mixed 
jonsumption, 

ound  of  par- 
sh,  and  high 
lacerate  fonr 
•ee  quarts  of 
•aiii,  add  one 
lemove  from 

pressed  out 
3,  under  the 

by  all  phy- 
ion,  profuse 
two  ounces, 


:e  ten  drams 
soda,  twelve 
cid  (glacial), 
;  of  potassa, 
of  water  of 
iter  to  make 
drops  of  oil 
ices  of  boil- 
's of  boiling 
hosphate  of 

)iling  water, 
recipitute'  it 

•ed,  add  the 
n  clear,  add 
!nt  muriatic 

t,  and  when 

1  taste,  and 
chronic  de- 
le  he»h,  etc- 


MEDICINES  AND  THEIR  PREPARATIONS. 


687 


Compound  Syrnp  of  Rhubarb  and  Potassa  {Neutralizing-  Cordial). — 
Take  half  a  pound  each  of  powdered  rhubarb  and  bicarbonate  po- 
tasHa,  and  four  ounces  each  of  cinnamon  and  golden  seal ;  macerate 
for  four  days  in  one  gallon  of  best  fourth  proof  brandy.  Express  the 
tincture  with  strong  pressure,  and  add  to  it  two  Huid  drams  of  oil  of 
peppermint,  previously  dissolved  in  a  little  alcohol.  Break  up  the 
cake  from  the  press,  place  it  in  a  percolator,  and  gradually  pass 
through  it  warm  water  till  the  strength  is  exhausted.  Evaporate  this 
solution  1o  four  quarts,  and  while  the  liquor  is  still  hot,  dissolve  in  it 
fix  pounds  of  refined  sugar.  Continue  the  evaporation,  if  necessary, 
till  the  addition  of  the  tincture  first  obtained  will  make  three  gallons, 
riieii  add  the  tincture. 

A  valuable  antacid  and  laxative  in  diarrhoea,  dysentery,  cholera 
morbus,  and  summer  complaint  of  children.  Dose,  for  an  adult,  a 
tablespoonful,  to  be  taken  as  circumstances  require. 

Compound  Syrup  of  Sarsaparilla.  —  Take  a  i)ound  each  of  sarsa- 
parilla,  yellow  parilla,  and  pipsissewa;  an  ounce  and  a  half  of  guaia- 
cum  ;  one  ounce  each  of  red  roses,  senna,  and  liquorice  root ;  and 
three  minims  each  of  oil  of  sassafVas,  anise,  and  partridge-berry ;  di- 
luted alcohol,  five  pints,  and  four  pounds  of  refined  sugar.  Grind 
and  mix  the  sarsaparilla,  yellow  parilla,  pipsissewa,  guaiacum,  roses, 
senna,  and  liquorice,  and  add  to  them  the  alcohol.  Let  the  whole 
stand  fourteen  days ;  then  express  and  filter.  Evaporate  by  a  water 
bath  to  one  quart,  and  add  the  sugar.  Lastly,  rub  the  oils  in  a  mor- 
tar with  a  little  of  the  syrup,  and  thoroughly  mix  with  the  remainder. 

This  is  a  valuable  alterative  syrup,  and  is  used  for  syphilis,  scrofula, 
diseases  of  the  skin,  etc.  It  is  much  improved  by  adding  half  an 
ounce  of  the  iodide  of  potassium  to  each  pint  of  the  syrup.  Dose,  a 
tablespoonful. 

Compound  Aromatic  Syrup  of  Senna.  —  Take  four  ounces  of  senna, 
one  ounce  and  a  half  of  jalap  root,  half  an  ounce  of  rhubarb,  one 
dram  of  cinnamon,  one  dram  of  cloves,  and  half  a  dram  of  nutmeg. 
Reduce  these  articles  to  a  coarse  powder ;  add  one  quart  of  diluted 
alcohol.  Let  ♦^he  whole  stand  two  days,  and  percolate.  Filter,  dis- 
solve in  it  ouv  pound  of  refined  sugar,  and  add  one  dram  of  oil  of 
lemons. 

An  excellent  cordial  physic. 

Compound  Syrup  of  StiUing:ia.  —  Take  a  pound  each  of  queen's 
root  and  turkey  corn ;  half  a  pound  each  of  pipsissewa  leaves  and 
elder  flowers  ;  and  four  ounces  each  of  prickly  ash  berries  and  carda- 
mom seeds.  Grind  all  the  articles,  mix,  and  place  them  in  ajar,  and 
moisten  them  well  with  alcohol.  Let  them  stand  two  days ;  then 
place  them  in  a  percolator,  and  gradually  add  hot  water  till  two  pints 
are  obtained,  ■  hich  must  be  strained  and  set  aside.  Then  continue 
the  percolatioii  so  long  as  there  is  a  sensible  taste  of  the  spirit  Re- 
serve this  also.  Then  continue  the  percolation  till  what  is  obtained 
is  almost  tasteless.  Boil  down  this  last  till  the  addition  of  the  two 
reserved  tinctures  will  make  two  gallons  of  the  whole.  Now  add 
twelve  pounds  of  refined  sugar,  and  make  a  syrup. 


i 


m 


I 


688 


MEDICINES  AND  THEIR  PREPARATIONS. 


Thia  is  one  of  the  Eclectic  medicines ;  and  is  quite  an  effectivu 
alterative  for  syphilis,  scrofula,  etc.  Improved  by  adding  iodide  of 
potassium.     Dose,  from  a  teaspoonful  to  a  tablespoonful. 

Componnil  Syrnp  of  Yellow  Dock.  —  Take  two  pounds  of  yellow 
dock- root,  one  pound  of  the  bark  of  the  root  of  false  bittersweet,  and 
half  a  pound  each  of  American  ivy  and  figwort.  Make  a  syrup  ac- 
cording to  the  directions  for  compound  syrnp  of  stillingia,  using  six- 
teen pounds  of  sugar,  and  making  two  gallons  of  syrup. 

A  valuable  preparation  for  scrofula.  Improved  by  iodide  of  potas- 
sium.    Dose,  a  tablespoonful,  three  or  four  times  a  day. 

Tinctures. 

Fon  a  description  of  the  method  of  making  tinctures,  see  page  588, 
I  will  simply  add  here,  that  an  ethereal  tincture  is  one  which  is  made 
with  ether  as  the  solvent  instead  of  alcohol,  and  an  amtnonialed  tine 
ture,  one  made  with  water  of  ammonia  as  the  soivenr, 

Simple  tinctures,  in  which  only  one  medicinal  article  is  used,  are 
made  thus : 

Tincture  of  Aconite.  —  Take  eight  ounces  of  powdered  aconite  root, 
and  one  pint  of  alcohol.  Mix,  and  let  them  stand  for  two  weeks,  fre- 
quently stiiring.     Then  express,  and  filter  through  paper. 

Given  in  fevers  and  inflammatory  diseases.  Dose,  three  drops 
every  hour  or  two  in  a  little  water. 

In  the  above  manner  all  simple  tinctures  are  made.  Some  medi- 
cines require  alcohol  to  extract  their  active  principle ;  some  only 
diluted  alcohol. 

One  Onnce  to  the  Pint  of  Alcohol.  —  In  preparing  simple  tinctures 
from  the  following  articles,  alcohol  is  used,  and  one  ounce  only  of  the 
medicine  is  employed  to  the  pint,  namely : 

Castor,  Saflron,  Leptandria. 

One  Onnce  to  the  Pint  of  Diluted  Alcohol.  —  In  making  tinctures 
from  the  following  articles,  one  ounce  is  used  to  the  pint  of  diluted 
alcohol : 

Iodine,  Quassia.  j 

Two  Ounces  to  a  Pint  of  Alcohol  t 

AssafoBtida,  Camphor,  Oil  of  i'eppermint.  Oil  of  Speatmint,  Ben- 
zoin, Colchicum  seeds,  Lupulin. 

Two  Ounces  to  a  Pint  of  Diluted  Alcoiiol : 

Cardamom,  Cotton  Bark,  Cochineal,  Colombo,  Colchicum,  Ergot, 
Galls,  Hemlock,  Cubebs,  Foxglove,  Black  Hellebore,  Henbane,  Lactu- 
carium.  Lobelia,  Poke,  Shrubby  Trefoil,  Bloodroot,  Squill,  Valerian, 
Bittersweet,  Belladonna. 

Three  Ounces  to  a  Pint  of  Diluted  Alcohol : 

Peruvian  Bark,  Rhatany,  Poison  Hemlock,  Sheep  Laurel,  Stramo- 
nium, White  Hellebore,  Yarrow,  Prickly  Elder,  Jalap. 


r:^.;ftiirVs.'..'L'.?hiv:- 


MEDICINES  AND  THEIR  PREPARATIONS. 


an  effective 
ig  itJdide  of 


Is  of  yellow 

erswcet,  and 

a  syrup  ac- 

la,  using  nh- 

dc  of  potns- 


ee  page  «58B, 
lich  is  made 
onialed  tine- 
is  used,  are 


aconite  root, 

0  weeks,  fre- 

tRree  drops 

Some  medi- 
Bome  only 

pie  tinctures 

1  only  of  the 


»  tinctures 
of  diluted 


trmint,  Ben 


um.  Ergot 

ane,  Lactu- 

,  Valerian, 


■el,  StramO' 


Four  Oniices  to  n  Pint  of  Alcohol : 

Nux  Vomica,  Ginger,  Guaiacum,  Black  Cohosh 

Four  Ounces  to  ti  Pint  of  Dilut.'d  Alcoliol: 

Yellow  Jessamine,  Frickly-ash  Berries,  Ergot,  Matico. 

The  following  tinctures  embrace  those  which  vary  from  the  above 
proportions  among  the  simple  tinctures,  and  also  the  compound  tinc- 
tures : 

Tincture  of  Orange  Peel.  —  Take  three  and  a  half  ounces  of  dried 
orange  peel,  and  one  quart  of  diluted  alcohol.  Macerate  for  seven 
ilays,  express  and  filter. 

Tincture  of  Bnclia.  —  Take  five  ounces  of  buchu,  and  one  quart  ot 
diluted  alcohol.     Digest  seven  days ;  pour  off  the  clear  liquor,  and 

eiter. 

Tincture  of  Indian  Hemp.  —  Take  of  extract  of  Indian  Hemp 
(Cannabis  Indica)  one  ounce,  and  one  pint  of  alcohol.  Dissolve  tht 
extract  in  the  spirit     Dose,  from  twenty  to  forty  drops. 

Tincture  of  Cantharides.  —  Take  an  ounce  of  bruised  Spanish  flies, 
and  two  pints  of  diluted  alcohol.  Macerate  for  fourteen  days,  express 
and  filter  through  paper. 

Dose,  from  twenty  drops  to  a  dram,  three  or  four  times  a  day. 

Tincture  of  Cayenne  Pepper.  —  Take  an  ounce  of  pulverized  cay- 
enne, and  two  pints  of  diluted  alcohol.  Macerate  fourteen  days,  and 
filter  through  paper. 

Tiuctnre  of  Catc<;liu.  —  Take  an  ounce  and  a  half  of  catechu,  an 
ounce  of  bruised  cinnamon,  and  one  pint  of  diluted  alcohol.  Let 
them  stand  together  two  weeks,  frequently  shaking ;  then  express  and 
filter.  V 

Dose,  from  thirty  drops  to  a  tablespoonful. 

Tincture  of  Cinnamon.  —  Take  an  ounce  and  a  half  of  powdered 
cinnamon,  and  one  pint  of  diluted  alcohol.  Let  them  stand  together 
for  two  weeks ;  express  and  filter. 

Dose,  from  one  to  four  teaspoonfuls  in  sweetened  water. 

Elixir  Vitriol.  —  Take  half  a  pint  of  alcohol;  drop  into  it  seven 
fluid  drams  of  sulphuric  acid,  and  let  the  mixture  stand  three  days  in 
a  close  vessel ;  then  add  two  drams  of  powdered  ginger,  and  three 
drams  of  powdered  cinnamon.     Macerate  seven  days,  and  filter. 

Useful  in  diarrhoea,  dysentery,  etc.  Dose,  from  five  to  twenty  drops 
To  avoid  injury  to  the  teeth,  it  should  be  take-i  through  a  quill,  or  else 
the  mouth  should  be  rinsed  immediately  after  swallowing  it. 


Tincture  of  Lobelia.  —  Take  four  ounces  of  lobelia,  and  one  pint 
each  of  distilled  vinegar  and  alcohol.  Macerate  two  weeks,  express 
and  iilter. 

Dose,  as  a  nauseant  or  expectorant,  from  thirty  to  sixty  drops. 

Tincture  of  Opium  (Laudanum).  —  Take  two  and  a  half  ounces  of 


'•*1 


'V^^tfWk^ 


cgu 


MEDICINES  AND  THEIU  PREPARATIONS. 


opium,  and  two  pints  of  diluted  alcohol.  Macerate  fourteen  days, 
express,  and  filter  through  paper.  Dose,  from  ten  to  twenty -five 
dropy. 

Tincture  of  Tolu. —  Dissolve  one  ounce  of  Balsam  of  tolu  in  ono 
pint  of  alcohol,  and  filter. 

Tiiictnre  of  Rliubnrb.  —  Take  three  ounces  of  bruised  rhubarb,  half 
an  ounce  of  bruised  cardamom,  and  a  quart  of  diluted  alcohol.  Mac- 
erate two  weeks,  express,  and  filter  through  paper. 

Tincture  of  Vlrfpinia  Snake  Root. —  Take  three  ounces  of  bruised 
Virginia  snake  root,  and  one  quart  of  diluted  alcohol.  Macerate  two 
weeks,  express,  and  filter  through  paper. 

This  is  advantageously  added  to  the  infusion  of  Peruvian  bark,  in 
low  states  of  the  system.     Dose,  one  to  two  fluid  drams. 

Compound  Tincture  of  Aloes.  -^  Take  three  ounces  of  powdered 
aloes,  one  ounce  of  saffron,  and  two  pints  of  tincture  of  myrrh.  Mac- 
erate fourteen  days,  and  filter. 

This  is  the  well  known  elixir  proprietatis,  or,  more  commonly,  c/iirtr 
pro.  It  is  considerably  used  in  female  disorders,  connected  with  sup- 
pressed, retained,  or  deficient  menstruation.  Dose,  one -to  two  fluid 
drams. 

Compound  Tincture  of  Assafoe^da.  — ^ake  half  an  ounce  each  of 
lupulin,  assafcetida,  in  small  pieces,  bruieed  stramonium  seeds,  pow- 
dered valerian  root,  and  one  pint  and  a  half  of  alcohol ;  macerate  two 
weeks,  shaking  frequently,  then  express  and  filter. 

This  is  anodyne  and  antispasmodic,  and  is  used  in  epilepsy,  St 
Vitus's  dance,  and  hysterics.     Dose,  a  teaspoonful. 

Compound  Tincture  of  Benzoin.  —  Take  three  ounces  of  benzoin, 
two  ounces  of  purified  storax,  one  ounce  of  balsam  of  tolu,  half  an 
ounce  of  powdered  aloes,  and  two  pints  of  alcohol.  Macerate  two 
weeks,  and  filter. 

This  is  used  in  chronic  dbeases  of  the  air  passages.  Dose,  from 
thirty  to  sixty  drops. 

Compound  Tincture  of  Cardamom.  —  Take  six  drams  of  bruised 
cardamom,  two  ounces  of  bruised  caraway,  five  drams  of  bruised 
cinnamon,  five  ounces  of  seeded  raisins,  one  dram  of  bruised  cochi- 
neal, and  two  pints  and  a  half  of  diluted  alcohol.  Macerate  two 
weeks,  and  filter. 

This  is  a  very  agreeable  aromatic;  used  as  a  carminative,  and  to 
improve  other  preparations.     Dose,  one  or  two  fluid  drams. 

Compound  Tincture  of  Catechu.  —  Take  three  ounces  of  catechu, 
two  ounces  of  bruised  cinnamon,  and  two  pints  of  diluted  alcohol. 
Macerate  fourteen  days,  express  and  filter. 

This  is  frequently  added  to  chalk  preparations  for  diarrhoea,  etc. 
Dose,  from  one  to  three  fluid  drams. 

Compound  Tincture  of  Cinnamon. — Take  one  ounce  of  bruised  cin- 
na)tion,  half  an  ounce  of  bruised  cardamom  seeds,  three  drams  of 


arteen  days, 
twenty-five 

tolu  in  onn 


hubarb,  half 
ohol.     Mac- 


Si  of  bruised 
lacerate  two 

rian  bark,  in 


)f  powdered 
lyrrh.     Mac- 

monly,  elixtr 
ed  with  sup- 
to  two  fluid 


ince  each  of 

seeds,  pow- 

nacerate  two 

epilepsy,  8t 

of  benzoin, 
tolu,  half  an 
lacerate  two 

Dose,  from 

9  of  bruised 
i  of  bruitied 
•uised  cochi- 
Acerate  two 

itive,  and  to 

18. 

of  catechu, 
ited  alcohol. 

iarrhcea,  etc. 

bruised  cin- 
ee  drams  of 


HEDICIMKS  AND  THEIR  PREPARATIONS. 


691 


bruised  ginger,  and  two  pints  of  proof  spirits.     Macerate  fourteen 
days,  expn*88,  and  filter. 
This  is  a  warnn,  arom 
the  stomach. 


aromatic  tincture,  useful  in  spasms,  and  debility  of 
Dose,  one  to  two  fluid  drams. 

Compound  Tincture  of  Black  Cohosh.  —  Take  one  fluid  ounce  of 
tincture  of  black  cohosh,  half  a  fluid  ounce  of  tincture  of  bloodroot, 
and  two  fluid  drams  of  tincture  of  poke  root.     Mix. 

This  is  used  in  diseases  uf  the  lungs,  liver,  and  stomach.  Dose, 
from  twenty  to  sixty  drops,  three  or  four  times  a  day. 

Compound  Tincture  of  Blue  Cohoslh — Take  one  ounce  of  powdered 
blue  cohosh  root,  half  an  ounce  each  of  bruised  water  |>epper  and 
ergot,  two  fluid  drams  of  oil  of  savin,  and  twelve  fluid  ounces  of 
alcohol ;  mix,  macerate  for  a  fortnight,  and  filter. 

A  uterine  tonic,  used  for  suppressed  and  painfu.  menstruation,  etc. 
Dose,  a  teaspoonful,  two  or  three  times  a  day. 

Compound  Tincture  of  Colchicum. —  Mix  one  fluid  ounce  each  of 
tincture  of  black  cohosh  and  tincture  of  colcnicum  seed. 

U«ed  for  inflammatory  rheumatism  and  gout.  Dose,  ten  to  sixty 
drops. 

Compound  Tincture  of  Gentian.  —  Take  two  ounces  of  bruised 
gentian,  one  ounce  of  orange  ptel,  half  an  ounce  of  bruised  carda- 
mom seeds,  and  two  pints  of  diluted  alcohol.  Macerate  fourteen 
days,  express,  and  filter. 

An  elegant  bitter,  much  used  in  dyspepsia,  and  as  an  addition  to 
tonic  mixtures  for  a  weakened  state  of  the  stomach.  Dose,  one  or 
two  fluid  drams. 

Compound  Tincture  of  Golden  Seal.  —  Take  one  ounce  each  of 
powdered  lobelia  seed  and  golden  seal,  and  one  pint  of  diluted  alco- 
hol.    Macerate  two  weeks,  express,  and  filter. 

This  is  used  as  a  local  application  to  diseased  mucous  membranes, 
in  leucorrhoea,  gleet,  etc. 

Animoniated  Tincture  of  Gualac.  —  Take  four  ounces  of  powdered 
guaiac,  and  a  pint  and  a  half  of  aromatic  spirits  of  ammonia.  Mac- 
erate for  two  weeks,  and  filter. 

This  tincture  has  considerable  reputation  in  the  treatment  of  chronic 
rheumatism.     Dose,  one  or  two  fluid  drams. 

Compound  Tincture  of  Hemlock  ( Golden  Tincture).  —  Take  one 
ounce  each  of  powdered  balsam  of  tolu,  guaiacum,  gum  hemlock, 
and  gum  myrrh,  one  ounce  and  a  half  of  oil  of  hemlock,  one  ounce 
of  oil  of  winter  green,  and  four  pints  of  alcohol.  Mix,  let  them 
stand  fourteen  days,  shaking  frequently,  then  filter. 

This  is  used  by  the  Eclectics  for  rheumatism,  wind  colic,  water 
brash,  soreness  of  the  chesti  etc  Dose,  a  teaspoonful  in  a  wineglass* 
ful  of  water. 

Compound  Tincture  of  High  Cranberry.  —  Take  one  ounce  of  high 
cranberry  bark,  powdered,  half  an  ounce  each  of  powdered  lobelia 
seed  and  bruised  skunk  cabbage  seed,  two  drams  eaph  of  bruised 


^ 


692 


MEDICINES  AND  THXIR  PREPARATIONS. 


ftramoniuin  oecd,  powdered  bloodroot,  and  captiioum,  and  two  piiita 
of  alcohol.     Macerate  two  weeks,  express,  and  filter. 

This  id  an  Eclectic  remedy,  and  is  iweful  in  nervous  and  spnHmodir 
complaints,  particularly  hysterics,  etc.  Dose,  from  twenty  drops  to  a 
tcaspoonfui. 

Compound  Tincture  of  Lavender.  —  Take  three  fluid  drams  of  oil 
of  lavender,  one  dram  and  a  half  of  oil  of  anise,  one  ounce  of  pow- 
dered cloves,  three  drams  of  mace,  one  ounce  of  raininH,  two  ounces 
of  red  Saunders,  and  one  gallon  of  Jamaica  runt.  Mix,  and  maccrata 
fourteen  days ;  then  express  and  filter. 

This  is  often  used  for  flatulence,  hysterica,  and  faintness.  Dose, 
from  one  to  three  teaspoonfulu,  in  water. 

Compound  Tincture  of  Lobelia  {Dr.  J.  King's  Expectorant  Tincture). 
—  Tfke  one  ounce  each  of  coarsely  powdered  lobelia,  bloodroot,  skunk 
cabbage,  wild  ginger,  and  pleurisy  root.  Place  them  in  a  vessel,  and 
pour  over  them  one  pint  of  boiling  water  or  vinegar,  and  rover  tiyliiiy. 
When  cold,  add  three  pints  of  alcohol.  Macerate  two  weeks,  then 
express  aiid  filter. 

A  valuable  emetic  for  infants  and  children,  in  croup,  hooping-cough, 
bronchitis,  and  convulsions.  Used  also  as  an  expectorant,  in  coughs, 
pleurisy,  etc.  Dose,  as  an  emetic  for  a  child,  half  a  teaspoonful  and 
upwards. 

Compound  Tincture  of  Lobelia  ond  Capsicum.  —  Take  one  ounce 
each  of  powdered  lobelia,  capsicum,  and  skunk  cabbage,  and  one  pint 
of  diluted  alcohol.     Mix,  macerate  fourteen  days,  and  filter. 

A  prompt  antispasmodic  in  cramps,  spasms,  lock-jaw,  etc.  Dose, 
half  a  dram  to  a  dram. 

Compound  Tincture  of  RIjTrli  (Hot  Drops).  —  Take  four  ounces  o^ 
bruised  myrrh,  two  ounces  of  capsicum,  and  four  pints  of  nlcoho) 
Mix,  macerate  a  fortnight,  and  filter. 

Applied  externally,  and  occasionally  given  internally  for  distresB  d 
stomach,  flatulence,  etc. 

Camphorated  Tincture  of  Opium.  —  Take  one  dram  each  of  pow 
dered  opium  and  benzoic  acid,  one  fluid  dram  of  oil  of  anise,  twO' 
ounces  of  clarified  honey,  two  scruples  of  camphor,  and  two  pints  ol 
diluted  alcohol.     Macerate  fourteen  days,  and  filter. 

This  is  known  to  all  the  world  as  paregoric  elixir.  It  is  an  agree* 
able  anodyne  and  antispasmodic,  and  a  good  deal  ustvi  among  chil- 
dren to  allay  cough,  and  to  relieve  pains,  diarrhoea,  ere. 

Compound  Tincture  of  Pemvlan  Bark.  —  Take  two  oe».nces  of  red 
bark,  powdered,  one  ounce  and  a  half  of  bruised  orange  peel,  three 
drams  of  bruised  Virginia  snake-root,  one  dram  each  of  saffiron,  cut, 
and  red  saunders,  rasped,  and  twenty  fluid  ounces  of  diluted  alcohoL 
Macerate  two  weeks,  express,  and  filter. 

This  ia  Hvxham's  tincture.  It  is  an  excellent  stoinach  cordial  and 
is  used  with  advantage  in  low  forms  of  fever,  etc  Dose,  from  oi>e  to 
four  fluid  drams. 


id  two  pinta 

id  spnHmodir 
ty  dropd  to  a 

dramw  of  oil 
nice  of  povr- 
,  two  ounces 
kiid  macerate 

:ncHa.     Dose, 

m/  Tincture). 
)droot,  akunk 
a  vessel,  and 
fovcr  ti^liily. 
weeks,  then 

oping-cough, 
it,  in  coughs, 
tpoonful  and 


i  one  ounce 

and  one  pint 

\er. 

,  etc.     Dose, 

ar  ounces  o^ 
of  flicoho) 

>r  distresH  oi 


ach  of  pow 
f  anise,  tw* 
two  pints  ol 

is  an  agree 
among  chil* 


ir\ces  of  red 
;  peel,  three 
sai^on,  cut, 
ted  alcohol 

cordial  and 
from  oi^e  to 


UEDICINRS  AND  TIIKIR  PREPARATIONS. 


«93 


Compound  Tincture  of  RliubHrb  {Sweet  Tincture  of  Rhubarb).^ 
Take  two  ounces  and  u  half  of  bruised  rhnharl),  six  draniH  of  bruised 
liquorice  root,  three  drams  each  of  bruise  ginger  and  satl'ron,  two 
ounces  of  refined  sugar,  and  one  quart  of  uimted  alcohol.  Macerate 
one  week,  express,  and  filter. 

A  warm,  gentle  aperient,  weF  fitted  for  debilitated  states  of  the 
■toniach.     Dose,  from  a  dram  or  two  to  an  ounce. 

Tincture  of  Senna  and  Jalap  (Elixir  Sa/ulis).  —  Take  three  ounces 
of  senna,  one  ounce  of  powdered  jalap,  half  an  ounce  each  of  bruiHed 
coriander  and  caraway  seeds,  two  drams  of  uruised  cardamom  seeds, 
four  ounces  of  sugar,  and  three  pints  of  diluted  alcohol.  Macerate 
two  weeks,  express,  and  filter. 

This  is  a  warm  cordial  purgative,  useful  in  costiveness,  and  gout 
attended  w'.lh  debility.     Dose,  two  fluid  drams  to  an  ounce. 

Compound  llncture  of  Tamarac  {Bone's  Bitters).  —  Take  three 
ounces  each  of  tamarac  bark  and  juniper  berries,  two  ounces  of 
prickly-ash  bark,  one  ounce  and  a  half  each  of  wild-cherry  bark  and 
seneca  snake-root,  and  half  an  ounce  of  tansy  ;  powder  coarsely,  and 
mix ;  then  add  one  pint  and  a  half  of  whiskey,  and  let  them  stand 
twenty-fou"  hours ;  then  place  the  whole  in  a  vapor  displacement 
apparatus,  md  force  through  the  mixture,  the  vapor  of  another  pint 
of  whiskey,  after  which,  steam  from  water  enough  to  make  the  tinc- 
ture equal  to  six  quarts.  To  this  add  twelve  ounces  of  molasses,  and 
six  drams  of  thoroughly  dissolved  alcoholic  extract  of  mandrake. 

This  is  tonic,  diuretic,  and  aperient.  Useful  in  dyspepsia,  etc. 
Dose,  a  tablespoonful  three  times  a  day. 

Ammoniated  Tincture  of  Valerian.  —  Take  four  oances  of  bruised 
valerian,  and  one  quart  of  aromatic  spirit  of  ammonia.  Macerate 
two  weeks,  express,  and  filter. 

This  is  used  as  an  antispasmodic  in  hysterics,  and  other  nervous 
diseases.     Dose,  one  or  two  fluid  drams,  in  sweetened  water. 

Compound  Tincture  of  Tirg^inla  Snake-root  {Sudorific  Tincture). — 
Take  eight  scruples  each,  in  coarse  powder,  of  Virginia  snake-root, 
ipecacuanha,  safiron,  opium,  and  camphor,  and  one  pint  of  Holland 
gin,  or  proof  spirit.     Mix,  macerate  two  weeks,  express,  and  filter. 

This  tincture  tends  powerfully  to  induce  perspiration,  and  is  used 
for  such  purpose  when  it  is  desirab'e  to  procure  sleep,  etc.  Dose,  from 
ten  drops  to  a  teaspoonful,  every  hour  or  two,  in  catnip  or  balm  tea. 

Vinegars. 

Tine^rar  of  Lobelia.  —  Take  two  ounces  of  powdered  lobelia  seed, 
"■.nd  one  pint  of  distilled  vinegar.  Macerate  in  a  close  vessel  one 
week ;  then  express  and  filter,  and  add  one  fluid  ounce  of  alcohol. 

This  is  useful  as  an  emetic  and  expectorant ;  externally,  it  is  val- 
uable in  skin  diseases.  Dose,  one  to  four  teaspoonfuls.  as  often  as 
necessary. 


■y^ 


694 


MEDICINES  AND  THEIR  PREPARATIONS. 


Vinegar  of  Squill. —  Take  two  ounces  of  sliced  squill,  and  one  pint 
of  distilled  vinegar ;  macerate  in  a  close  glass  vessel  one  week  ;  then 
express,  strain,  and  add  one  Huid  ounce  of  alcohol. 

This  is  expectorant  and  diuretic,  and  is  sometimes  used  for  coughs, 
and  diseases  of  the  chest 


,        Miscellaneous. 

The  recipes  of  a  few  popular' proprietary  medicines  are  given  here 
merely  as  matters  of  curiosity. 

Brrilidreth's  Pills.  —  Take  two  pounds  of  aloes,  one  pound  of  gam- 
boge, four  ounces  of  extract  of  colocynth,  half  a  pound  of  castile  s<oap, 
two  fluid  drams  of  oil  of  peppermint,  and  one  fluid  dram  of  cinna- 
mon.    Mix,  and  form  into  pills. 

Brown's  Bronchial  Troches.  —  Take  one  pound  of  pulverized  ex- 
tract of  liquorice,  one  and  a  half  pounds  of  pulverized  sugar,  four 
ounces  of  pulverized  cubebs,  four  ounces  of  pulverized  gum  arable, 
and  one  ounce  of  pulverized  extract  of  conium.     Mix. 

Haulier's  Red  Drop.  —  Take  ten  grains  of  corrosive  sublimate, 
twelve  drops  of  muriatic  acid,  and  one  fluid  ounce  of  compound 
spirits  of  lavender.  Dose,  five  to  twenty  drops  in  water,  or  white 
wine,  sufficient  to  produce  one  evacuation  daily^  but  not  over  two. 

Ayer's  Cherry  Pectoral.  —  Take  four  grains  of  acetate  of  n)orphia, 
two  fluid  drams  of  tincture  of  bloodroot,  three  fluid  drams  each  of 
antimonial  wine  and  wine  of  ipecacuanha,  and  three  fluid  ounces  of 
syrup  of  wild  cherry.     Mix. 

Hackenzte's  Ointment — Take  four  ounces  of  powdered  sulphate 
of  zinc,  one  ounce  and  a  half  of  tar,  and  one  pint  of  lard  ;  mix,  and 
boil  slowly  one  hour,  stirring  all  the  time. 

For  tetter,  scald  head,  and  other  diseases  of  the  skin.  To  be  ap- 
plied twice  a  day,  washing  the  part  with  castile  soap-suds  daily. 

Wood's  Hair  Restorative.  —  Ta!ie  four  drams  of  lac  sulphur,  two 
drams  of  sugar  of  lead,  and  one  pint  of  rose  water.     Mix. 

Frey's  Vermifuge.  —  Take  one  ounce  of  castor  oil,  one  ounce  of 
aromatic  syrup  of  rhubarb,  thirty  drops  of  oil  of  chenopodium,  five 
drops  of  croton  oil.     Mix. 

Conclilin's  Salve. — Take  twelve  ounces  of  resin,  and  one  ounce  each 
of  beeswax,  mutton,  and  tallow ;  melt  together,  strain,  and  work  into 
rolls  in  cold  water. 


CANKER. 


695 


ind  one  pint 
week ;  then 

I  for  coughs. 


e  given  here 

ind  of  gam- 
;astile  jsoap, 
in  of  cinna* 

Iverized  ex- 
sugar,  four 
fum  arabic, 

sublimate, 
compound 

r,  or  white 

ver  two. 

)f  morphia, 

ns  each  of 

ounces  of 

id  sulphate 
;  mix,  and 

To  be  ap- 
iaily. 

Iphur,  two 

ounce  of 
>dium,  five 

Junce  each 
work  into 


Canker.  —  Aptha  Communis, 

Very  few,  if  any,  standard  medical  writers  have  treated  of  canker. 
In  truth,  it  is  only  a  symptom  of  various  complaints,  and  not  itself  a 
disease.  It  has  accordingly  been  shut  out  from  medical  books.  Fol- 
lowing the  general  practice,  I  omitted  it  in  this  v/ork.  I  now  regret 
the  omission,  and  place  it  here  at  the  end.  It  afflicts  —  ye»,  afflicts 
—  sorely  afflicts,  numerous  persons,  who,  though  doubtless  affected  by 
some  constitutional  disturbance,  as  its  cause,  are  not  conscious  of 
any  complaint  except  this  single  manifestation  —  Canker.  You  find 
not  only  the  disease,  therefore,  but  complaints  respecting  it,  in  almost 
everybody's  mouth  — "  What  shall  I  do  for  the  canker,?  "  meets  us  at 
almost  every  turn.  "  I  am  sorely  afflicted  with  the  canker,"  says  one. 
'*  I  am  literally  sick  with  the  canker,"  says  another.  Aiid  a  third  says, 
"  I  can  neither  eat,  nor  converse,  nor  take  rest,  I  am  in  such  pain  from 
canker  in  my  mouth."  And  these  complaints  are  not  unnatural,  for 
the  sufferings  occasioned  by  this  affection  are  indeed  terrible. 

Canker  begins  in  the  torm  of  small  blisters,  generally  upon  the 
tongue,  or  inside  of  the  cheeks  or  lips,  which,  after  a  time,  break  and 
form  little  ulcers,  which  are  oftentimes  very  sore  and  painful.  These 
ulcers  will,  at  times,  not  only  multiply,  but  spread  themselves  to  large 
dimensions,  going  deep  into  the  flesh,  and  becoming  painful  almost 
beyond  endurance.  In  many  cases,  the  parts  swell,  and  become  so 
sensitive  and  tender  that  it  is  almost  impossible  to  swallow  the 
blandest  food.  The  mouth  will  frequently  become  filled  with  saliva, 
which  runs  involuntarily  out,  to  the  great  annoyance  of  the  patient 

Trenfineilt. —  C-.nker  is  frequently  dependent  on  a  deranged  state 
of  the  stomach  and  bowels.  When  this  is  the  case,  the  treatment 
may  begin  with  a  dose  of  gentle  physic  (12),  (15),  (19),  (26).  If  the 
stomach  be  quite  permanently  deranged,  let  this  be  followed  with  a 
somewhat  prolonged  use  of  prescription  No.  28,  or  37,  or  of  the  Neu- 
tralizing Cordial.  If  the  mouth  be  very  sore,  use  a  tea  of  slippery 
elm  bark,  or  flax-seed,  or  a  solution  of  gum  arabic;  and  as  the  in- 
flammation subsides,  touch  the  ulcerated  patches  with  the  stick  nitrate 
of  silver  (lunar  caustic) ;  or  use  gargle  No.  201,  or  202,  or  203,  or 
205,  or  20H,  or  209,  or  232,  or  243,  or  244,  or  sulphate  of  copper  8 
grains,  dissolved  in  two  ozs.  of  water.  A  tea  made  of  red  raspberry 
leaves,  or  blackberry  roots,  may  be  freely  used  as  a  drink. 

One  of  the  best  remedies  is  creosote.  About  ten  drops  may  be 
mixed  with  an  ounce  of  mucilage  of  gum  arabic,  well  sweetened 
with  loaf  sugar.  Of  this,  a  dessert  spoonful  may  be  held  for  a  few 
moments  in  the  mouth,  and  then  swallowed,  from  two  to  four  times 
a  day.  Recipe  205  is  r»ot  only  useful  as  a  gargle,  but  may  be  re- 
duced by  adding  one  pint  of  water,  and  may  then  be  swallowed  four 
or  five  times  a  day,  in  doses  of  two  tablespoonfuls  at  a  time. 

The  diet  should  always  be  carefully  regulated,  and  only  the  more 
simple  food  taken,  and  at  regular  meals. 


Diphtheria*  —  DijMheritis. 


During  the  past  year  the  public  heart  has  been  impressed,  and 
public  fears  extensively  excited,  by  a  new  epidemic  and  contagious 
cl:se<ise,  called  diplUheria  —  from  a  Greek  word  signifying  «Art/}.  I 
siiy  new  disease,  for  it  has  been  stated  that  as  late  as  20  years  ago, 
no  medical  practitioner,  either  in  England  or  America,  had  any  per- 
sonal knowledge  or  experience  respecting  it. 

Yet  the  disease  had  existed  in  other  countries,  at  periods  of  time 
more  or  less  widely  separated,  from  quite  a  remote  antiquity.  Are- 
teeus  is  thought  to  have  described  it  as  early  as  the  second  century. 
Spain,  Italy,  and  Sicily  felt  its  ravages  in  the  sixteenth  and  seven- 
teenth centuries,  and  England,  France,  Gormiuiy,  Holland,  Italy, 
Sweden,  and  the  United  States  about  the  midtile  of  the  eighteenth 
century ;  after  which  it  seems  to  have  disappcvrjred,  and  been  little 
heard  of  till  quite  recently,  —  so  that  the  present  generation  of 
physicians  have  to  meet  it  as  a  new  diricase. 

Diphtheria  is  evidently  a  contagious  epidemic.  It  would  not,  per- 
haps, be  far  out  of  the  way,  to  call  it  by  either  of  the  following  names: 
Epidemic  Croup,  Malignant  Croup,  Contagious  Croup.  Though 
originating,  it  is  thought,  in  certain  atmospheric  conditions,  it  shows  a 
remarkable  affinity  for  particular  localities,  and  exhibits  spefial  malig- 
nity and  fatality  in  individual  families.  Some  have  thoui^.a.  it  to  be 
caused  by  the  parasitic  fungus  called  oidium  albicans,  which,  fasten- 
ing upon  the  mucous  membrane  of  the  throat,  causes  the  exudation 
of  matter,  which  hardens,  with  the  fungus,  into  a  skin,  or  membrane. 
Those  who  hold  this  view,  consider  the  contagiousness  of  the  disease 
to  consist  in  the  passage  of  the  fungus  from  one  person  to  another. 

Symptoms. —  The  incipient  stage  of  diphtheria  is  generally  only  a 
slight  feeling  of  illness  lasting  for  a  few  days,  more  or  less,  before  the 
more  serious  attack.  Sometimes  during  "his  period  of  indispositioa, 
there  is  slight  drowsiness  or  chilliness,  followed  by  feverishness ; 
sometimes  headache  and  aching  of  the  limbs.  Generally,  one  of  the 
first  things  complained  of  is  a  little  stiffness  or  soreness  of  the  neck, 
with  a  pricking  sensation  about  the  roots  of  the  tongue.  An  almost 
characteristic  symptom  is  a  slightly  swollen  and  tender  condition  of 
the  glands  at  the  angles  of  the  lower  jaw.  The  tonsils,  one  or  both, 
are  usually  red  and  swollen, —  sometimes  swollen,  but  not  red.  In 
young  children  the  redness  is  of  the  rose-color;  in  older  children  and 
adults,  of  a  crimson  or  deep  p'iarlet.  The  uvula,  the  velum,  the 
arches  of  the  palate,  and  the  back  wall  of  the  pharynx,  gt^ierally 
show  the  inHammation.  Swallowing,  though  painful  sometimes,  is 
often  easy  enough,  even  to  the  end  of  bad  cases.  The  pulse  is 
usually  quickened  somewhat,  and  the  warmth  of  the  skin  is  raised  a 
little,  tliough  not  greatly,  above  the  healthy  standard. 

in  some  cases,  the  above  symptoms  constitute  the  whole  of  the 
complaint —  recovery  taking  place  without  serious  consequences.  In 
others,  they  are  but  the  begitming  of  more  alarming  indications.     In 


sssed,  and 
contagious 
ig  skin.  I 
years  ago, 
d  any  per- 

ds  of  time 
ity.  Are- 
id  century. 
,nd  seven- 
tnd,  Italy, 
eighteenth 
been  little 
eration   of 

d  not,  per- 
iig  names: 
Though 
it  show?*  a 
■iiil  maiig- 
iit.  it  to  be 
eh,  fasten- 
exudation 
nembrane. 
he  disease 
mother. 

y  only  a 

before  the 
position, 

erishness ; 

)ne  of  the 

;he  neck, 

n  almost 

ndition  of 
or  both, 
red.  In 
dren  and 
lum,  the 
^Mierally 

etimes,  ie 
pulse  is 
raised  a 

e  of  the 
nces.  In 
ions.     In 


DIPHTHERIA. 


697 


such  instances  they  are  followed  by  the  exudation  upon  the  surface 
of  fibrinous  matter,  which  hardens  into  a  leathery  membrane.  This 
membrane,  if  not  broken  up  and  removed,  grows  thicker  and  stronger 
by  additions  to  its  under  surface,  until  it  obstructs  the  breathing 
and  strangles  the  patirp.t.  The  exudation  first  shows  itself  upon  the 
tonsils,  or  some  neighboring  part,  in  the  form  of  white,  gray,  or  ash- 
colored  specks  or  patches,  which  gradually  enlarge  or  spread  until  they 
meet  and  form  one  continuous  pellicle.  This  membrane  sometimes 
extends  into  neighborini^  parts,  as  the  back  passages  to  the  nose,  and 
the  larynx,  wind-pipe,  bronchial  tubes,  and  gullet.  These  extensions 
make  the  case  all  the  more  dangerous  and  unmanageable.  1  may  add 
that  there  is  great  difiVrence  in  the  time  occupied  by  diflerent  caj^es 
in  running  their  jourse,  —  some  reaching  a  climax  only  after  several 
days'  continuance,  while  others  dash  on  to  a  fatal  termination  in  the 
brief  space  of  a  few  hours. 

Tretitilient. —  Blisters,  and  bleeding,  and  severe  purging,  and  what- 
ever else  may  tend  to  reduce  the  system,  are  to  be  carefully  and 
always  avoided.  They  invariably  do  mischief.  The  disease  itself 
generally  has  a  strangely  depressing  efliect  upon  the  vital  powers. 
Never  add  to  this  depression  by  any  exhaustive  treatment. 

Subxtancen  are  in  use,  mentioned  below,  to  Avhich  a  specific  action 
upon  the  diphtheritic  mucous  membrane  is  attributed,  either  disin- 
fectant or  parasiticidul.  The  parasiticidal  action  is  bused  upon  the 
undeinonstrated  parasitic  nature  of  the  disease ;  the  disinfectant 
notion  is,  in  most  instances,  chiefly  a  deodorizing  one,  though  a 
cleansing  one  also,  which  is  of  the  greatest  importance  for  the  com- 
fort of  the  patient  and  for  the  greater  safety  of  his  attendants. 
Those  substances  are  employed  in  the  dry  or  liquid  form,  by  insuf- 
flation or  by  inhalation,  —  in  the  latter  instance  several  times  a  day. 
The  remedy  to  be  especially  commended  is  common  sublimed  sul- 
phur, to  '  _  'sed  every  four  to  six  hours,  by  being  blown  through 
a  long  quill  upon  the  aflfected  parts,  and  allowed  to  remain  for  at 
least  a  half  hour,  without  being  disturbed  by  food,  drink,  or  gargles. 

This  use  of  sulphur  has  many  warm  advocates  ;  it  is  harmless,  and 
cannot  interfe-e  with  the  action  of  most  other  remedies  likely  to  be 
employed. 

Gargles  p.re  often  used  with  great  advantage.  The  following  is 
Cflfcellent:  Chlorinated  soda,  one  ounce;  muriatic  tincture  of  iron, 
half  an  ounce;  water,  six  ounces;  use  every  half  hour  or  hour.  The 
following  is  also  a  good  gargle:  Chlorate  of  potash,  half  an  ounce; 
ijtrong  hydrochloric  acid,  eighty  drops ;  water,  one  pint.  One  prac- 
titioner speaks  of  obtaining  great  success  by  the  use  of  the  tincture 
of  black  cohosh,  mixed  with  an  equal  quantity  of  water,  and  em- 
ployed, every  few  minutes,  in  two  teaspoonful  doses,  as  a  gargle.  Its 
use  should  begin  at  a  very  early  stage  of  the  disease. 

The  internal  treatment  should  consist  mainly  of  antiseptics  and 
tonics.    The  muriatic  tincture  of  iron  is  highly  praised  in  this  disease, 
as  well  for  internal  use  as  for  external.     Prescription  73  is  a  suitable 
88 


% 


, 


\     ' 


698 


DU'HTHERIA. 


form  ill  which  to  talte  it.  If  rose-water  is  not  at  band,  soft  waler 
may  be  substituted.  If  there  be  offensive  breath,  and  a  tendi-ncy  to 
rotting  of  the  tonsils,  a  littie  chlorinated  soda,  or  chlorate  of  polat^h, 
may  be  added  to  the  above:  one  or  the  other  of  these  two  last-named 
articles  may  sometimes  be  taken  alone.  The  following  is  a  good 
recipe  :  Pulv.  guaiacum,  two  drams;  pulv,  gum  arabic,  one-half  dram  ; 
pulv.  white  sugar,  one  dram;  water,  six  ounces:  mix,  and  then  add 
chlorate  of  potash  one-half Ndram.  Let  two  great  spoonluls  of  this 
be  taken  once  in  two  hours.  The  same  dose  may  be  taken,  with 
siiuilar  frequency,  of  tlie  following:  Chlorate  of  potash,  one  ('ram; 
diluted  hydrochloric  acid,  two  drams;  muriatic  tincture  of  iron,  three 
drams;  water,  twelve  ounces;  mix.  This  mixture  may  also  be  used 
as  a  gargle.  Should  there  be  great  depression  and  sinking,  —  as  there 
often  is,  —  carbonate  of  ammonia  may  be  taken,  or  muriate  of  am- 
monia (134),  or  aromatic  spirit  of  ammonia,  prescription  135,  leaving 
out  the  laudanum.  Brandy  and  wines  are  often  used  with  advan- 
tage. In  cases  of  great  depression,  if  there  be  a  tendency  to  the 
formation  of  purple  spots  upon  the  flesh,  add  ten  to  fifteen  drops  of 
hydrochloric  acid  to  each  dose  of  prescription  73.  The  following  pre- 
scription is  likewise  a  useful  one  :  Quinine,  diluted  hydioc  hloric  aeid, 
and  rnuriated  tincture  of  iron,  each  two  drams  ;  cinnamon  water, 
twelve  ounces;  mix..  Dose,  two  great  spoonfuls  three  times  a  day, 
Or  the  following:  Muriated  tincture  of  iron,  one  ounce;  diluted 
hydrochloric  acid,  two  drams;  cinnamon  water,  twelve  ounces.  Mix, 
and  take  two  table-spoonfuls  every  four  hours. 

The  diet  should  generally  consist  of  that  which  is  nourishing  and 
easily  digested,  —  as  beef-tea,  chicken-broth,  eggs,  with  wine,  new 
milk,  arrowroot,  cream,  etc.  As  recovery  advances,  beefsteak,  lamb, 
chicken,  etc.,  may  be  taken.  Many  patients  die  of  pure  debility.  Let 
the  diet,  therefore,  be  such  as  to  guard  against  such  a  termination  of 
the  complaint.  Let  all  drinks  be  given  warm,  as  cold  drinks  tend  to 
aggravate  the  complaint. 

-  When  recovery  begins  to  take  place,  use  all  possible  precautions 
against  a  relapse.  Let  exercise  taken  at  this  time  be  gentle,  and 
not  pushed  to  the  extent  of  great  fatigue.  The  blood  is  generally 
reduced  so  low,  that  sudden  death  may  result  from  overdoing. 

Especially,  let  all  cases  of  this  complaint  receive  early  attention. 
Throat  ails,  generally,  while  diphtheria  is  abroad,  should  have  prompt 
and  careful  treatment,  and  if  possible,  be  removed,  lor  their  preseucM 
invites  an  attack. 


Liid,  soft  waler 
a  tnidfiicy  to 
'ute  of  poliiyh, 
wo  last-natiiccl 
iiig  iri  a  good 
;)iu'-lialf  dram; 
and  llicn  add 
)oi)luls  of  this 
bf  laki'ii,  wiih 
«li,  one  f'ram ; 
;  of  iron,  three 
y  alho  be  used 
iiig,  —  as  there 
luriaic  of  am- 
m  135,  leaving 
d  with  advan- 
iidency  to  the 
iftcen  drops  of 
following  pre- 
liO(  hloric  acid, 
namon  water, 
a  times  a  day. 
)unce;  diluted 
ounces.     Mix, 

nuritshing  and 
th  wine,  new 
efsteak,  lamb, 
debility.  Let 
erriii  nation  of 
Jrinks  tend  to 

B  precautions 
e  gentle,  and 
is   generally 
loing. 

riy  attention, 
have  prompt 
heir  pret>eucM 


OLD  AGE,  AND  ITS  DISEASES. 


Life,  iJke  the  natural  day,  has  its  morning,  its  noon,  and  its  even- 
ing. Each  period  has  its  sunshine  and  its  clouds ;  its  light  and  its 
darkness ;  its  fuir  weather  and  its  storms ;  its  joys  and  its  sorrows. 
The  old  do  not  feel  the  exhilarating  brightness  of  the  morning  of  life, 
nor  the  fer  id  strength  of  its  noon  ;  but  they  often  experience  what  is 
better:  a  calm,  quiet  stillness,  and  peaceful  repose,  in  its  evening. 

There  is,  perhaps,  no  one  thing — certainly  not  many  things  — 
which  impress  the  reflective  mind  and  tender  heart  with  more  sad- 
ness, than  to  see  an  old  man,  bending  low  with  years,  with  little  or  no 
self-restraint;  the  passions  all  untamed,  except  so  far  as  age  has 
quenched  their  fires  ;  fretful,  peevish,  jealous,  complaining  ;  distrustful 
of  the  ways  of  Providence;  doubting  the  integrity  of  any  human 
being;  surrounded  by  clouds  and  darkness  ;  and  stepping  down  grad- 
ually and  reluctantly,  amid  a  cold,  drizly,  sleety,  moral  rain,  into  a  dark, 
uncheered,  and  unillumined  grave. 

On  the  other  hand,  how  unspeakably  pleasant  it  is  to  see  the  silver- 
haired  pilgrim,  in  the  evening  time  of  life,  cheerful,  happy,  trustful  in 
God  and  hopeful  of  men ;  the  winds  and  storms  of  life  bringing  little 
or  no  disturbance  of  his  peace  ;  bareing  the  head  reverently  and  bow- 
ing it  meekly  in  the  presence  of  great  afflictions,  and  lifting  it  up 
rejoicingly  when  blessitigs  fall  upon  it ;  converting,  by  the  soft,  sub- 
dued, and  beautiful  sunshine  which  he  spreads  around  him,  the  very 
unpromising  elements  of  the  latest  autumn  into  the  finest  Indian 
summer  of  life ;  and  finally  sinking  down  peacefully  to  his  rest  amid 
the  golden  evening  sunlight,  and  leaving  the  sky,  long  after,  tinted 
with  colorings  more  beautiful  than  artists  ever  conceived. 

"  Why  weep  ye,  then,  for  him  who,  having  won 
1  he  bound  of  man's  appointed  years,  at  last,  — 
Life's  blessings  all  enjoyed,  life's  labors  done,  — 

Serenely  to  his  final  rest  has  passed  : 
While  the  soft  memory  of  his  virtues  yet 
Lingers,  like  twilight  hues  when  the  bright  son  is  sot  ?  " 

Beside  these  general  reflections,  it  is  proper  in  this  chapter  to  con- 
template the  old  from  several  points  of  view. 

They  are  Experienced  Persons,  and  we  may  learn  much  from  Iht-nt. 
To  be  sure,  they  have,  in  moat  cases,  lost  the  acuteness  of  their 


r  ; 


senses.  They  do  not  hear,  or  see,  or  taste  as  sharply  as  the  young, 
or  even  always  think  as  quickly ;  yet  their  judgments  are  founded  on 
a  large  experience  ;  their  decisions,  though  not  as  prompt,  or  emphatic, 
or  brilliant  as  those  of  younger  persons,  are  more  safe  and  reliable. 
They  are  worthy,  therefore,  of  our  respectful  confidence.  We  may 
seek  their  council  and  advice,  and  in  most  cases  follow  it  with  safety. 
True,  they  are  apt  to  be  conservative,  and  to  distrust  new  things  and 
ideas  ;  but  these  new  things  and  ideas  are  matters  in  which  they  have 
had  no  experience  —  matters  which  belong  to  an  age  subsequent  to 
tlieir  time  —  matters,  therefore,  which  lie  outside  the  sweep  of  their 
active  life,  and  respecting  which  they  should  not  be  expected  to  judge. 
It  is  no  disparagement  to  them  to  say  that  they  are  not  fitted  to  judge 
of  those  new  thoughts  and  discoveries  which  have  swarmed  upon  the 
world  since  the  sun  of  their  life  has  been  sinking  low  in  the  western 
sky.  But  in  all  those  staple  maxims  and  ideas  which  underlie  human 
duties,  in  all  ages,  the  old  may  safely  be  taken  as  our  counsellors. 

Depositories  of  Family  History.  —  They  are  the  frail  depositories 
and  keepers  of  a  vast  deal  of  valuable  family  history,  anecdote,  and 
reminiscences  of  events  fast  fading  from  human  recollection.  Few 
errors  of  my  own  early  life  have  been  so  much  regretted  by  me  as  the 
neglect  to  learn  from  my  aged  relatives,  when  I  had  the  opportunity, 
some  of  the  more  important  points  in  the  history  of  my  family.  My 
grandfather,  CoL  Gideon  Warren,  —  a  first  cousin  of  Gen.  Joseph 
Warren,  and  a  personal  friend  of  Ethan  Allen,  —  lived  in  some  of  the 
towns  of  southern  Vermont,  and  finally  spent  his  last  days,  and  died, 
in  Hampton,  N.  Y.  There  stands  his  tombstone  to  this  day,  with 
the  following  beautiful  words  from  Young's  Night  Thoughts  engraved 


upon  it : 


"  An  angel'i  arm  can't  snatch  me  from  the  erave ; 
Legioiu  of  angela  can't  confine  me  there. 


These  few  facts  are  about  the  substance  of  what  I  know  of  his  his- 
tory. In  what  town  his  father  settled,  who  was  one  of  three  brothers 
who  immigrated  to  this  country,  or  who  were  his  brothers  and  sisters, 
or  what  became  of  them,  I  have  not  been  informed,  simply  becau-^e 
I  did  not  obtain  the  information,  now  so  much  desired  by  me,  as  1 
might  easily  have  done,  between  thirty  and  forty  years  ago,  while 
spending  a  year  in  Hampton  fitting  for  college.  An  uncle  of  uiim-, 
Caleb  Warren,  was  then  living  in  Hampton,  an  old  man.  He  had 
learned  from  my  grandfather  the  full  history  of  the  family  ;  and  from 
him  I  might  have  derived  knowledge  which  I  should  now  value  above 
price  —  knowledge  which  I  intend  yet  to  acquire,  if  the  pressure  of 
professional  business  shall  ever  be  so  lifted  from  me  that  I  can  com- 
mand time  for  the  investigation.  But  I  shall  never  cease  to  remember 
the  fact,  or  to  lament  my  misimprovement  of  it,  that  from  this  vener- 
able relative  I  might  hare  learned  facts  and  put  them  on  record  in  one 
hour,  which  it  will  cost  me  weeks  and  months  of  correspondence, 
iaravel,  and  the  Bearc,hir>g  of  fecords  to  acquire  I  say  to  all  young 
persons,  value  very  highly  the  knowledge  of  your  family  history,  which 


<■ 


y  as  the  young, 
are  founded  on 
pt,  or  emphatic, 
fe  and  reliable, 
nee.  We  may 
V  it  with  safety. 
new  things  and 
vhich  they  have 
subsequent  to 
sweep  of  their 
)ected  to  judge. 
t  fitted  to  judge 
irmed  upon  the 
in  the  western 
inderlie  human 
counsellors. 

lil  depositories 
,  anecdote,  and 
•lleotion.  Few 
d  by  me  as  the 
le  opportunity, 
y  family.  My 
»f  Gen.  Joseph 
in  some  of  the 
lays,  and  died, 
this  day,  with 
ighta  engraved 


low  of  his  his- 
three  brothers 
era  and  sisters, 
limply  because 
2(1  by  me,  as  1 
irs  ago,  while 
ancle  of  mini', 
nan.     He  bad 
ily  ;  and  from 
V  value  above 
e  pressure  of 
at  I  can  com- 
f  to  remember 
>m  this  vener- 
record  in  one 
rrespondence, 
to  all  young 
listory,  which 


OLD  AGE,  ANP  ITS  DISEASES. 


701 


you  may  easily  learn  from  your  parents,  grandparents,  uncles  and 
aunts,  etc.,  and  esteem  those  very  highly  who  are  able  to  impart  it  to 
you.  Soon  these  living  records  will  be  suddenly  blotted  by  the  hand 
of  death  ;  and  then  no  regret  for  past  negligence  will  enable  you  to 
repair  your  loss,  if  you  have  misimproved  your  opportunity. 

The  Fathers  of  our  Race  and  the  Founders  of  onr  Institutions. — 

The  aged  people  who  yet  linger  among  us  are  our  fathers.  We 
have  our  existence,  through  God,  from  them,  and  from  others  who 
have  preceded  them  to  the  silent  land.  They  educated  the  present 
race.  All  that  is  valuable  in  the  moral  principle  and  mental  culture 
of  the  men  and  women  of  thi»  generation,  has  been  derived  from 
them.  Much  of  their  lives  was  spent  in  training  us,  mentally  and 
morally,  and  fitting  us  for  usefulness. 

Not  only  the  fine  moral  and  intellectual  characters  which  are  found 
everywhere,  acting  like  salt  and  leaven  in  human  society,  are  the  work 
of  their  hands,  but  society,  and  government  itself,  have  been  handed 
down  to  us  by  them,  with  much  valuable  instruction  as  to  the  means 
of  their  preservation.  We  can  scarcely  conceive  the  amount  of  obli- 
^  It  ion  our  fathers  have  laid  upon  us  in  giving  us  these  vast  blessings, 
'i'iie  men  who  have  been  the  means  of  bringing  us  into  life  ;  who  have 
educated  and  trained  us;  who  have  preserved  our  government  and 
|)iissi'd  it  into  our  hands  unbroken  ;  who  have  built  and  enlarged  our 
colleges,  established  and  improved  our  unequalled  common  schools ; 
ii  ive  founded  and  endowed  our  charitable  institutions,  and  thus  made 
our  land  famous  throughout  the  world,  are  certainly  worthy  —  those 
of  them  who  are  yet  among  us  —  of  our  constant  regard  and  ven- 
eration. 

Loneliness  of  the  Aged.  —  The  old  are  left,  in  some  sense,  alone  in 
the  world.  The  age  in  which  they  had  their  active  being  has  gone 
by.  The  world  has  slid  from  under  them ;  and  they  stand  far  out,  as 
it  were,  on  a  narrow  neck  of  land  between  this  world  and  the  next, 
from  which  they  hear  strange  sounds  coming  to  them  from  the  moving 
mass  of  beings  of  whom  they  are  soon  to  take  leave.  Most  of  the 
companions  with  whom  they  started  in  the  journey  of  life  have,  one 
by  one,  dropped  away  from  their  side,  and  the  younger  and  stirring 
multitude  who  have  come  after  them,  are  moved  by  new,  and  to  them 
strange,  thoughts  and  aspirations.  The  tj^rong  of  younger  men  is 
driven  forward  by  impulses  which  they  never  felt,  and  in  paths  which 
they  never  trod.  Manners,  speech,  dress,  modes  of  doing  business  — 
all  have  changed.  The  old-fashioned  fire-place,  the  stage-coach,  the 
spinning-wheel,  the  hand-loom,  the  polite  yes  sir,  and  no  madam,  the 
boy's  bow  and  the  girl's  courtesy  to  strangers  in  the  street,  —  these 
all  —  some  of  them  useful  and  some  of  no  further  value  —  have  dis. 
appeared,  never  more  to  be  enjoyed  by  those  who  so  much  prized 
them  in  their  day. 

What  wonder  if  at  iiiues  a  seiiue  of  loiieliiieiid  and  desolation 
thould  steal  into  the  minds  of  the  aged  ?    It  is  not  without  cause 


.• ,  I 


702 


OLD  AOE,  AND  ITS  DISEASES. 


that  they  often  yield  to  melancholy  reflections.  The  young  have  their 
companions,  and  their  Bports.  The  companions  of  the  old  have  mostly 
gone ;  and  for  sports  they  have  no  agility.  Cut  off  from  the  present, 
they  are  thrown  upon  the  past,  and  too  oft«n  look  gloomily  to  the 
future.  They  Hhould  be  sympathized  with  and  encouraged.  We 
should  sit  by  their  side,  and  talk  with  them  of  the  manners  and  eventa 
of  other  days.  Their  conversation  is  often  instructive  as  well  a? 
amusing.  Would  we  engage  in  it  with  right  feelings  towards  the 
old,  it  would  be  to  us  a  source  both  of  profit  and  pleasure.  To  a 
right-minded  person,  few  things  are  more  pleasurable  than  to  sit  by 
intelligent  aged  persons,  cozify  seated  in  a  large  armed-chair,  and 
listen  to  their  tales  of  personal  adventure  and  experience.  They 
enter  upon  such  narratives  with  so  much  animation,  and  live  over 
the  past  with  such  evident  satisfaction,  that  the  benevolent  person 
would  find  pleasure  in  engaging  them  in  that  conversation  for  this 
reason  alone. 

Helpless  Dependence  of  the  Aged.  —  No  one  thing  should  tend  more 
to  excite  our  pity,  compassion,  and  kindly  feelings  for  old  people,  than 
their  helplessness  and  dependence.  It  is  one  of  the  best  indications 
of  humanity  to  deal  gently  with  the  weak.  The  old  are  in  their 
second  childhood.  In  their  day,  they  have  been  strong  and  vigorous 
—  laboring,  many  of  them,  in  season  and  out  of  season,  to  support 
their  families  and  gain  a  competence.  They  have  felled  the  primitive 
forests,  and  brought  the  soil  under  the  dominion  of  the  plough  and 
hoe ;  they  have  constructed  turnpikes  and  built  bridges  ;  made  ships 
and  sailed  them  over  stormy  seas ,  whitened  every  harbor  with  the 
emblems  of  commerce ;  filled  every  city  with  the  beautiful  creations 
of  art,  and  the  useful  productions  of  mechanical  handicraft ;  created 
systems  of  education  and  philanthropy;  framed  strong  governments 
and  worked  them, —  in  a  word,  have  carried  the  world  upon  their 
shoulders,  without  bending  or  giving  tokens  of  exhaustion.  But  a 
multitude  of  years  have  robbed  them  of  the  strength  which  did  all 
these  things.  They  now  totter  like  a  young  child.  The  brain  which 
conceived  and  the  arm  which  executed,  are  alike  feeble.  How  proper 
that  much  which  is  kindly  should  nov  Je  done  for  those  who  have 
done  so  much  for  us  and  for  the  world !  Oh,  let  the  old  have  a  warm 
place  in  the  affections!  Supply,  as  far  as  possible,  all  their  wants. 
Go  with  them,  in  spirit,  into  the  shadows  of  evening,  within  which 
they  are  retiring,  and  there  hold  them  up.  Be  a  staff  to  them  in 
their  weakness ;  and,  if  it  be  possible,  when  the  shades  deepen  around 
them,  lift  the  curtains  of  the  future,  and  let  in  upon  them,  though 
it  be  never  so  few,  some  rays  of  light  from  the  heavenly  world. 

From  these  general  remarks,  I  pass  to  consider  — 


The  Ohangea  oeoiirring  in  Advasced  Life. 

Growth,  maturity,  and  decline  are  the  three  periods  which  divide 
and  measure  human  life. 


I 


aung  have  their 
)ld  have  mostly 
om  the  present, 
gloomily  to  the 
iouraged.  We 
iiers  and  events 
ive  as  well  as 
J9  towards  the 
leasure.     To  a 

than  to  sit  by 
iied-chair,  anJi 
irience.     They 

and  live  over 
evolent  person 
aation  for  this 

»uld  tend  more 
d  people,  than 
;8t  indications 
d  are  in  their 

and  vigorous 
5n,  to  support 

the  primitive 
e  plough  and 

;  made  ships 
rbor  with  the 
tiful  creations 
craft;  created 
■  governments 
Id  upon  their 
stion.  But  a 
which  did  all 
2  brain  which 

How  proper 
we  who  have 
have  a  warm 

their  wants, 
within  which 
r  to  them  in 
sepen  around 
hem,  though 
world. 


which  divide 


« 


During  growth,  the  deposit  of  new  matter  takes  place  more  rap- 
idly than  the  decay  or  waste  which  is  also  going  on. 

During  healthy  maturity,  waste  and  increase  are  exactly  equal, 
the  one  taking  place  just  as  rapidly  as  the  other. 

The  decline  of  old  age  reverses  the  order  of  growth,  and  waste 
autstripa  addition.  The  newly  deposited  matter  comes,  but  not  so 
rapidly  as  the  old  is  cast  away. 

Declining;  Age  may  be  said  to  extend  from  fifty  to  sixty. 

Incipient  Old  Ag^e  from  sixty  to  seventy. 

Ripe  Old  Ajfe  from  seventy  to  eighty. 

Decrepitude  or  Second  Infancy  from  eighty  to  the  end  of  life. 

During  all  these  periods,  particularly  during  the  latter,  important 
structural  and  other  changes  are  occurring  in  the  human  system. 
Piles,  apoplexy,  paralysis,  diseases  of  the  liver,  kidneys,  and  bladder, 
with  organic  changes  of  the  heart,  dropsy,  chronic  affections  of  the 
breathing  organs,  gout,  eta,  frequently  appear. 

No  fear  of  Death.  —  It  is  a  wise  and  merciful  provision  of  Provi 
dence,  that  as  old  age  advances,  and  the  natural  end  of  life  draws 
near,  the  dread  of  death  diminishes.  As  the  aged  gradually  lose 
their  hold  upon  life,  they  do  so  with  less  and  less  reluctance,  until 
finally  they  let  go  willingly,  and  part  from  it  even  with  joy.  Persons 
passing  from  life  at  the  age  of  eighty  or  upwards,  generally  look 
forward  to  death  with  more  of  pleasure  than  of  fear.  It  is  one  good 
reason  why  it  is  desirable  to  live  to  great  age,  that  life  may  come  to 
a  close  without  those  harrassing  fears  which  so  many  dread. 


Preservation  of  Old  People's  Health. 

It  is  proper  here  to  speak  of  the  hygiene  of  old  age,  or  the  means  of 
preserving"  aged  people's  health. 

It  IS  natural  to  desire  a  continuance  of  life;  and  except  in  the  case 
of  the  extremely  old,  there  is  a  genera!  wish  for  its  prolongation. 
Those  who  are  born  of  parents  who  have  lived  long,  are  more  likely 
to  attain  length  of  days  than  those  who  have  descended  from  short- 
lived ancestors;  yet  the  influence  of  correct  habits  may  add  quite  as 
many  years  to  their  lives. 

Rejpnlnr  Habits.  —  The  old  feel  the  evil  influence  of  irregular  habits 
much  more  than  the  young.  It  is  seldom  that  any  change  of  habit 
long  indulged,  is  well  borne  by  the  aged.  So  true  is  this,  that  the  at- 
tempt to  correct  some  habits  of  evil  tendency  is  sometimes  danger- 
ous to  the  old  BO  much  have  they  lost  the  power  of  adapting 
themselves  to  o.hnnffe.  Thn  <1i«continu»nce  of  the  habitual  use  of 
spirit,  or  tobacco,  or  opium  by  an  old  person,  —  though  the  use  of 
either  is  of  acknowledged  evil  tendency,  will  frequently  prove  fatal. 
It  is  almost  necessary  that  the  habits  ol'  the  aged  should  remain  as 


.r, 


•A- 


■I 


704 


OLD  AOE,  AND  ITS  DI8EA8ER. 


they  are.     What  an  impressive  lesson  this  fact  sives  the  yoang  on 
the  neccHtiity  of  forming  good  habits  in  early  life ! 

Even  the  hours  of  taking  meals  should  not  be  changed  in  the 
decline  of  life.  Removing  to  new  climates,  and  forming  new  social 
relations  by  thotie  advanced  in  years,  is  not  favorable  to  length  of 
days.  Okl  trees  do  not  often  take  root  and  live  long  when  transferred 
to  a  new  soil. 

Diet.  —  The  food  of  old  people  should  of  course  be  easy  of  diges- 
tion. It  is  often  the  case  that  they  bear  made  dishes  such  as  "  hash," 
so  called,  better  than  plain  boiled  or  roasted  meat.  This  can  only  be 
explained  on  the  ground  that  the  meat  is  chopped  fine,  and  id  more 
thoroughly  cooked. 

node  of  Cookinjic  meats.  —  This  leads  me  to  speak  of  the  best 
methods  of  cooking  meats  so  that  they  may  be  tender. 

The  Hesh  of  all  warm-blooded  animals  is  identical  in  composition 
with  that  of  human  beings.  That  the  flesh  of  animals  used  as  food, 
therefore,  may  form  flesh  in  the  human  body  in  the  easiest  manner, 
none  of  its  essential  constituents  or  parts  should  be  taken  from  it 
during  the  process  of  cooking.  If  any  one  of  its  constituents  is 
extracted,  it  will  no  longer  be  like  human  flesh ;  and  that  lost  part 
will  have  to  be  resupplied  before  it  can  become  a  part  of  the  frame  of 
man. 

Flesh  is  composed  of  two  parts  —  that  which  can  be  dissolved,  and 
that  which  cannot.  The  separation  between  these  two  parts  is  more 
or  less  completely  effected  in  boiling  according  to  the  amount  of  water 
used,  and  the  length  of  time  employed  in  the  process. 

In  making  soup,  we  have  no  objection  to  a  separation  between  the 
hard  and  juicy  parts  of  the  meat,  because  the  latter  passes  into  the 
water  and  helps  form  the  soup.  Hence  the  proper  way  is  to  put  the 
meat  into  cold  water  when  it  is  put  over  the  fire,  and  let  it  come  to 
the  boiling  point  very  gradually ;  during  which  time  the  juicy  part 
has  a  chance  to  dissolve  out,  and,  uniting  with  the  water,  make  rich 
soup. 

But  when  the  meat  is  to  be  boiled  simply,  and  eat  as  boiled  meat, 
we  should  aim  to  retain  the  juice  within  it,  that  we  may  retain  the 
whole  of  it.  To  do  this,  we  must  put  the  meat  into  water  which  is 
briskly  boiling  over  the  fire.  The  juice  of  the  meat  contains  a  large 
quantity  of  albumen,  a  substance  just  like  the  white  of  egg ;  a  id 
putting  the  meat  suddenly  into  boiling  water  almost  instantly  hardens 
this  albumea  all  around  the  surface,  just  as  boiling  water  hardens 
white  of  egg,  and  this  prevents  all  the  jui  ^e  of  the  inner  portion  of 
the  meat  from  running  out  into  the  water  i* ad  being  lost.  Keep  the 
meat  in  the  briskly-boiling  water  a  few  minutes,  then  pour  in  a  little 
cold  water  to  reduce  the  temperature  slightly,  and  keep  it  in  this  some- 
what reduced  temperature  until  it  is  done  tl  'ough. 

Broiling  and  roasting  are   pretty  generally  understood,  and  are 
done  well  enough  where  persons  are  disposed  to  take  pains.     Frying 
is  an  abomination  ;  and  should  be  banished  from  all  civilized  house 
holds. 


fca:ij.k;3vtii  fi   ■  1  rif-iiMMaB^B^jiiff^jj^giiff 


f,J^jy^mHjl 


the  yonng  on 

laiiged  in  the 

ig  new  Hocial 

to  length  of 

leii  transft'rred 


easy  of  digox- 
ch  as  «  hiiHh," 
is  can  only  be 
,  and  id  more 

of  the   best 

1  composition 
used  as  food, 
siest  manner, 
;aken  from  it 
onstituents  is 
that  lost  part 
the  frame  of 

lissolved,  and 
ports  is  more 
uunt  of  water 

between  the 
*ses  into  the 
is  to  put  the 
it  it  come  to 
le  juicy  part 
ir,  make  rich 

boiled  meat, 
»y  retain  the 
Iter  which  is 
taina  a  large 
)f  egg;  aid 
ntly  hardens 
ater  hardens 
T  portion  of 
i:.  Keep  the 
ur  in  a  little 
in  this  some- 
ad,  and  are 
ns.  Frying 
ized  house 


OLD  AGE,  AND  ITR  DISEASES. 


705 


Milk  is  an  excellent  article  of  diet  for  old  persons.  Except  in  somo 
few  cases  where  it  disagrees  with  the  Htomach,  it  is  among  the  very 
i)cst.  Sometimes,  when  it  disagrees  with  ii  weak  stomuch,  n  little  linuv 
water  added  to  it  will  make  all  right.  Artiticiiil  ass'  milk,  which  will 
generally  set  well  on  aged  people's  stomachs,  may  be  nmde  by  dis' 
.solving  one  ounce  of  pulverized  sugar  of  milk  in  one  pint  of  skinmicd 
cow's  milk. 

Potatoes,  beets,  carrots,  parsnips,  and  asparagus  are  healthful ;  peas, 
beans,  cabbages,  etc.,  had  better  not  bo  largely  indulged  in. 

Ripe  Fruits,  taken  in  moderation,  are  useful ;  but  should  bo  eaten 
at  meal  time,  not  l)etween  meals.  Anjong  the.o,  ripe  apples,  i)ears, 
peaches,  plums,  8trawl)erries,  currants,  and  grapes  are  luxuries  in 
wliich  not  even  the  oldest  persons  need  fear  to  indulge  to  a  roasoU'' 
able  extent. 

Plain  Pnddings  and  Pies  are  not  entirely  objectionable  ;  but  all  rich 
and  high-seasoned  articles  of  pastry  should  be  strictly  rejected  by  the 
old,  as  they  should,  in  fact,  by  all  classes. 

Wine,  etc.  — If  any  persons  in  the  world  may  indulge  in  a  little 
wine  for  their  stomach's  sake,  it  is  the  old.  But  even  they,  if  they 
have  not  been  accustomed  to  its  use,  often  get  along  very  well  without 
it ;  and  when  they  can  do  so  it  is  better,  for  various  reasons,  especially 
that  their  example  may  have  a  good  influence  with  others.  When  the 
feel)lo  vitality  of  the  aged  seems  to  require  it,  especially  if  they  have 
been  in  the  habit  of  leaning  upon  it,  they  should  be  encouraged  to 
use  it.  And  if  they  chance  to  be  poor,  and  cannot  procure  it  them- 
selves, for  friends  to  withhold  it  from  them  on  the  ground  of  economy, 
or  from  the  feeling  of  grudging  stinginess,  is  nothing  less  than  inhu- 
manity and  cruelty. 

To  these  remarks  upon  diet,  I  add  :  the  old  should  never  eat  to 
excess  or  repletion.  They  should  eat  slowly,  and  chew  their  food  very 
thoroughly. 

Susceptibility  to  Cold.  — Aged  people  suffer  very  much  from  cold 
hands  and  feet,  and,  indeed,  from  languid  circulation  and  low  tem- 
perature generally.  The  heart,  like  all  their  other  muscles,  has 
i)ecome  feeble,  and  sends  the  blood  very  lazily  along  the  arteries. 
The  clothing  of  the  old  should  be  thicker  and  warmer  than  that  ot 
younger  people.  We  must  prevent  the  escape  of  what  little  animal 
heat  there  is  by  flannel  worn  next  to  the  skin,  and  by  woollen  clothes 
jrenerally  —  they  being  bad  conductors  of  heat.  Unless  very  fleshy, 
they  seldom  suffer  from  heat,  even  when  their  flannels  are  continued 
through  the  summer. 

It  is  during  winter  nights  that  the  old  are  apt  to  suffer  most  from 
cold.  On  going  to  bed,  therefore,  they  should  be  warm  ;  and  in  very 
cold  nights  should  have  a  heated  stone,  or  a  bottle  filled  with  hot 
water,  at  iheir  feet.  The  comr^''nication  of  animal  heat,  particularly 
Horn  the  young,  is  better  even  man  this  to  support  the  vital  energies 
and  some  tvriters  have  recommended  that  the  vital  warmth 
89 


01  age 


'  ^ 


ru6 


OLD  AQK,  AND  ITS   DISKASES. 


of  the  old  sliould  be  kept  up  by  letting  the  young  of  our  own  Mpccits 
sleep  with  them.  Tlie  liunmnity  of  thin  suggcHtion  is  very  (picslion. 
able.  The  aged  would  doubth>i<s  be  benefited  by  Huch  u  proct'odiiif^ ; 
i)ut  tlie  young  would  bo  injured.  Whatever  vitality  Hliould  be  giiininl 
by  one  would  be  lost  by  the  other.  While  a  few  might  be  added  to 
the  limited  days  of  the  aged,  many  would  be  (piite  as  likely  to  he 
Kwbtracted  from  those  of  the  young.  I  would  much  sooner  recom- 
mend that  old  people  attach  to  themselves,  and  take  to  their  bed,  an 
allectionato,  clean,  and  silkon-huired  English  terrier  dog.  Such  mi 
animal,  usually  as  clean  as  a  child,  would  impart  warmth  and  vitality 
iit  night,  and  be  a  true,  afi'ectionate,  and  an  amusing  companion 
(lining  many  a  lonely  hour  of  the  day.  Whatever  may  bo  said 
against  this  recommendation,  —  and  of  course  some  over-nice  peoi>!e 
will  object,  —  I  insist  that  it  is  in  every  sense  far  more  proper  than 
the  expedient  adopted  with  King  David,  when  he  "  was  old  and 
stricken  in  years,"  and  after  "they  covered  him  with  clothes,  but  ho 
gat  no  heat."     (1  Kings  i,  1.) 

Mortality  in  Cold  Weatlier.  —  Far  more  of  the  old  people  die  in 
winter  than  in  summer,  or,  indeed,  in  any  other  season.  For  this 
reason,  old  people  should  be  very  careful  how  they  expose  themselves 
during  the  coldest  days  of  the  winter. 

If  there  be  any  change  which  the  old  are  likely  to  bear  with  im- 
punity or  advantage,  it  is  from  a  cold  to  a  warm  climate  in  their  hitter 
years.  The  wealthy  Romans,  when  they  grew  old,  were  taken  to 
Naples. 

Care  of  the  Skin.  —  Attention  to  the  skin,  always  important  to 
health,  is  very  essentially  so  in  the  latter  years  of  life.  The  scarf- 
skin  of  the  old  tends  to  become  dry,  and  peel  off.  This  may  bo  pre- 
vented in  a  great  measure  by  regular  washing  with  tepid  water,  and 
rubbing.  If  the  bath  cannot  be  endured,  not  oven  the  sponge-bath,  let 
friction  alone  be  employed.  For  friction,  either  the  naked  hand,  a  piece 
of  flannel,  or  the  flosh-brush  may  be  used.  In  rubbing  the  belly,  the 
band  should  follow  the  course  of  the  large  bowel ;  that  is,  in  the 
region  of  the  stomach  pass  across  from  right  to  left,  down  on  the  left, 
iicross  on  the  lower  parts  of  the  bowels,  up  on  the  right,  etc.  By 
this  method,  constipation  and  a  windy  condition  of  the  stomach  and 
bowels  may  frequently  be  removed,  or  rendered  less  distressing. 

Exercise.  —  Always  impoiiant,  in  all  periods  of  life,  exercise  does 
not  lose  its  advantages  in  old  age.  But  the  aged  should  always  exer- 
cise with  moderation.  The  violence  used  in  youth  would  break  the 
bones,  and  do  various  kinds  of  mischief  were  it  indulged  by  the  old. 
Carriage  exercise  is  very  suitable  for  old  people,  but  the  more  active 
exercise  of  horseback  riding,  walking,  and  even  working  in  the  gar- 
den, should  not  be  omitted  —  bearing  always  in  mind  that  great 
fatigue  is  injurious. 

Sleep.  —  Aged  people  should  get  about  as  much  sleep  as  nature  asks 
for.     They  should  retire  early,  and  not  be  in  haste  to  rise  with  the 


? 


"^ 


11"  own  Mpocics 
very  (juostion- 
II  protvcdiiif; ; 
)ui(l  1)0  <,'aiiic(l 
t  be  a(l(l((J  to 
i  likely  to  Ix- 
sooner  recoiii- 
tlioir  bed,  an 
t)g.  Suoh  an 
h  and  vitality 
ig  companioi) 
may  bo  Ha  id 
5r-nico  peop'o 
3  proper  liian 
was  old  and 
Hhea,  but  ho 

)eople  die  in 
m.  For  this 
io  themselves 

)oar  with  ini- 
in  their  latter 
cere  taken  to 

important  to 
The  scarf- 
1  may  be  pre- 
id  water,  and 
•nge-bath,  l«t 
hand,  a  piece 
he  belly,  the 
lat  is,  in  the 
n  on  the  left, 
ht,  etc.  By 
stomach  and 
ressing. 

axercise  does 
always  exer- 
Id  break  the 

by  the  old. 

more  active 
Z  in  the  gar- 
great 


1  that 


i  nature  asks 
•ise  with  the 


OLD  AGE.  AND   ITS   DI.SKA8K8. 


707 


dawn.     They  'equiro  more  sleep  than  persons  in  middle  life.     Kiglit 
to  ton  hours  in  the  twenty-four  is  not  too  nuich. 

NleepleHsness.  —  Though  the  old  refjuiro  a  good  deal  of  sleep,  it  is 
luilortunate  that  many  of  them  can  sloop  but  liitlc  A  large  propor- 
tion of  p«'rsons  far  advanced  in  life,  complain  of  iiial>ility  to  sleep. 
Many  ol<l  people  deceive  themselves,  and  really  sleep  nnich  more 
than  they  are  aware.  Y<!t  they  often  persist  that  they  sleep  none  at 
nil,  night  after  night.  Their  case  is  illustrated  l)y  an  old  lady  whose 
doctor  entered  her  room  and  found  her  sleeping  very  soundly  and 
c'()mfortal)ly.  The  noise  of  a  person  entering  the  room  awoke  her 
>()on  after,  when,  rubbing  her  eyes,  she  turned  to  the  doctor,  and  said 
nil  she  wanted  was  sleep,  that  she  had  slept  none  for  a  month  ;  and 
unless  he  could  give  her  something  to  bring  sleep,  she  must  die. 

Medical  art,  I  am  sorry  to  say,  frequently  fails  to  bring  relief,  wIumi 
there  is  real  want  of  sleep.  Narcotics  should  always  be  avoided  if 
possible.  They  do  too  much  mischief;  yet  it  is  necessary,  sometimes, 
to  resort  to  them.  Much  may  be  done  sometimes  by  taking  an  earlier 
or  a  lighter  supper.  Early  rising,  and  exercise  in  the  open  air,  will 
often  bring  sleep  at  night.  Occasionally  a  glass  of  wine,  or  a  little 
sjjirit  of  any  kind,  taken  just  before  retiring,  will  bring  the  needed 
sleep. 

Electricity.  —  In  connection  with  sleep,  the  disturbing  and  the  tran- 
quillizing influence  of  electricity  and  magnetism  has  received  some 
attention  within  a  few  years.  A  German  philosopher  contends  that 
terrestnal  magnetism  exeits  on  persons  of  a  sensitive  organization  a 
very  soothing  influence,  when  placed  in  proj)cr  relations  with  its  cur- 
rents, and  a  disturbing  impression  when  otherwise  situated.  He 
cites  cases,  to  show  that  lying  from  east  to  west  is  so  intolerable  that 
persons  of  delicacy  cannot  endure  it ;  while  the  horizontal  position 
from  north  to  south,  witK  the  head  south,  is  more  agreeable;  and  most 
agreeable  and  tranquillizing  with  the  head  to  the  north.  A  Geramn 
surgeon  is  mentioned  in  Reichenback's  Memoirs,  who  always  Avoke 
early  in  the  morning,  and  turning  his  head  whore  his  feet  had  been, 
invariably  fell  into  a  sound  slumber,  which  was  more  refreshing  than 
that  of  the  night.  When  he  chanced  to  omit  this,  he  felt  ill  all  day. 
Observing  that  the  head  of  his  bed  was  directed  to  the  south,  Rcich- 
enback  persuaded  him  to  turn  it  to  the  north  ;  and  ever  after  he  slept 
soimdly  till  the  proper  time  to  rise  in  the  morning. 

Without  pronouncing  upon  the  correctness  of  this  theory,  I  will 
simply  Bay  that  in  my  winter  residence  in  town,  the  head  of  my  bed 
is  to  the  Bouth.  I  sleep  tolerably  well ;  but  not  as  well  as  at  my 
summer  residence  a  little  out  of  town,  v/iiore  the  head  of  my  bed  is 
towards  the  north.  How  much  the  stillness  of  the  country,  and  the 
greater  purity  of  its  atmosphere  may  contribute  to  this  difference,  I 
will  not  pretend  to  decide. 


•'I. 


708 


OLD  AGE,  AND   ITS  DISEASES. 


Medical  Treatment  of  the  Old. 

In  prescribing  medicine  for  old  people,  we  should  bear  in  mindtho 
difference  between  the  sexes.  Women  in  advanced  life  are  less  ex- 
citable, and  enjoy  better  health,  frequently,  than  in  early  life.  Old 
men,  on  the  contrary,  are  more  nervous,  in  their  latter  years,  and 
consequently  more  easily  affected. 

The  physician  cannot  rely  on  the  reaction  of  the  system  in  old  age. 
He  must  do  more  by  his  remedies,  and  dei)cnd  less  upon  nature  to 
help  him  out  of  straits. 

The  small  power  of  rallying  in  the  systems  of  the  old,  puts  all 
blood-letting,  severe  purging,  etc.,  entirely  out  of  the  question,  the 
man  is  near  enough  to  insanity  who,  except  in  some  very  rare  case, 
Moods  the  young.  He  who  takes  a  drop  of  blood  from  the  old,  should 
1)0  put  in  a  straight-jacket  and  sent  to  the  insane  hospital. 

tiarger  Do^es. — The  torpid  condition  of  the  system  in  old  age,  fre- 
quently requires  larger  doses  of  medicine  to  make  an  impression. 

Fluid  Medicines. — Pills  and  jwwders  sometimes  pass  through  the 
stomach  and  bowels  in  the  same  state  in  which  they  entered.  Fluids 
are  more  readily  appropriated  —  especially  when  the  more  active  me- 
dicinal ingredient  is  mixed  with  wine,  or  some  stimulating  tincture, 
or  aromatic  water.  These  things  rouse  up  the  torpid  stomach  and 
bowels,  and  cause  the  medicine  to  take  effect. 

Medicine  by  Rectum.  —  When  the  disease  is  situated  in  the  imme- 
diate neighborhood  of  the  lower  bowel,  as  the  bladder,  etc.,  it  is 
sometimes  better  to  administer  the  medicine  by  injection  into  the 
rectum. 

Suitable  Medicines  for  the  Old.  — The  acids,  the  alkalies,  and  the 
neutral  salts  are  unsuitable  'to  be  administered  much  to  old  people. 
All  metallic  medicines  must  be  given  sparingly,  and  with  caution. 
Iodine  and  iodide  of  potassium  are  not  very  well  borne.  Narcotics 
must  sometimes  be  used  to  some  extent.  Harsh  and  drastic  purga- 
tives are  out  of  the  question,  except  in  some  few  instances  in  which 
they  may  be  given  sparingly  in  connection  with  compound  tincture 
of  gentian,  or  some  orher  stimulating  tonic.  Sulphur  is  a  valual)le 
remedy  for  aged  people.  So  are  the  stimulant  tonics,  bitters,  astrin- 
gents, gum-resiiio,  balsams,  etc.,  together  with  the  various  carmina- 
tives, as  anise,  coriander,  fennel,  cascarilla,  ginger,  etc. 

Surgical  Operations.  —  Some  of  the  smaller  operations  in  surgery 
need  not  be  forbidden  in  the  caso  of  the  old  ;  but  great  operations  are 
not  to  be  thought  of.  There  is  not  recuperative  power  enough  to 
bear  them. 

Diseases  of  the  Old. 

Most  of  the  diseases  which  afflict  aged  people  are  of  course  much 
the  same  with  tho.    'vhich  come  upon  people  at  all  periods  of  life. 


d. 

ar  in  mind  the 
)  are  less  ex- 
fly  life.  Old 
er  years,  and 

m  in  old  age. 
ion  nature  to 

old,  puts  all 
uestion.  the 
ry  rare  case, 
le  old,  should 
il. 

I  old  age,  fre- 
ipression. 

through  the 
red.  Fluids 
re  active  me- 
ing  tincture, 
stomach  and 


in  the  imme- 
r,  etc.,  it  is 
:ion  into  the 

lies,  and  the 
old  people. 
nih.  caution. 
!.  Narcotics 
•astic  purga- 
;es  in  which 
und  tmcture 
s  a  valuable 
tters,  astrin- 
>us  carmina^ 


3  m  surgery 
lei'ations  are 
I-  enough  to 


;ourse  much 
iods  of  life. 


These  having  all  been  treated  of  in  the  previous  pages  of  this  book, 
do  not  require  to  be  gone  over  particularly  again.  There  are  a  few 
complaints,  however,  which  are  peculiar  to  the  old,  of  which  I  must 
briefly  speak. 

Bronchial  Flnx.  —  Bronchorrhcea. 

A  MORE  than  usual  amount  of  mucous  expectoration,  accompanied 
with  cough,  is  very  common  with  old  people  —  so  common  that  in 
many  cases  they  think  very  little  of  it,  even  when  the  expectoi'ation 
becomes  very  profuse.  This  discharge,  however,  from  the  mucous 
surface  of  the  l)ronchial  tubes,  is  very  apt  to  be  attended  by  shortness 
of  breath  on  making  even  very  slight  exertion  ;  and  the  whole  trouble 
is  aggravated  in  damp  weather,  ar  1  by  constipation,  and  the  stoppage 
of  leucorrhoja  in  females,  or  the  interrupti  n  of  insensible  perspiration 
through  the  skin. 

Slow  progress.  — This  complaint  makes  very  slow  progress,  as  a 
general  rule,  often  continuing  many  years  without  doing  any  great 
mischief.  It  is  apt,  however,  to  degenerate  into  a  mischievous  con- 
dition in  the  end ;  and  should,  therefore,  as  a  general  thing,  receive 
some  attention. 

Treatment. —  Attend  carefully  to  the  skin .  Keep  it  in  as  healthy  a 
condition  as  possible,  by  regular  and  faithful  bathing  and  friction. 
This  is  of  prime  importance. 

Care  must  be  had  not  to  suppress  the  discharge  too  suddenly.  It 
may  be  necessary,  at  times,  to  use  some  expectomnt  (see  expectorants 
among  the  lu'escriptions)  to  make  the  raising  easier.  But  when  it  is 
thoroughly  loosened  up,  we  should  begin  to  supp  ess  it  by  astrmgent 
inhalations.  For  this  purpose  Inhalant  No.  4  is  excellent.  It  might 
be  well,  however,  to  begin  with  the  Inhalant  No.  6,  which  is  slightly 
styptic. 

If  ulcers  on  the  legs  have  I'ecently  healed,  they  should  be  opened, 
or  blisters  applied  in  their  vicinity. 

Removal  to  a  diy  climate  is  a  valuable  remedy,  provided  the  cli- 
mate is  not  too  hot,  and  is  healthful  in  every  other  respect. 

Other  Diseases-  — The  other  diseases  with  which  old  persons  are 
alHicted  are  so  common  to  all  ages,  that  I  do  little  more  than  name 
them,  adding  a  few  genei'al  remarks. 

Asthma.  —  The  asthma,  or  intermittent  difficulty  of  breathing  of 
the  old,  is  connected  with  various  other  troubles,  asch:  tc  inuimma- 
tioa  of  the  bronchial  tubes,  air  in  the  lung  tissue,  swelling  of  the 
lungs,  enlargement  and  dilatation  of  the  heart,  and  diseases  (<f  its 
valves,  etc.  It  is  also  dependent  on  impurities  of  the  blood,  and  is 
connected  witn  torpid  action  of  the  kidneys.  It  is  impossible,  some- 
times, to  say  which  of  these  conditions  it  is  dependent  upon.  As  far 
as  may  be,  however,  the  cause  must  be  searched  out ;  and  then,  while 


■J'! 


iO 


OLD  AGE,  AND  ITS  DISEASES. 


the  general  remedies  for  asthma  must  be  employed,  the  particular 
tliiiig  with  which  it  is  connected  must  also  receive  attention,  especially 
if  it  be  connected  with  derangement  of  the  kidneys. 

Asthmatic  old  people  are  almost  always  dyspei^lics.  The  stomach 
and  bowels,  therefore,  require  particular  attention.  The  warm  pur- 
gatives, combined  with  alkalies,  are  generally  useful :  as  rhubarb  and 
soda,  equal  parts,  or  Mettauer's  Aperient,  with  a  little  tincture  of 
ginger  or  tincture  of  cayenne  in  it.  A  very  valuable  preparation  is 
compound  tincture  of  gentian  and  tincture  of  columbo,  two  ounces 
each,  one  half  ounce  of  tincture  of  ginger,  and  half  an  ounce  of  bi- 
carl)onate  of  soda.  Mix,  and  take  a  teaspoonful  as  occasion  may 
require. 

Apoplexy  and  Paralysis.  —  The  nervous  system  being  weakened  in 
aged  people,  the  way  is  opened  for  greater  frequency  of  attack  from 
apoplexy  and  paralysis.  The  exciting  cause  may  be  hypereemia, 
too  nmch  blood ;  or  anaemia,  too  little  blood.  It  may  be  general 
debility,  or  gout,  or  a  poisoned  state  of  the  blood. 

The  treatment  is  to  be  conducted  much  on  the  same  principles  as 
when  these  diseases  occur  in  younger  subjects. 

1  pass  over  numerous  complaints  whicl  may  be  said  to  be  somewhat 
more  common  in  advanced  life  than  at  earlier  periods.  They  are  so 
fully  treated  in  previous  pages  of  this  book,  that  it  is  deemed  needless 
even  to  name  them  here.  There  is,  however,  one  other  class  of  dis- 
eases occuiring  so  very  often  in  old  age,  and  in  so  many  cases  mak- 
ing advanced  life  a  burden,  that  I  cannot  pass  them  wuolly  in  silence. 
I  refer  to 

Diseases  of  the  Urinary  Organs.  —  These  afflict  the  old,  not  only 
vei'y  commonly,  but  very  severely.  An  old  man  who  reaches  the  age 
of  seventy  or  eighty  without  experiencing  some  serious  trouble  from 
deranged  kidneys,  diseased  bladder  or  prostate  gland,  or  gall  stones, 
or  gi-avel,  or  unhealthy  urinary  deposits  of  some  sort,  may  think  him- 
self greatly  favored. 

Treatment.  —  It  is  not  necessary  here  to  go  over  the  whole  ground 
of  treatment.  That  is  done  in  other  parts  of  the  book.  I  will  say, 
however,  that  a  surgical  operation  for  stone  in  the  bladder  is  not  often 
to  be  thought  of  in  the  case  of  old  people.  Other  remedies  must  be 
sought.  And  among  these,  none  hold  out  so  good  a  chance  of  relief 
as  the  free  drinking  of  the  alkaline  bicarbonates  dissolved  iu  water. 
This  will  frequently  dissolve  stones  formed  of  uric  acid,  urate  of  am- 
monia, and  triple  phosphates. 


Pulmonic  Cherry  Cordial. 

Wild-Cherry  bark,  ground,  10  pounds  ;  ipecac  root,  20  ounces  ; 
bloodroot,  24  ounces ;  squill  root,  bruised,  12  ounces ;  pulverized 
liquorice  I'oot,  5  ounces  ;  cochineal,  bruised,  2  ounces  ;  anise  seed,  32 
ounces ;  fennel  seed,  8  ounces ;  orange  peel,  16  ounces ;  acetate  of 


OLD  AGE,  AND   ITS  DISEASES. 


711 


e  particular 
especially 

'he  stomach 
warm  pur- 
hubarb  and 
tincture  of 
5paration  is 
two  ounces 
mce  of  bi- 
casion  may 

'eakened  in 
ittack  from 
lypereemia, 
be  general 

:'inciples  as 

somewhat 
hey  are  so 
d  needless 
lass  of  dis- 
eased mak- 
in  silence. 

I,  not  only 
les  the  age 
juble  from 
:all  stones, 
think  him- 

)le  ground 
[  will  say, 
I  not  often 
!s  must  be 
3  of  relief 
in  water, 
ite  of  am- 


•  ounces ; 
•ulverized 
!  seed,  32 
cetate  of 


morphine,  12  drams  ;  alcohol,  8  gallons  ;  water,  8  gallons  ;  pulverized 
white  sugar,  40  pounds  ;  sulphuric  acid,  1  ounce. 

Directions/or  making.  —  Grind  all  the  articles  to  a  coarse  powder 
except  those  directed  to  be  bruised  or  pulverized,  and  put  them  all 
to  the  alcohol  except  the  wild-cherry  bark,  the  water,  the  sugar,  and 
the  sulphuric  acid.  Let  them  stand  one  week,  shaking  or  stirring 
thoroughly  twice  a  day.  Then,  having  kept  the  wild-cherry  bark  two 
days  in  a  covered  vessel,  with  water  enough  upon  it  to  wet  it  through, 
jilace  it  in  a  percolator,  and  run  eight  gallons  of  water  through  it. 
Add  this  to  the  alcohol  and  other  ingredients.  Let  the  whole  stand 
three  days  longer,  stirring  as  before,  twice  a  day.  Draw  off",  and  filter 
through  paper.  Now  add  the  sugar,  and  lastly  the  sulphuric  acid. 
The  acid  is  intended  mainly  to  improve  the  color,  by  acting  chemi- 
cally upon  the  cochineal.  The  color  is  a  fine  cherry  red,  tinged  with 
orange. 

I  have  given  the  directions  for  making  sixteen  gallons  —  this  being 
the  smallest  quantity  in  which  I  make  it.  Any  person  can  easily 
make  the  calculation  for  reducing  the  quantity. 

This  is  the  preparation  which  I  mentioned  on  page  226  of  this 
book.  Its  insertion  at  the  proper  place  was  omitted  by  mistake  ;  and 
I  thought  I  would  not  mar  the  order  of  the  book  by  inserting  it  out 
of  place.  I  have  much  regretted  this.  Had  I  inserted  it  anywhere, 
it  would  have  saved  me  the  answering  of  a  greater  number  of  letters 
than  I  care  tt>  conjecture. 

Upon  no  other  preparation  of  medicine  I  have  iever  compounded 
ha>'e  I  bestowed  as  much  thought  and  care  as  upon  this.  For  five 
years  I  was  incessantly  experimenting,  making  and  trying  new  com- 
binations ;  and  this  is  the  result.  The  assertion  previously  made  that 
this  is  the  "  best  cough  preparation  ever  made,"  I  see  no  cause  to 
modify  in  the  smallest  degree.  Were  it  kept  in  every  apothecary 
shop,  and  were  physicians  to  prescribe  in  pulmonary  complaints, 
adding  a  little  syrup  of  squill  or  wine  of  ipecac  when  a  more  expec- 
torant eflect  is  wanted,  or  a  little  morphine  if  greater  narcotism  is 
sought,  it  would  save  them  much  trouble  ii,  compounding  cough 
syrups,  and  give  them  much  more  satisfactory  results.  I  have  com- 
pared ''s  eflect,  again  and  again,  with  the  best  other  preparations  in 
use,  and  I  pledge  my  word  that  it  will  succeed  in  twice  as  many  cases 
as  any  other  compound  that  may  be  chosen.  Let  physicians  try  it ; 
and  I  will  be  responsible  for  every  hair's  breadth  in  which  they  find 
this  proportion  of  successful  results  abridged. 


amms^ 


■x~~T?iT"T"^^''" 


PHYSICAL  CULTURE -THE  NEW  GYMNASTICS. 


In  America  the  noblest  interests  of  the  race  have  reached  unpar- 
alleled developments.  In  no  other  country,  in  no  other  age,  has 
mental  culture  been  so  complete  and  universal.  It  is  an  era  in  the 
progress  of  the  race.  The  fruits  of  labor  which  in  other  times  and 
lands  have  been  wasted  upon  the  abnormal  life  of  the  few,  have  here, 
like  air  and  light,  the  two  great  representative  gifts  of  Heaven,  found 
their  way  to  the  normal  life  of  the  million.  The  grand  ideal  results 
of  the  philosopher's  dreams  seem  within  our  grasp. 

But  in  this  honr  of  triumph  the  national  life  is  jeopardized  by 
physical  exhaustion.  While  the  admiring  world  looks  on,  our  bodies 
upon  which  as  a  foundation  our  higher  faculties  must  rest,  crumble 
and  give  way.  Precocious  brains  are  l)orne  about  by  doubtful  spines  ; 
brilliant  talents  are  linked  with  dying  bodies. 

But  in  the  light  which  nowlbegins  to  dawn,  this  rock  in  our  nation's 
pathway  is  clearly  seen,  and  the  discovery  must  result  in  the  adop- 
tion of  vigorous  measures.  Already  the  leading  educatoi-s  of  the 
country  are  aroused,  and  to  use  the  language  of  that  veteran  educa- 
tional magazine,  the  "Massachusetts  Teacher,"  "To  Dr.  Lewis, 
more  than  to  any  other  man,  is  the  country  indebted  for  the  present 
deep  practical  interest  in  physical  culture.  He  has  done  a  noble 
work." 

And  in  introducing  the  "New  Gymnastics"  invented  and  de- 
velojwd  by  Dr.  Dio  Lewis,  of  Boston,  it  may  be  proper  to  say  that 
Dr,  Lewis  is  a  regularly  educated  physician.  From  the  beginning  of 
his  professional  career  he  evinced  the  most  earnest  interest  in  sanitary 
questions.  Located  in  Buffalo,  N.  Y. ,  during  those  memorable  cholera 
seasons  1849  and  1851,  in  the  midst  of  an  immense  practice,  he  called 
public  attention  to  certain  preventive  sanitary  regulations  with  such 
earnestness  and  force,  that  hearty  municipal  recognition  and  action 
were  secured. 

Some  years  since  the  Doctor  abandoned  the  practice  of  his  pro- 
fession, and  entered  the  field  as  a  lecturer  upon  sanitary  science. 
Both  in  this  country  and  abroad  all  the  great  health  questions  were 
ably  discussed.  Three  winters  were  devoted  to  lecturing  in  our'South- 
ern  States.  In  many  Southern  cities  a  profound  interest  M'as  elicited. 
About  twenty  pieces  of  silver  plate  were  presented  to  the  lecturer  hy 


ncs. 


the  various  cities  visited.     The  citizens  of  Richmond,  Va.,  presented 
Dr.  Lewis  with  an  entire  tea  service  of  splendid  silver  plate. 

A  few  years  ago,  Dr.  Lewis  began  his  investigations  in  the  depart- 
ment of  gymnastic  training.  The  pul)lic  is  now  pretty  well  informed 
in  reference  to  his  labors  in  this  field.  The  journals  and  magazines 
of  the  country  have  spoken  out  in  hearty  commendation  of  "Dr. 
Lewis's  New  Oymnastica."     A  few  of  these  notices  may  be  given. 


hed  unpar- 
r  age,  has 
1  era  in  the 
times  and 
have  here, 
iven,  found 
ieal  results 

irdized  by 
our  bodies 
3t,  crumble 
ful  spines ; 

)ur  nation's 
the  ado{>- 
ors  of  the 
ran  educa- 
>r.  Lewis, 
lie  present 
le  a  noble 

I  and  de- 
o  say  that 
iginning  ot 
in  samtary 
ble  cholera 
,  he  called 
with  such 
ind  action 

f  his  pro- 
y  science, 
tions  were 
)ur"South- 
8  elicited. 
Jcturer  by 


"We  look  upon  Dr.  Lewis  as  one  of  the  benefactors  of  his  race." —  Grace  Greenwood. 

"  Success  to  Dr.  Lewis's  Oymnasium.  No  better  institution  exists."  —  The  Knick- 
erbocker. 

"  It  was  my  privilege  to  welcome  Dr.  Lewis  at  his  very  first  arrival  here,  and 
everything  since  then  has  only  confirmed  my  confidence  in  his  ability  to  superintend 
this  system. "  —  Rtv.  Dr.  Kirk. 

"  We  shall  look  for  great  results  in  the  physical  development  of  the  nation,  If  this 
aUinirable  system  should  be  generally  adopted."  —  Boston  Traveller. 

"Every  muscle  of  the  body  is  brought  into  motion  without  straining  or  unpleas- 
ant e£fort.  Many  of  the  attitudes  are  graceful  and  striking.  In  a  word,  it  is  poetry 
in  motion,  and  motion  set  to  music."  —  N.  T.  Tribune. 

"  We  are  glad  to  hear  that  this  simple  apparatus  and  ingenious  series  of  exercises 
are  being  introduced  into  many  of  the  best  schools  of  the  State."  —  Boston  Cotimr. 

"  The  Boston  Gymnasium  has  sent  a  graduate  to  our  city  who  is  teaching  large 
classes,  composed  of  our  gravest  divines,  physicians,  and  others.  Ladies  mingle  in 
the  happy  crowd."  —  N.  Y.  Times. 

"  This  system  avoids  the  objections  of  other  systems.  I  have  witnessed  its  effects 
in  several  schools,  and  can  say  they  are  all  good  without  exception."  —  President 
Felton,  in  an  address  <u  Dr.  Lewis's  Gymnasium,  of  which  he  was  the  presiding  officer 
up  to  the  time  of  his  death. 

He  has  recently  issued  a  handsome  volume,  known  as  "  The  Kew 
Gymnastics  for  Men,  Women,  and  Children,"  through  Ticknor  & 
Fields — a  beautiful  volume,  full  of  illustiitive  cuts.  The  book  has 
been  so  generally  noticed  by  the  press  of  the  country  that  all  have 
learned  of  its  features.     A  single  notice  oi'  two  may  be  given. 

"  Dr.  Lewis's  book  is  the  most  practical,  sensible  work  on  this  subject,  extant  in 
any  language."  —  CorUinental  Monthly. 

"  Dr.  Lewis  has  given  us  far  the  best  and  most  practical  of  all  publications  on  the 
subject  of  physical  culture."  —  N.  Y.  Independent. 

This  vigorous  worker  in  the  field  of  physical  education  has  recently 
established  in  Boston  a  Normal  Institute  for  physical  education,  in 
vhich  he  is  pre[)aringteachero  of  the  New  Gymnastics.  About  seventy 
persons  of  either  sex  have  already  i)een  fitted,  and  have  gone  out  to 
teach.  Nearly  every  progressive  school  in  the  Northern  States  has 
more  or  less  of  the  New  Gymnastics  in  its  daily  drill.  And  so  far  as 
teachers  can  be  obtained,  the  schools  have  added  a  gymnast  to  tiieir 
corps  of  teachers.  There  is  room  for  a  thousand  or  ten  tliousanJ 
laborers  in  the  new  profession.  Persons  of  either  sex  may  find  in  this 
calling  health,  usefulness,  and  large  profit. 

In  addition  to  the  New  Gymnastics,  the  graduates  go  out  prepared 


vimm 


«il:  ■ 


714 


PHYSICAL  CULTURE. 


to  teach  elocution,  and  to  act  as  guides  in  all  other  departments  of 
physical  culture.  Dr.  Walter  Chiinning,  Prof.  Leonai-d  the  elocu- 
tionist, and  other  well-known  scientific  gentlemen  assist  Dr.  Lewis  in 
fitting  the  pupils  for  their  important  work.  We  are  satisfied  that 
this  new  profession  is  to  become  one  of  much  dignity  and  importaiit'c. 
Those  who  enter  the  field  early  will  have  reason  to  congratulate 
themselves. 


.  M: 


THE  NEW   GYMNASTICS. 


BT  DID  LEWIS,  U.   V. 

Thk  apparatus  used  in  my  system  of  gymnastics  is  all  light. 
This  is  its  distinctive  peculiarity.  The  dumb-bell  weighs  from  one  to 
four  pounds.  In  the  system  heretofore  in  vogue,  dumb-bells  weighing 
as  much  as  150  lbs.  have  been  used. 

Perhaps  no  other  piece  of  apparatus,  common  to  the  two  systems, 
will  so  well  illustrate  the  superiority  of  the  new  system. 


Dumb-Bell    Exercises. 

For  more  than  two  thousand  years  the  dumb-bell  has  been  in  use 
as  a  means  of  physical  culture.  It  was  highly  prized  by  the  Greeks. 
Many  advantages  are  justly  claimed  in  its  behalf.  If  used  in  private, 
it  occupies  little  space  either  at  rest  or  in  action.  For  the  same  reason 
it  is  excellent  in  the  training  of  large  classes.  Although  not  to  he 
compared  with  the  New  Gymnastic  ring,  the  dumb-bell  deserves  its 
great  popularity. 

Among  the  Greeks  it  had  a  peculiar  shape,  and  in  this  respect  has 
undergone  many  changes,  of  which  something  will  be  said  hereafter. 
Its  present  shape  is  well  known.  A  practical  suggestion  upon  this 
point  may  not  be  amiss.  The  handle  should  be  at  least  half  an  inch 
longer  than  the  Avidth  of  the  hand,  of  such  size  as  can  be  easily 
grasped,  with  a  slight  swell  in  the  middle.  The  manufacturer  must 
not  forget  there  is  a  wide  difference  between  the  hand  of  a  little  girl 
and  that  of  a  large  man. 

Heretofore  dumlvbells  have  been  made  of  metals.  The  weight  in 
this  country  has  usually  been  considerable.  The  general  policy  at 
present  is  to  employ  those  as  heavy  as  the  health-seeker  can  put  up. 
This  is  wrong.  In  the  great  German  gymnastic  institutes,  dumb- 
bells were  formerly  employed  weighing  from  fifty  to  one  hundred 
pounds,  but  now  Schreber  and  other  distinguished  authors  con- 
demn such  Aveights,  and  advocate  those  weighing  from  two  to  five 
pounds.     I  think  those  weighing  two  pounds  are  heavy  enough  for 


PHYSICAL  CULTURE 


715 


depnrfments  of 
lanl  tho  elotii- 
st  Dr.  Lewis  in 
e  satisfied  that 
nd  importanoo. 
:o  congratulate 


I  is  all  light, 
hs  from  one  to 
-bells  weighing 

two  systems, 
n. 


IS  been  in  use 
>y  the  Greeks, 
sed  in  private, 
le  same  reason 
gh  not  to  be 
i  deserves  its 

is  respect  has 
aid  hereafter, 
ion  upon  this 
;  half  an  inch 
an  be  easily 
acturer  must 
f  a  little  girl 

he  weight  in 
ral  policy  at 
can  put  up. 
utes,  duinb- 
one  hundred 
authors  con- 
two  to  five 
enough  for 


any  man  ;  and  as  it  is  important  that  they  lie  of  considerable  size,  I 
introduced,  some  years  ago,  those  made  of  wood.  Every  year  my 
fiiith  grows  stronger  in  their  superiority. 

In  my  early  experience  as  a  teacher  of  Gymnastics,  I  advocated 
lu'iivy  dumb-bells,  prescribing  for  those  who  could  put  up  one  hun- 
dred pounds,  a  bell  of  that  weight.  As  my  success  had  always  been 
with  heavy  weights,  pride  led  mc  to  continue  their  use  long  after  I 
doubted  tlie  wisdom  of  such  a  course.  For  some  years  I  have  em- 
jiloyed  only  those  made  of  wood. 

1  know  it  will  be  said  that  dumb-bells  of  two  pounds  weight  will 
do  for  women  and  children,  but  cannot  answer  the  requirements  of 
strong  men. 

The  weight  of  the  dumb-bell  turns  entirely  on  the  manner  in  which 
it  is  used.  If  only  lifted  over  the  head,  one  or  two  pounds  would  l)e 
absurdly  light ;  but  if  used  as  we  employ  them,  then  one  weighing 
ten  pounds  is  beyond  the  strength  of  the  strongest.  No  man  can 
enter  one  of  my  classes,  of  little  girls  even,  and  go  through  the  exer- 
cises with  bells  weighing  ten  pounds  each. 

We  had  a  good  opportunity  to  laugh  at  a  class  of  young  men  last 
year,  who,  upon  entering  the  gymnasium,  organized  an  insurrection 
against  the  wooden  dumb-bells,  and  through  a  committee  asked  me  to 
procure  iron  ones.  I  ordered  a  quantity  weighing  three  pounds  each  ; 
they  used  them  part  of  one  evening,  and  when  asked  the  following 
evening  which  they  would  have,  replied,  "The  wooden  ones  will  do  !" 

A  just  statement  of  the  issue  is  this  :  if  you  only  lift  the  duml)-bell 
from  the  floor,  put  it  up,  and  then  put  it  down  again,  of  course  it 
should  be  heavy,  or  there  is  no  exercise  ;  but  if  you  would  use  it  in  a 
great  variety  of  ways,  assuming  a  hundred  graceful  attitudes,  and 
bringing  the  muscles  into  use  in  every  direction,  requiring  skill  and 
followed  l)y  a  harnwuious  development,  the  bell  must  be  light. 

There  need  be  no  controversy  between  the  light  weight  and  the 
heavy  weight  party  on  this  point.  We  of  the  light  weight  party 
agree  that  if  the  bell  is  to  bo  used  as  the  heavy  weight  party  uses  it, 
it  must  be  heavy  ;  but  if  as  we  use  it,  then  it  must  be  light.  If  they 
of  the  heavy  weight  party  think  not,  we  only  ask  them  to  try  it. 

The  only  question  which  remains  is  that  which  lies  between  all 
heavy  and  light  gymnastics,  viz. :  whether  strength  or  flexibility  is  to 
be  preferred.  Without  entering  upon  a  discussion  of  the  physiologi- 
cal principles  which  underlie  this  subject,  I  will  simply  say  that  I 
prefer  the  latter.  The  Hanlon  brothers  and  Heenan  are  physiologi- 
cally considered  greatly  superior  to  heavy  lifters. 

But  here  I  ought  to  say  that  no  man  can  be  flexible  without  a  good 
degree  of  strength.  It  is  not,  however,  that  kind  of  strength  involved 
in  great  lifting.  Heenan  is  a  very  strong  man,  can  strike  a  blow 
twice  as  hard  as  Windship,  but  cannot  lift  seven  hundred  pounds 
nor  put  up  a  hundred-pound  dumb-boll.  Wm.  Hanlon,  who  is 
probably  the  finest  gymnast,  with  the  exception  of  Blondin,  ever  seen 
on  this  continent,  cannot  lift  six  hundred  pounds.     Such  men  have  a 


■5* 


716 


PHYSICAL  CULTUBB. 


^,.\ 


great  fear  of  lifting.  They  know,  almost  by  instinct,  that  it  spoils 
their  muscles. 

One  of  the  finest  gymnasts  in  the  country  told  me  that  in  several 
attempts  to  lift  five  hundred  pounds  ho  failed,  and  that  ho  should 
never  try  it  again.  This  same  gymnast  owns  a  fine  horse.  Ask  him 
to  lend  that  horse  to  draw  before  a  cart  and  he  will  refuse,  because 
such  labor  would  make  the  animal  stiff,  and  unfit  hira  for  light, 
graceful  movements  before  the  carriage. 

The  same  physiological  law  holds  true  of  man :  lifting  great 
weights  aft'ects  him  as  drawing  heavy  loads  affects  the  horse.  So  fur 
from  man's  body  being  an  exception  to  this  law,  it  iiears  with  peculiar 
force  upon  him.  Moving  great  weights  through  small  spaces  pro- 
duces a  slow,  inelastic,  inflexible  man.  No  matter  how  flexible;  a 
young  man  may  be,  lot  him  join  a  circus  company,  and  lift  the  can- 
non twice  a  day  for  two  or  three  years,  and  he  will  become  as  inflex- 
ible as  a  cart-horse.  No  matter  how  elastic  the  colt  is  when  first 
harnessed  to  the  cart,  he  will  soon  become  so  inelastic  that  he  is  unfit 
to  serve  before  a  carriage. 

Men,  women,  and  children  should  be  strong,  but  it  should  be  the 
strength  of  grace,  flexibility,  agility,  and  endurance  ;  it  should  not  be 
the  strength  of  a  great  lifter.  I  alluded  to  the  gymnastics  of  the 
circus.  Let  all  who  are  curious  in  regard  to  the  point  I  am  discuss- 
ing, visit  it.  Permit  me  to  call  special  attention  to  three  features  — 
to  the  man  who  lifts  the  cannon,  to  the  india-rubber  man,  and  to  the 
general  performer.  The  lifter  and  the  india-rubber  man  constitute 
the  two  mischievous  extremes.  It  is  impossible  that  in  either  there 
should  be  the  highest  physiological  conditions ;  but,  in  the  persons 
of  the  Hanlon  brothei-s,  who  are  genei-al  performers,  is  found  the 
model  gymnast.  They  can  neither  lift  great  weights  nor  tie  them- 
selves into  knots,  but  they  occupy  a  point  between  these  two  ex- 
tremes. They  possess  both  strength  and  flexibility,  and  resemble 
fine,  active,  agile,  vigorous  carriage-horses,  which  occupy  a  ponit  be- 
tween the  slow  cart-horse  and  the  long-legged,  loose-jointed  animal. 

With  heavy  dum'o-bells  the  extent  of  motions  is  very  slight,  and  of 
course  the  range  and  freedom  of  action  will  be  correspondingly  so. 
This  is  a  point  of  great  importance.  The  limbs,  and  indeed  the  en- 
tire body,  should  have  the  widest  and  freest  range  of  motion.  It  is 
only  thus  that  our  performances  in  the  business  or  pleasures  of  lii'e 
become  most  effective.  A  complete,  equable  circulation  of  the  blood 
is  thereby  most  perfectly  secui'ed.  And  this,  I  may  remark,  is  in 
one  aspect  the  physiological  purpose  of  all  exercise.  The  race-horse 
has  a  much  more  vigorous  circulation  than  the  cait-hoi*se.  It  is  a 
fact  not  unfamiliar  with  horsemen,  that  when  a  horse  is  transferred 
from  slow,  heavy  work  to  the  carriage,  the  surface  veins  about  the 
neck  and  legs  begin  at  once  to  enlarge ;  when  the  change  is  made 
from  the  carriage  to  the  cart,  the  reverse  is  the  result. 

And  when  we  consider  that  the  principal  object  of  all  physical 
training  is  an  elastic,  vigorous  condition  of  the  neiTous  system,  the 


!t,  that  it  spoils 

that  in  several 
that  ho  should 
lorse.  Ask  him 
refuse,  becau.so 
him  for  light, 


lifting 


{Jieat 
80  fiir 


1 

B  horse 
irs  with  peculiiir 
mil  spaces  pro- 
how  flexible  a 
nd  lift  the  caii- 
econie  as  inflox- 
It  is  when  first 
that  he  is  unfit 

t  should  1)0  the 
it  should  not  he 
mnastics  of  the 
It  I  am  discuss- 
liree  features  — 
nan,  and  to  llio 

man  constitute 
in  either  there 
in  the  persons 
i,  is  found  the 
I  nor  tie  theni- 

these  two  ex- 
,  and  resemble 
upy  a  ponit  bo- 
jointed  aninial, 
y  slight,  and  of 
ispondingly  so. 
indeed  the  en- 
motion.  It  is 
leasures  of  life 
on  of  the  blood 
'  remark,  is  in 
The  ruce-hor:-e 
lorse.     It  is  a 

is  transferred 
eins  about  the 
bange  is  made 

jf  all  physical 
us  system,  the 


PHYSICAL  CULTUKK. 


717 


superiority  of  light  gymnastics  l)ecome3  still  more  obvious.  The 
nervous  system  is  the  fundamental  fact  of  our  earthly  life.  All  other 
parts  of  the  organism  exist  and  work  for  it.  It  controls  all,  and  is 
the  seat  of  pain  and  pleasure. 

The  impressions  upon  the  stomach,  for  example,  resulting  in  a  bet- 
ter or  Avorse  digestion,  must  be  made  through  the  nerves.  This  su~ 
j)rcme  control  of  the  nervous  system  is  forcibly  illustrated  in  the 
change  made  by  joyful  or  sad  tidings. 

The  overdue  ship  is  believed  to  have  gone  down  with  her  valuable, 
uninsured  cargo.  Her  owner  paces  the  wharf,  sallow  and  wan ; 
ippetite  and  digestion  gone.  She  heaves  in  sight !  She  lies  at  the 
wharf !  The  happy  man  goes  a])oard,  hears  all  is  safe,  and,  taking  the 
officers  to  a  hotel,  devours  with  them  a  dozen  monstrous  compounds, 
with  the  keenest  appetite,  and  without  a  subsequent  pang. 

I  am  confident  that  the  loyal  people  of  this  country  have  eaten  and 
digested,  since  Koanoke  and  Donelson,  as  they  had  not  before  since 
Sumter. 

Could  we  have  an  unbroken  succession  of  good  news,  we  should  all 
have  good  digestion  without  a  gymnasium.  But  in  a  world  of  vexa- 
tion and  disappointment,  we  are  driven  to  the  necessity  of  muscle 
culture,  and  otlier  hygienic  expedients,  to  give  the  nervous  system 
that  support  and  vitality  which  our  fitful  surroundings  deny. 

If  we  would  make  our  muscle-training  contributive  in  the  highest 
degree  to  the  healthful  elasticity  of  our  nerves,  the  exercise  must  be 
such  as  will  bring  into  varied  combinations  and  play  all  our  muscles 
and  nerves.  Those  exercises  which  require  gi'eat  accuracy,  skill,  and 
dash  are  just  those  which  secure  this  happy  and  complete  intermar- 
riage of  nerve  and  muscle.  If  any  one  doubts  that  boxing  and  small 
Hword  will  do  more  to  give  elastitity  and  tone  to  the  nervous  system 
than  lifting  kegs  of  nails,  then  I  will  give  him  over  to  the  heavy  lifters. 

Another  point  I  take  the  liberty  to  I'.rge.  Without  acairacy  in  the 
performance  of  the  feats,  the  interest  must  be  transient.  This  prin- 
ciple is  strikingly  exemplified  in  military  training.  Those  who  have 
studied  our  inmntry  drill  have  been  struck  with  its  simplicity,  and 
have  wondered  that  men  could  go  through  with  its  details  every  day 
lor  yeara  withcv-t  disgust.  If  the  drill-master  permits  carelessness, 
I  lien  authority  alcne  can  force  the  men  through  the  evolutions  ;  but 
if  he  enforce  the  greatest  precision,  they  return  to  their  task  every 
morning  for  twenty  years  with  fresh  and  increasing  interest. 

What  precision,  permit  me  to  ask,  is  possible  in  "putting  up"  a 
heavy  dumb-l)ell?  But  in  the  new  dumb-bell  exercises  there  is 
opportunity  and  necessity  for  all  the  accuracy  and  skill  which  are 
ibund  in  the  most  elaborate  military  drills. 

I  have  been  a  teacher  of  boxing  and  fencing,  and  I  say  with  con- 
fidence that,  in  neither  nor  both  is  there  such  a  field  for  fine  posturing, 
wide,  graceful  action,  and  studied  accuracy,  as  is  to  bo  found  in  the 
new  series  of  dumb-bell  exercises. 

But,  it  is  said,  if  you  use  bells  weighing  only  two  pounds,  you 


■f 


718 


PHYSICAL  CU.'  lURE. 


must  work  an  hour  to  reach  tho  exorci^  -  which  the  hciivy  ones  would 
funiish  in  five  minutes.  I  need  not  in<  -m  those  Avho  have  practised 
Mio  new  series  with  the  light  hells,  that  this  objection  is  made  in 
ignorance.  If  you  simply  "put  up"  tii  light  hell,  it  is  true  ;  but  it 
you  use  it  as  herein  described  and  ilhisl 
contrary,  in  less  than  five  minutes  legs, 
neck,  lungs,  and  heart  will  each  and 
remonstrance  against  even  a  quarter  f 
feats. 

At  this  point  it  may  be  urged  that  th( 


■ited,  it  is  not  true.  On  tlie 
iiips,  back,  arms,  shoulders, 
ill  make  the  most  emphiiiic 
hour's  practice  of  such 


an 


0  exercises  which  hasten  11 


10 


action  of  the  thoracic  viscera  to  any  con  'deniblo  degree  are  simply 
exhaustive.  This  is  another  blunder  of  tl  e  "  big-muscle  "  men.  Tlicv 
seem  to  think  you  can  determine  every  n.  m's  constitution  and  heultli 
by  the  tape-line  ;  and  that  all  exercises  vl  ose  results  are  not  deter- 
minable by  measurement  are  worthless. 

I  need  scarcely  say,  there  are  certain  conditions  of  brain  musclo, 
and  of  every  other  tissue,  far  more  imporuint  than  size  ;  but  what  I 
desire  to  urge  more  particularly  in  this  connection,  is  the  importance, 
the  great  physiological  advantages,  of  just  those  exercises  in  which 
the  lungs  and  heart  are  brought  into  active  play.  These  organs  are 
no  exceptions  to  the  law  that  exercise  is  the  principal  conditioji  of 
development.  Their  vigorous  training  adds  more  to  tho  stock  of 
vitality  than  that  of  other  organs.  A  man  may  stand  still  and  lift 
kegs  of  nails  and  heavy  dumb-bells  until  his  shoulders  and  arms  are 
Sampsonian ;  he  will  contribute  far  less  to  his  health  and  longevity 
than  by  a  daily  run  of  a  mile  or  two. 

Speaking  in  a  general  way,  those  exercises  in  which  the  lungs  and 
heart  are  made  to  go  at  a  vigorous  i*ate,  are  to  be  ranked  among  the 
most  useful.  Th§  "double-quick"  of  the  soldier  contributes  more  in 
five  minutes  to  his  digestion  and  endurance,  than  the  ordinary  drill  iu 
two  hours. 

I  have  said  an  elastic  tone  of  the  nervous  system  is  the  physiological 
purpose  of  all  physical  training.  If  one  may  be  allowed  such  an  analy- 
sis, I  would  add  that  we  exercise  our  muscles  to  invigorate  the  thoracic 
and  abdominal  viscera.  These  in  their  turn  support  and  invigorate 
the  nervous  system.  All  exercises  which  operate  more  directly  upon 
these  inteimal  organs,  as,  for  example,  laughing,  deep  breathing,  and 
running,  contribute  most  efiectly  to  the  stamina  of  the  brain  and 
nerves.  It  is  only  this  mania  for  monstrous  arms  and  shoulders  that 
could  have  misled  the  intelligent  gymnast  on  this  point. 

But,  finally,  it  is  said  you  certainly  cannot  deny  that  rapid  motions, 
with  great  sweep,  exhaust  more  than  slow  motions  through  limited 
spaces.  A  great  lifter  said  to  me  the  other  day,  "  Do  you  pretend  to 
deny  that  a  locomotive  with  a  light  train,  flying  at  the  rate  of  forty 
miles  an  hour,  consumes  more  fuel  than  one  with  a  heavy  train  mov- 
ing at  the  rate  of  five  miles  ? "  I  did  not  attempt  to  deny  it.  "  Well, 
then,"  he  added,  with  an  air  of  triumph,  "what  have  you  to  say  now 
about  these  great  sweeping  feats  with  your  light  dumb-bells,  as  com- 


leavy  ones  would 
lo  liave  practised 
'tioii  is  inado  in 
it  is  tnie  ;  but  it 
3t  true.  On  the 
arms,  shoulders, 
>  niost  einpiiiitic 
practiro  of  .such 

vhich  hasten  Iho 
?ree  are  sinipiv 
le"nien.  TlicV 
Jtion  and  health 
i  are  not  deter- 

f  brain  musclo, 
ze;  but  what  I 
the  iinportanco, 
rcises  in  which 
lese  organs  are 
lal  condition  of 
to  the  stock  of 
id  still  and  lift 
s  and  arms  arc 
and  longevity 

I  the  lungs  and 

fed  among  the 

ibutes  more  in 

•dlnary  drill  in 

e  physiological 
such  an  analy- 
ite  the  thoracic 
and  invigorate 
I  directly  upon 
breathing,  and 
the  brain  and 
shoulders  that 

'apid  motions, 
rough  limited 
ou  pretend  to 
rate  of  forty 
vy  train  mov- 
yit.  "Well, 
i)u  to  say  now 
bells,  as  coni- 


PHYSICAL  CULTURE. 


719 


pared  with  the  slow  putting  up  of  heavy  ones?"  I  replied  by  asking 
liini  another  question.  "  Do  you  pretend  to  deny  that  when  you 
drive  your  horse  ten  miles  within  an  hour,  before  a  light  carriage, 
ho  is  more  exhausted  than  by  drawing  a  load  two  miles  an  hour?" 
"That's  my  doctrine,  exnctly,"  said  he.  "Then,"  I  asked,  "why 
don't  you  always  drive  iwo  miles  an  hour?"  "But  my  patients 
would  all  die,"  replied  my  friend.  I  did  not  say  aloud  what  was 
jKissing  in  my  mimi,  —  that  the  danger  to  his  patients  might  be  less 
than  he  imagined,  —  but  I  suggested  that  nearly  every  man,  as  well 
IIS  every  horse,  had  duties  in  this  life  which  involved  the  necessity 
of  rapid  and  vigorous  motions ;  that  were  this  slow  movement 
;;(MH"rally  adopted,  every  jjliase  of  human  life  would  be  stripped  of 
progress,  success,  and  glory. 

As  our  artificial  training  is  designed  to  fit  us  for  the  more  success- 
ful performance  of  the  business  of  life,  I  suggest  that  the  training 
should  be,  in  character,  somewhat  preparatory  for  those  duties.  If 
yon  would  train  a  horse  for  the  carriage,  you  would  not  do  it  I)y 
driving  at  a  slow  pace  before  a  heavy  load.  If  you  did,  the  first  fast 
drive  would  go  hard  with  him. 

.lust  so  with  a  man.  If  he  is  to  lift  hogsheads  of  sugar,  or  kegs  of 
nails,  as  a  business,  he  may  be  trained  by  heavy  lifting;  but  if  his 
liusiness  requires  the  average  velocity  and  free  motions  of  human 
occupations,  then  upon  the  basis  of  his  heavy  slow  training,  bo  will 
find  himself,  in  actual  life,  in  the  condition  of  the  dray  horse,  who  is 
pushed  before  the  light  carriage  at  a  high  speed. 

Perhaps  it  is  not  improper  to  add,  that,  to  me,  all  this  talk  about 
expenditure  of  vitality,  is  full  of  sophistry.  Teachers  and  writers 
speak  of  our  stock  of  vitality,  as  if  it  was  a  vault  of  gold,  upon  which 
you  cannot  draw  without  lessening  the  quantity,  whereas,  it  is  rather 
like  the  mind  or  heart  enlarged  by  action,  increased  by  expenditure. 

When  Daniel  Boone  was  living  alone  in  Kentucky,  his  intellectual 
exercises  were,  doubtless,  of  the  quiet,  slow,  heavy  character.  Other 
white  men  joined  him.  Under  the  social  stimulus,  his  thinking 
l)ecame  more  sprightly.  Suppose  that  in  time  he  had  come  to  write 
vigorously,  and  to  speak  in  the  most  eloquent,  brilliant  manner,  does 
v.\y  one  imagine  that  he  would  have  lost  in  mental  vigor  and  dash 
Ity  the  process?  Would  not  the  brain,  which  had  only  slow  exercise 
in  his  isolated  life,  become  bold,  brilliant,  and  dashing,  by  bold, 
l)rilliant,  and  dashing  efforts? 

A  farm  boy  has  slow,  heavy  muscles.  He  has  been  accustomed 
to  heavy  exercises.  He  is  transferred  to  the  circus,  and  performs, 
after  a  few  years' training,  a  hundred  beautiful,  splendid  feats.  He 
at  length  reaches  the  matchless  Zampillaerstation  of  Wm.  Hanlon. 
Does  any  one  think  that  his  body  has  lost  power  in  this  brilliant 
education  ? 

Is  it  true  that  in  either  intellectual  or  physical  training,  bold, 
brilliant  eflbrts,  under  proper  conditions  and  limitations,  exhaust  the 
powers  of  life?    On  the  contrary,  is  it  not  true  that  we  find  in  vig- 


720 


PHYSICAL  CULTURE. 


orous,  bold,  dashing,  lirilliunt  cfTortn  tho  only  8oui'uo  of  vigorous, 
l>old,  dashing,  and  brilliant  powers? 

In  this  discussion  I  bavo  not  considftrod  the  trontmont  of  invalids. 
Tho  principles  presented  are  uppliciihle  to  tho  trainin^r  of  chihlren 
and  adults  of  average  vitality. 

In  a  work  upon  which  1  am  now  engaged,  devoted  to  the  "  Movo- 
nu'ut  Cure,"  to  bo  pul)li.shed  early  in  1863,  I  shall  advocate,  and  for 
riMisons  which  will  appear  in  the  work,  an  entirely  ditt'erent  policy. 

In  tlie  moan  time,  I  will  vest  upon  the  general  statement,  that  all 
persons  of  both  sexes,  and  of  every  age,  who  are  possessed  of  avcni<:o 
vitality,  should,  in  thodepartment  of  physical  education,  employ  li;i'lit 
apparatus,  and  execute  a  great  variety  of  feats,  which  require  skill, 
accuracy,  courage,  dash,  presence  of  mind,  quick  eye  and  hand,  —  in 
hi'ief,  which  demands  a  vigorous  and  comi)lete  exercise  of  all  thi; 
powers  and  faculties  with  which  the  Creator  has  endowed  us ;,  while 
deformed  and  diseased  persons  should  be  treated  in  consonance  with 
(lio  philosophy  of  the  Swedish  Movement  Cure,  in  which  vhe  move- 
ments are  slow  and  limited. 

It  is  but  justice  to  the  following  series  of  exercises  with  dumb-bells, 
as  well  as  to  myself,  to  state  that  not  only  are  they,  with  two  or 
three  exceptions,  my  own  invention,  but  the  wisdom  of  the  precise 
arrangement  given,  as  well  as  the  balance  of  exercise  in  all  the  mus- 
cles of  the  body  and  limbs,  have  been  well  proved  by  an  extensive 
use  for  several  years. 

It  must  not  be  forgotten  that,  in  all  the  dumb-bell  exercises  tho 
pupil  should,  as  a  beginning  position,  stand  with  his  heels  together, 
the  toes  separated  so  as  to  make  between  the  feet  a  right  angle,  and 
the  arms  hanging  by  the  sides,  with  the  dumb-bells  horizontal  aod 
Durallel  to  each  other. 

Not  only  in  all  the  exercises,  but  in  all  the  changes  from  one  exer- 
cise to  another,  the  pupil  must  keep  time  to  the  music.  In  tho 
absence  of  other  musical  instruments,  a  drum  may  be  employed  to 
mark  the  time ;  and  even  without  this  it  may  be  kept  by  counting 
one,  two  ;  one,  two  ;  one,  two. 

It  must  be  remembered  that  in  no  case  should  the  pupil  bend  the 
legs  at  the  knee,  or  his  ai'ms  at  the  elbow,  unless  it  is  so  directed.  No 
rule  in  the  dumb-bell  exercises  is  so  important  as  this.  If  it  be  foi- 
gottcn,  exorcises  with  dumb-l)ells  will  lose  more  than  half  their  value. 

No.  1.  The  position  is  shown  in  i^tj'.  1.  Thumbs  outward.  Bells 
exactly  horizontal.  Turn  the  thumb  ends  of  ti  e  bells  to  the  hips,  and 
jlhen  back  again  to  the  position  shown  in  tliv  figure.  Repeal  ten 
limes.  liet  the  change  be  made  with  the  greal  Hst  accuracy.  When 
it  is  well  done,  no  matter  which  end  is  at  the  ll  p,  a  straight  rod  run 
through  one  dumb-bell,  lengthwise,  would  i\  ^he  same  time  run 
through  the  centre  of  the  other. 

In  this  and  all  subsequent  dumb-bell  exercises,  the  pupil  must  be 
careful  not  to  bend  the  elbows.  When  exceptions  to  this  rule  occur, 
they  will  be  plainly  indicated. 


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IMAGE  EVALUATION 
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Collection  de 
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Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


PHYSICAL  CULTURE. 


721 


No.  2.  Position  seen  Fig.  2.  Keep  the  elbows  pressed  against 
the  sides,  and  twist  tlie  hells  so  the  ends  are  exactly  reversed,  lie 
sure  they  are  exactly  in  line  with  each  other,  and  the  forearms  par- 
allel.    Repeat  ten  times. 


figure  1. 


Figure  2. 


No.  3.     In  passing  from  No.  2  to  No.  3,  bring  the  bells  to  the  chest,., 
nnd  on  the  next  beat  to  the  position  in  Fig.  3.     The  palms  of  the 
liands  are  upward.     Bells  exactly  horizontal  and  parallel  to  each 
other.     Turn  the  hands  over,  knuckles  upward.     IJells  now  exactly  in 
the  same  position  as  before.     Repeat  ten  times. 


Figun-  3. 


Figure  4. 


No.  4.     In  passing  from  No.  3  to  No.  4,  bring  the  bells  to  the  chest, 
and  on  the  next  Injat  to  the  j^Kwition  in  Fig.  4.     The  palms  forward. 


91 


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722 


PHYSICAL  CULTURE. 


9'.     . 

1^      '         : 


Twist  the  belKs  so  the  knuckles  are  forward.  Repeat  ten  times.  Arms 
to  he  kept  parallei  from  first  to  last. 

No.  5.  Position  as  in  Fig.  5.  In  passing  from  No.  4  to  No.  5, 
bring  the  I)ell3  to  the  chest.  Twist  the  arms  so  that  the  hells  are 
exactly  reversed. 

Jt  will  be  seen  in  the  figure,  the  palms  are  upward.  When  the 
I)eli.s  are  reversed,  the  knuckles  are  upward.  Keep  the  anus  parallel. 
lit-peat  (en  times. 

In  i>assLng  from  one  exercise  to  another,  I  have  spoken  of  bringing 
tho  bells  to  the  chest.  They  should  strike  the  chest  exactly  at  the 
point  shown  in  Fig.  6. 


Figure  5. 


Figure  a. 


No.  6.  Thrust  the  two  bells  down  by  the  side  of  the  legs.  Bring 
to  the  chest,  and  thrust  them  sideways.  Bring  to  tho  chest  and 
thrust  them  upward.     Bring  to  the  chest  and  thrust  them  forward. 

liepeat  these  four  thrusts  Jive  times. 

When  the  down  thrust  is  made,  the  pupil  must  bo  careful  that  at 
the  lowest  point  the  bells  are  precisely  horizontjil,  and  parallel  to  each 
other.  When  the  side  thrust  is  made,  the  arms  must  be  horizontal, 
tbe  I)ells  perpendicular  and  parallel  to  each  other.  When  the  upward 
thrust  is  made,  the  arras  must  be  accurately  perpendicular,  l)ells 
parallel  and  horizontal. 

When  tho  forward  thrust  is  executed,  the  arms  must  be  exactly 
horizontal,  and  tho  bells  perpendicular  and  parallel. 

No.  7.  Raise  tho  right-hand  bell  from  the  side  of  the  leg  into  the 
arm-pit,  five  times.  {Fig.  7.)  Left,  five  tunes.  Alternately  and 
sfmultiuieously,  five  times. 

Be  sure  that  each  time  when  the  bells  come  into  the  arm-pits  they 
are  exactly  horizontal. 

No.  8.  Passing  from  No.  7  to  No.  8,  bring  the  bells  to  the  chest ; 
on  the  next  beat  to  the  top  of  the  shouldei*s  ;  on^the  next  beat  carry  up 


.     Arms 

0  No.  5, 
hells  are 

/"hen  the 
parallel. 

bringing 
ly  at  the 


Bring 
lost  and 
i-ward. 

that  at 

lo  cacli 

rizontal, 

upward 

lar,  bells 

exactly 

into  the 
tely  and 

pits  they 

le  chest ; 
carry  up 


Figure  7. 


Ilgure  8. 


No.  9.  Passing  from  No.  8  to  No.  9,  bring  the  bells  to  the  chest 
(the  dotted  lines  in  Fig.  9  show  it),  then  down  by  the  sides ;  in  all, 
as  usual,  keeping  good  time  to  the  music.     Now  carry  the  right  bell 


Figure  9. 


Figure  10. 


to  the  chest,  then  up,  reaching  the  position  shown  in  Fig.  9.  Return 
to  the  hip,  marking  one  beat  on  the  chest  in  going  down.  Repeat 
ten  times.  Left,  the  same.   Alternately  and  simultaneously,  ten  times. 


l^r-^ 


» ■- 

I 


724 


PHYSICAL  CULTURE. 


•^ 


No.  10.  Bring  the  l)ells  to  the  chest.  Strike  out  the  right  one  in 
front,  arm  precisely  horizontal,  bell  perpendicular.  {Fio.  10.)  Ite- 
peat  twenty  times.  Left,  the  same.  Alternately  and  Himultaneously, 
twenty  times. 

As  usual,  keep  the  chest  well  forward,  and  the  shoulders  dniwn 
far  back. 

No.  11.  Holding  the  bells  in  the  position  seen  in  Fig.  11,  bring 
them  with  great  force  into  the  position  seen  in  the  dotted  line,  forty 
times.  In  beginning  this  elbow-thrust  backward,  it  is  well  to  first 
raise  the  bells  a  foot,  that  they  may  be  brought  back  with  more  force, 
and  more  directly  into  the  position  seea  in  the  dotted  lines.  But  in 
carrying  them  forward  again,  it  should  be  first  into  the  position  seen 
in  the  figure. 


Figure  11. 


Figure  12. 


No.  12.  Stamp  the  left  foot,  then  the  right,  then  charge  out  into 
the  position  seen  in  Fig.  12.  Make  sure  that  the  leg  behind,  in  this 
and  all  subsequent  charges,  is  kept  entirely  straight,  while  the  one 
forward  is  placed  as-shown  in  the  figure.  Holding  the  arms  as  illus- 
trated, force  the  entire  person  into  the  position  of  the  dotted  lines, 
five  times.  There  should  be  no  motion  in  the  ahordder  joints.  The 
chest  is  pushed  far  forward,  and  the  shoulders  drawn  well  back.  These 
directions  are  applicable  to  all  charging  exercises,  in  which  a  different 
course  is  not  plainly  indicated. 

It  will  be  observed  that  the  charge  in  No.  12  is  exactly  sideways. 

Rise  to  the  peipendicular  again,  stamp  with  the  right  foot,  then  the 
left,  and  lastly  charge  out  on  the  left  side,  and  repeat  the  perform- 
ance of  the  right  side_/?ve  times. 

No.  13.  Rise  to  the  perpendicular,  stamp  with  the  left  foot,  then 
with  the  right,  then  charge  out  as  shown  in  Fig.  13.  Under  the 
directions  given  iii  No.  12,  sink  five  times. 

Same  on  the  left  side,  of  course  with  the  intermediate  stamping. 


ight  one  in 
,10.)  lie- 
Itaneously, 

ers   drawn 

.11,  bring 
line,  forty 
ell  to  first 
wore  force, 
3.  But  in 
sition  seen 


O^ 


;e  out  into 
nd,  in  this 
e  the  one 
»9  as  illus- 
ted  lines, 
nts.  The 
ck.  These 
a  diiferent 

sideways. 
,  then  the 
perform- 

foot,  then 
Jnder  the 

amping. 


PHYSICAL  CULTURE. 


725 


No.  14.     After  the  regular  stamping,  the  pupil  should  charge  in 
the  manner  illustrated  in  Fig.  14.     Sink  five  times. 
Same  on  the  left  side, 
luthis,  as  in  Figa.  12  and  13,  the  charging  is  exactly  sideways. 


Figure  13-U. 

No.  15.  Stand  upright,  hands  by  the  side.  Raise  the  right  hand, 
as  shown  in  Fig.  15,  five  times.  Left,  the  same.  Alternately  and 
simultaneously,  five  times. 


Figure  15. 


Figure  16. 


In  this  the  arm  is  carried  up  with  a  quick,  strong  effort,  and  ar- 
rested at  the  horizontal  line,  precisely  as  if  it  had  struck  a  rock. 
When  it  is  brought  back  to  the  side  again,  it  is  with  the  same  force 
and  sudden  arrest.  This  and  the  next  one  are  among  the  most 
severe  of  the  dumb-bell  exercises. 


'i  1 
I 


Yi 


n 


!il 


1'^ 


^h: 


'i  i\ 

Mi 

J :»     ■: 


'  5 


Figure  :9.  F-Buru  -U. 

tion  of  the  clotted  line  in  Fig.  17.     Repeat  five  times, 
the  8ume.     Alternately  and  simultaneously,  five  times. 


Left  hand 


r. 


PHYSICAL  CULTURE. 


727 


J>aek  tho 
same.  Al- 


id  sudden 


comhino 
the  posi'. 


No.  18.  Stand  upright,  arms  hanging.  Raii^o  th«  riglit  arm  to 
the  horizontal,  at  tho  sidu,  with  the  palm  up.  Repeat  five  times. 
Left,  tho  same.  Alternately  and  simultaneously,  five  times.  The 
position  of  one  of  tho  arms  is  seen  in  Fig.  17. 

No.  19.  Having  tho  arms  extended  at  tho  sides  as  shown  in  Fig. 
18,  raise  the  right  arm  to  the  position  seen  in  the  dotted  line,  five 
times.     Left,  tho  same.     Alternately  and  sinmltaneously,  five  timc^' 

In  raising  the  dumlvbells  over  the  head,  be  careful  that  they  are 
in  such  a  position  that,  when  the  two  are  up  together,  they  are 
exactly  horizontal  and  parallel  to  each  other. 

No.  20.  Beginning  as  in  No.  18,  arms  hanging,  combine  Nos.  17 
and  18,  in  one  sweep,  each  arm  five  times.  Alternately  and  sinml- 
taneously, the  same. 


Figure  21. 


Figure  22. 


/ 


No.  21,  Standing  upright,  arms  hanging,  charge  into  tho  position 
shown  in  Fig.  19 ;  remaining  thus,  thrust  the  arms  iu  front,  in  a 
horizontal  line,  five  times,  alternately  and  simultaneously.  Rising  to 
the  perpendicular,  stamp  with  the  right  foot,  then  the  left,  then  charge 
out  with  the  left  foot,  and  repeat  the  exercises  witii  the  arms. 

It  will  be  seen  by  the  figure  that  the  leg  behind  is  kept  entirely 
straight  and  rests  on  the  toe.  The  special  point  in  this  exercise  is 
to  reach  the  dumb-bell  as  far  forward  as  possible. 

No.  22.  Standing  as  rein-esented  in  Fig.  20,  force  the  right  arm 
into  the  position  shown  in  the  dotted  line,  five  times.  Left  the  same. 
Alternately  and  simultaneously,  five  times. 

In  this  exercise  keep  the  body  as  erect  as  possible. 


ft  hand 


» 


"n-^    V 


728 


PHYSICAL  CULTURE. 


No.  23.  Ilavin}?  tho  nnns  purpendiculnr 
over  the  head,  perform  the  saiiio  exorcise 
as  in  tiie  hist  number,  with  rij^hthand,  left 
hand,  then  alternately  and. simultaneously. 
No.  24.  Placing  the  feet  in  position  of 
Fiff.  21,  raise  tho  arms  with  <rreat  force 
from  the  hanging  position  to  that  seen  in 
Fiff.  21.  On  the  next  heat  l)ring  tho  arms 
to  the  position  seen  in  Fiij.  22 ;  on  tho 
next  to  that  seen  in  Fiff.  23  ;  on  tho  next 
beat  sweep  i>aek  to  the  position  seen  in 
Fifj.  22  ;  then  to  the  position  seen  in  Fig. 
21.     lifjieut  five  tiiiien.     Stamp  right  and 

left,  then  step  out  with  tho  left  foot,  then  saving  the  arms  over  the 

head,  perfonning  the  same  exercise  on  tho  li^ft  side. 
In  this  exercise  neither  arms  nor  legs  siioiild  l)o  bent. 
No.  25.     Stund  erect,  arms  horizontal  in  front  and  jmndlel  to  each 

other.     Carry  the  right  hand  backward  in  tho  horizontal  i)lano  {Fig. 

24)  as  far  as  possible  ;  return  it.     liepoat  ton  tiujes.     Left  the  same  ; 

alternately  and  simultaDeously,  ten  times. 


Figure  23. 


Fiuuie  24. 


yitfUl^'^  2i3. 


No.  2G.  Standing  erect,  arms  hanging,  stamp  with  the  left  foot ; 
then  with  the  right ;  then  charge  into  the  position  seen  in  Fig.  25, 
and  thrust  the  arms  in  a  direct  line  upward,  alternately  and  simul- 
vaneously,  ten  times.  Assuming  the  erect  position,  drop  the  arms 
l»y  the  side,  stamp  the  right  foot,  then  the  left,  and  charge  out  on 
the  left  side  ;  rcjjeat  tho  exercise  with  the  arms. 

In  this  exercise,  it  will  be  seen,  the  leg  behind  is  straight,  that 
charged  forward,  considerably  bent. 


PHYSICAL  CULTURE. 


729 


No.  27.     Ah  in  nearly  ull  other  exerciseu,  begin  witii  Ihu  licols 


Tlguro  20. 


Figure  ST. 


together,  ])ocly  erect,  chest  forward,  shoulders  Iwck,  nrnis  hanging, 
dunih-bells  horizontal  and  parallel  to  each  other.     Step  diagonally 


Figure  28. 


Figure  29. 


backward  with  the  right  foot,  as  seen  in  Fig.  26,  and  repeat  the 
e.\ercise8  in  No.  2G.     Same  with  the  left  foot.        ".      -      . 
92 


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tvn 


w 


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730 


PHYSICAL  CULTURE. 


In  this  oxcfoiHc  tho  forward  leg  is  kept  straight,  that  behind  i.s  1»ent 
as  niucli  a.s  possiliie. 

No.  28.  Bells  on  the  chest.  Carry  the  right  nnn  out  at  the  side, 
tlirusting  it  as  far  hacii  as  possible ;  Huddcnly  bring  it  back  to  tlio 
ohcrtt  in  a  circle  as  if  grasping  a  large  body  standing  in  front.  Repent 
Avo  times.     Left  hand,  saniu.  Alternately  and  siniulUnieously,  same. 

In  this  exercise  (ho  arms  siioidd  be 
ke|)t  in  the  horizontal  plane,  and  .^houlil 
in  the  performance  of  the  exercise  enclose 
as  largo  an  armful  of  the  imaginary 
objects  as  possible. 

No.  29.  Standing  erect,  ai'ins  hanging 
at  the  side,  suddenly  turinng  the  body  to 
one  side  as  far  as  you  can  twist  it  with- 
out moving  the  fei^t,  carry  the  a'-nis  to 
the  position  seen  in  Fir/.  27.  Bring  them 
back  to  the  sides,  while  at  the  same  time 

G-..^#        \   '   f  I  y°"  bring  the  l)ody  to  the  first  ))osition. 

y\       Y'l    I  -  Swing  the  arms  up  on  the  othc  side,  and 

"Li»n     '  \\    I  so   continue,    alternating    twenty  times. 

No.  30.  Standing  erect,  arms  hanging, 
bring  the  l)ells  to  the  chest,  then  to  the 
floor,  as  shown  in  the  dotted  lino  in  Fiff. 
28  ;  then  rising,  bring  the  dumb-bells  again 
to  the  chest,  and  on  the  next  beat  thrust 
them  as  fav  upward  as  possible,  rising  on 
the  toes ;  then  back  to  the  chest.     Repeat  twenty  times. 


»   ^ 


Fivui-o  Rl 


No.  31.     Standing  erect,  dumb-bells  on  tlie  shoulders  (not  on  the 


^Mfa 


•ehind  i^  )>cnt 

t  nt  tho  side, 
l)iiok  to  tlie 
rout.  Repent 
lously,  simic. 
4  should  lit' 
,  and  should 
rcise  enclose 
a    iiimgintiry 

u'ins  lian<iin«r 
the  Ixxly  to 
wist  it  witli- 
tho  IP"  ns  to 
Briiii^  them 
0  8nnio  time 
rst  jw.sition. 
ie*"  side,  and 
rXMity  times, 
•nis  hanging, 
then  to  the 
lino  in  Fi(f. 
b-l)ell.s  again 
.  beat  thrust 
le,  rising  on 


(not  on  the 


PHYSICAL  CULTURE. 


731 


ehortt),  thrust  tho  right  arm  out  at  tho  side  as  seen  in  Fiff.  2?),  ten 
tiiiios.     Left,  tho  Hame.     Alternately  and  simultaneously,  tho  same. 

No  32.  Standing  orect,  arms  hanging,  carry  the  arms  to  the  hori- 
zontal in  front  ;  then  to  the  position  over  tio-vlieud  seen  in  Fi(j.  JU) ; 
now  down  to  tho  horizontal  again,  and  then  Uj  the  floor  as  seen  in 
the  dotted  line.     Repeat  ten  times. 

Jn  tliin  exercise  there  must  be  no  bending  at  the  knees  or  elbown. 

No.  33.     Standing  orcct,  arms  hanging,  charge  out  with  tho  right 


Figure  S2, 

foot,  and  sweep  the  left  arm  as  shown  in  Fig.  31  ;  on  tho  next  beat 
return  to  tho  first  possition,  Rt  ^  )at  five  times.  Same  on  the  left 
side.     Alternately,  five  tinies. 

No.  34.  Standing  erect,  arms  hanging,  without  moving  the  body 
carry  the  right  foot  out  sideways,  lifting  it  from  tho  floor,  and  bring- 
ing it  back  to  the  other  foot,  without  bending  the  knee,  five  times  ; 
then  charge  into  tho  position  seen  in  Fig.  32,  and  return  to  tho  tirst 
posi'ion,  five  times. 

The  arm  which  is  brought  over  the  head  must  bo  carried  in  a 
ilnoct  line  from  tho  side  to  tho  position  over  the  head,  and  not 
brought  toward  the  front  of  the  body  in  its  passage  up  or  down. 


--f-»^;tJEXfaBCt5S5Ste-&X';3Sfiiit5it- 


Mi 


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73J 


rilYSICAL  CULTURE. 


"■■A 


1:^ 


^^ 


^ 


' '    B  a  g  £  z  e  r  0  i  s  e  B. 

The  use  of  small  bags  filled  with  beans,  for  gymnastic  exercises, 
was  suggested  to  my  mind  six  years  since,  while  attempting  to 
d(;vi^e  a  series  of  games  willi  large  rubber  balls.  Throwing  and 
eatcliing  objects  in  cer*ain  ways,  requiring  skill  and  presence  of  mind, 
adbrds  not  oidy  good  exercise  of  the  muscles  of  the  arms  and  ui)per 
half  of  the  body,  but  cultivates  a  quickness  of  eye  and  coolness  of 
ncrv:  very  desirable.  Appreciating  this,  I  employed  large  rubber 
balls,  but  was  constantly  annoyed  at  the  irregularities  resulting  from 
the  difficulty  in  catching  them.  When  the  balls  wci'e  but  i>arlially 
inflated,  it  was  observed  the  hand  could  better  seize  them.  This  at 
lengUi  suggested  the  bean  bags.  Six  years'  use  of  these  bags  has 
resulted  in  the  adoption  of  the  following,  as  the  best  size  and  shape. 

The  material  is  a  strong  1>ed-ticking.  Bags  for  young  children 
should ))(!,  before  sewing  seven  inches  square  :  for  ladies,  nine  inches  : 
for  ladies  and  gentlemen  exercising  together,  ten  inches ;  for  gentle- 
men alone,  twelve  inches.  Sew  them  with  strong  linen  or  silk, 
thread,  doubh^d,  nearly  three  quarters  of  an  inch  from  the  edge, 
leaving  a  small  opening  at  one  corner lo  pour  in  the  beans.  Fill  the 
bags  three  quarters  full,  and  they  are  ready  for  use.  If  used  daily, 
onto  in  two  weeks  they  should  be  emptied  and  washed.  To  a'low 
tlionito  be  played  with  after  they  are  soiled,  is  pretty  sure  to  furnish 
much  dust  for  the  lungs  of  the  players,  beside  soiling  the  hands  and 
clothes.  Thei'e  cannot  be  too  much  care  exercised  in  regard  to  this  • 
point  of  cleanliness.  Befoni  the  beans  are  used  the  first  time,  they 
should  be  rinsed  with  water  antil  it  runs  from  them  quite  clean,  when 
they  nnist  be  dried  ;  and  every  month  or  two  afterwarda  this  cleans- 
ing should  be  repeated. 

The  dirty  carelessness  with  which  these  bag  exercises  are  gener- 
ally managed,  makes  them  a  positive  nuisance. 

Prenn.sing  this  indispensable  preparation  and  care  of  the  bags,  I 
shall  now  proceed  to  give- those  exercises  M'hich  I  have  found  best 
adapted  to  schools  and  gymnasiums. 

Pig.   1  represents  a  series   of  hoops  lashed  between  two  stronir 

ropes  and  stretched   across  tl 


j_ 


Figure  1, 


room,  the  ropes  fastened  on  the 
side  of  the  room  into  staples,  and 
ou  the  other  running  through 
pulleys.  By  these  means  the 
ropes  may  be  drawn  very  tjiut. 
It  is  well  to  fasten  the  staples  and  pulleys  into  slides,  that  the  hoops 
may  be  altered  lor  persons  of  diflerent  ages. 

Nearly  all  the  exerci.'-es  with  bags  are  gi'eatly  improved  by  throw- 
ing them  through  the  hoops.  It  will  be  ob.served  the  cut  srepresent 
the  player  as  throwing  the  bags  qu'te  high.  This  has  reference  to 
the  hoops.  But  the  bags  may  be  thrown  between  the  players  without 
the  hoops. 


V- 


ic  exercises, 
tempting  to 
irowing  and 
nco  of  mind, 
s  and  iipiHU' 
coolness  of 
arge  rul)l)or 
suiting  from 
nit  i>iiilially 
n.     This  !U 
se    hags  has 
and  siiapo. 
ing  children 
line  inches  : 
for  gentlc- 
len   or   silk. 
the    edge, 
3.     Fill  the 
used  daily, 
To  a'low 
c  to  furnish 
!  ))ands  and 
pird  to  this 
time,  thoy 
clean,  when 
this  cleans- 


are  gener- 


the  bags,  I 
found  best 

two  strong 

across  the 

mcd  on  the 

staples,  and 

ig  through 

means  the 

very  tjiut. 

the  hoops 

by  throw- 
srej)resent 
iference  to 
rs  without 


PHYSICAL  CULTURE. 


733 


No.  1.  Arrange  yourself  in  two  classes.  Classes  face  each 
other,  six  feet  apart.  Members  of  one  class  will  each  have  a  bag. 
The  other  class  will  have  no  bags.  Each  person  will  play  with  the 
one  standing  exactly   opposite.     Hold  the  bags  under  your  chins 


Figure  «  Figure  3. 

(  Fi(f.  2).  When  one  gives  the  work,  each  couple  is  to  throw  its  bag 
backwards  and  forward  ten  times,  counting  both  ways.  At  the  be- 
ginning of  this  and  the  following  exercises,  the  leader  will  announce 
how  many  times  the  bag  is  to  be  thrown. 


Flgiiro  4. 


Figure  5. 


Figure  6. 


Each  couple  will  play  as  rapidly  as  possible,  and  as  each  finishes, 
the  two  players  will  hold  up  their  hands,  and  cry  out  the  number  in 
a  loud  voice.  Now  ready  !  One,  two,  thhee  ! !  The  bag  is  always 
to  bo  thrown  from  the  chest,  never  to  be  thrown  from  the  lap. 

No,  2.  Same  as  the  last,  except  the  bag  is  thrown  and  caught 
with  the  right  hand.     The  position  is  well  shown  in  Fig.  3. 


-    ■[ 


iil 


l> 


'..A*v*'4^ 


Figure  9. 

No.  5.  Same  as  tho  last,  except  the  bag  is  thrown  with  the  right 
hand,  as  shown  in  Fig.  5.  The  unoccupied  hand  in  this  and  all  other 
single-handed  bag  exercises  is  to  be  hold  on  the  corresponding  side, 
with  the  arm  akimbo. 

No.  6.     Same  as  the  last,  except  with  the  left  hand. 

No.  7.  The  bag  is  to  be  thrown  over  the  head  from  tlie  position 
seen  in  Fiq.  <\. 


Figure  10.  Figure  11.  Figure  12. 

No.  8.  To  be  thrown  from  the  position  seen  in  Fig.  7,  with  the 
right  hand.  The  one  who  catches  must  receive  it,  while  the  left  hand 
grasps  the  arm  in  the  same  way. 

No.  9.     Same  as  the  last,  only  using  the  left  hand. 

No.  10.     Standing  with  your  right  side  toward  your  partner,  hold 


aen  the  right 
with  the  left. 
Is,  from  the 


> 


bh  the  right 
nd  all  other 
mding  side, 


he  position 


,  with  the 
J  left  hand 


tner,  hold 


PHYSICAL  CULTURE. 


735 


the  bag  on  the  point  of  the  elhow.  l)cing  sure  to  keep  the  forearm 
vertical  (/'Vy.  8) ;  throw  from  this  position  the  number  of  times  an- 
nounced l)y  the  leader.     To  bo  caught  in  the  hands. 

No.  11.  Same  as  the  last,  except  the  left  side  is  turned,  and  the 
bag  is  thrown  from  the  left  elbow. 

No.  12.  Hold  the  bag  as  re))re8ented  in  Fig.  9,  and  toss  to  your 
partner.  Ho  will  of  course  return  in  the  same  manner  to  you,  and 
tliiiH  it  will  bo  tossed  backward  and  forward  the  number  of  times  in- 
diciited  by  the  loader.  As  in  all  the  other  exercises  thus  far  given, 
each  couple  upon  xhing  the  indicated  number,  will  hold  up  their 
liaiids  and  cry  out  ihat  number  in  a  loud  voice. 

No.  13.     Turning  your  right  side  to  >our  partner,  throw  from  the 


Figure  1.3. 


Figure  M. 


Figure  15, 


position  represented  in  Fig.  10.  Your  partner  catches  the  bag,  stand- 
ing in  the  same  attitude. 

No.  14.  Same  as  the  last,  except  you  turn  your  left  side  to  your 
partner,  and  throw  with  the  left  hand,  either  without  bending  the 
knees,  as  seen  in  Fiff.  11,  or  bending  them,  as  seen  in  Fi;/.  10. 

No.  15.  Again  turn  your  right  side  to  your  partner,  and  throw  the 
bag  from  the  position  seen  in  Fig.  12. 

No.  1().  Same  as  the  last,  except  turning  the  left  side,  you  throw 
with  the  left  hand. 

No.  17;  Turn  your  back  to  your  partner,  and  bend  backwards,  so 
that  you  can  see  him  Ho  bends  back,  so  that  he  may  see  you,  and 
then  you  throw  the  bag  to  him  as  represented  in  Fig.  13.  Always 
cry  read;/!  that  he  may  not  be  kept  waiting  too  long  in  an  uncom- 
fortable position. 

No.  18.  Face  your  partner,  and  throw  from  the  position  repre- 
sented in  Fig.  14,  holding  the  bag  on  the  back  of  the  hand. 

No.  19.     Same  as  the  last,  except  the  left  hand  is  employed. 

No  20.  Face  .\our  partner,  and  throw  tho  bag  around  the  back 
and  over  the  opposite  shoulder,  as  shown  in  Fig.  15. 

No.  21.     Same  as  the  last,  except  you  see  the  other  hand. 


i 


(■  ■ 


No.  22.  Each  couplo  having  ton  hags,  you  throw  to  your  part- 
ner, and  he  catches  as  many  as  he  can  hold,  fohling  his  arms.  ( Fi>j. 
10.)  This  one  will  not  ordinarily  be  played  in  class,  as  the  number 
of  bags  will  scarcely  be  sufficient. 

No.  23  The  two  classes  will  stand  as  represented  in  Fir;  17. 
Place  ten  bags  on  a  chair  or  box  at  the  feet  of  the  first  player  of  eacli 
class.  The  leader  gives  the  word,  one,  livo,  three!  and  the  two  classes 
coni|)ete  in  passing  the  bags  over  their  heads  backwards,  to  the  fool 
of  Ihe  class,  when  they  whirl  round  and  immediately  pass  them  back 
The  chus  which  has  the  entire  ten  on  the  chair  or  l)ox  at  its  head, 
first,  counts  one  in  the  game.  It  is  usual  to  make  the  game  three, 
five,  or  ten. 


^' 


Figure  IS. 


rijjurc  17 


No.  24.  Let  the  two  classes  face  each  other  again,  and  pa.ss  the 
Mgs  as  in  the  last,  except  that  they  are  carried  along  in  front  and  as 
high  as  the  chest,  being  careful  not  to  stoop  forward. 

No.  25.     Let  the  bags  be  all  placed  at  the  head  of  one  of  the 
classes.     We  will  call  this  class  No.  1 ;  the  other,  chiss  No.  2.     The 
first  player  in  class  No.  1  throws  a  bag  to  the  first  player  in  class  N* 
2,  who  throws  it  back  to  the  second  player  in  class  No.  1,  who  throw 
it  back  to  the  second  player  in  class  No.  2,  who  in  turn,  throws  it  t 
the  third  jjlayer  in  class  No.  1.  and  so  on,  working  it  down  to  the  foo. 
of  the  class. 

But  one  bag  is  not  allowed  to  make  the  trip  alone  ;  all  follow,  one 
after  another,  in  rajjid  succession. 

In  this  game,  the  bags  are  all  thrown  from  the  chest  with  both 
hands,  as  represented  some  pages  Imck,  in  No.  1  of  the  bag  exercises 

No.  26.  The  whole  company  may  now  be  divided  into  trios,  each 
trio  playing  with  three  bags,  as  represented  iu  Fig.  18.  Each  one 
throws  the  bag  to  the  player  at  his  right  hand,  and  at  the  same  time 
catches  the  bag  thrown  from  the  player  at  his  left. 


PHYSICAL  CULTURE. 


737 


your  purl- 
ins. {Fig. 
the  niinibor 

in  Fiff  17. 
lyer  of  eaili 
two  clashes 
to  tho  foot 
them  hack 
it  it.s  head, 
janie  three, 


d  pass  the 
ont  and  as 

r)ne  of  tho 
2.      The 

n  clas.s  N( 
ho  throw 
irows  it  1 

to  the  foo; 

61  low,  one 

with  both 
exercises 
rios,  eaeli 
Each  one 
ianio  time 


To  secure  the  proper  distance  between 
the  players  for  this  game,  they  should 
lake  each  other  by  the  hands,  and  pull- 
in"  luird,  they  will  have  th(^  right  position. 
Each  player  must  look  constantly  at  the 
oiu!  from  whom  he  receives  the  bags,  and 
never  for  a  moment  at  the  one  to  whom 
lie  throws.  If  they  forget  this  rule,  the 
bags  will  soon  fall  to  the  (loor. 

No.  '.il.  Same  as  the  last,  except  the 
basis  arre  passed  the  opposite  way. 

No.  28.  The  company  is  again  divi- 
ded into  couples,  and  each  couple  plays 
with  two,  three,  four,  or  more  bags.  A 
throws  a  bag  with  his  right  hand  to  B, 
who  catches  it  with  his  left  hand,  and 
immediately  changing  it  to  his  right, 
throws  it  back  to  A,  who  catches  it 
with  his  left,  and  who,  changing  it  to  his  right,  throws  it  back  again 
to  B  (^Fig.  19).  Two,  three,  four,  or  five  bags  can  be  made  to  per- 
form this  circle  between  two  players  at  the  same  time. 


Figure  18. 


Figure.  19. 

The  bags,  in  this  as  in  all  the  other  bag  exercises,  except  one,  should 
bo  thrown,  and  not  tossed. 

No.  29.  Same  as  the  last,  except  the  bags  are  thrown  with  the 
left,  and  caught  with  the  rights  hand. 

No.  30.  Now  the  players  will  stand  in  two  classes  again,  the  classes 
to  be  six  feet  apart,  and  the  players  in  each  party  to  be  six  feet  from 
each  other.  Place  six  bags  on  a  chair  at  the  head  of  each  class.  Upon 
the  word  owe,  tioo.,  three  !  the  first  player  in  each  class  seizes  a  bag 
and  runs  with  it  to  the  second  player,  who  carries  it  to  the  third,  who 
in  turn  rushes  to  the  fourth,  and  so  on  to  the  foot  of  the  class.  But 
one  bag  is  not  allowed  to  make  the  journey  alone.  One  at  a  time,  the 
93 


fit;  I 


.^iiiiiiigliiiittiiliii 


738 


PHYSICAL  CULTUllE, 


whole  six  are  hurried  onward.  Instantly,  and  without  any  signal,  they 
are  sent  back  to  the  head  of  the  class  in  the  same  order.  .  The  class 
which  has  its  six  bags  on  the  chair  at  the  head  of  the  class  first,  counts 
one  in  the  game. 


Exercises  with  Biugs. 

'    •  '•  ''/""  •     -    . 

This  series  of  exercises  is  entirely  new,  and  beyond  all  comparison, 
the  best  ever  devised.  Physiologists  and  gymnasts  have  everywhere 
bestowed  upon  it  the  most  unqualified  commendation.  Indeed  it  is 
difficult  to  conceive  any  other  possible  series  so  complete  in  a  physio- 
logical point  of  view,  and  so  happily  adapted  to  family,  school,  and 
general  use. 

If  a  man  were  as  strong  as  Sampson,  he  would  find  in  the  use  of 


Figure  1. 


lignre  2. 


these  rings,  with  another  man  of  equal  strength,  the  fullest  opportu- 
nity to  exert  his  utmost  strength;  while  the  frailest  child,  engaged 
with  one  of  equal  strength,  would  never  be  injured. 

There  is  not  a  muscle  in  the  entire  body  which  may  not  be  brought 
into  direct  play  through  the  medium  of  the  rings.  And  if  one  partic- 
ular muscle,  or  set  of  muscles  is  especially  deficient  or  weak,  the  ex- 
ercises may  be  concentrated  upon  that  muscle  or  set  of  muscles. 

Wherever  these  rings  are  introduced,  they  will  obtain  the  highest 
favor  and  awaken  the  most  earnest  enthusiasm. 

The  ring  is  generally  turned  from  cherry  wood,  and  when  finished 
measures  six  inches  in  diameter,  while  the  body  is  one  inch  thick.  It 
should  be  highly  polished,  especially  on  the  inner  part.  Fig.  1.  gives 
a  good  idea  of  the  ring. 

No.  1.  Standing  in  the  position  represented  in  Fig.  2,  the  end  of 
the  right  toe  against  the  right  toe  of  your  partner,  the  toes  meeting  on 


signal,  they 

.  The  ( lass 

first,  count* 


3ompari8oi>, 
everywhere 
Indeed  it  is 
n  a  physio- 
school,  and 

I  the  use  of 


< 


A. 


at  opportu- 
d,  engaged 

je  brought 
one  partic- 

eak,  the  ex- 
scles. 

the  highest 

en  finished 
thick.  It 
^.  1.  gives 

the  end  of 
meeting  on 


PHYSICAL  CULTURE. 


739 


a  fttmight  line  drawn  through  the  entire  hall,  on  which  all  the  players 
jtund,  and  placing  the  left  foot  at  right  angles  with  the  right  foot,  as 
seen  in  the  figure,  pul'.  hard  and  twist  the  right  arm  hard  from  right 
to  it'ft  and  left  to  right  ten  times,  keeping  time  to  the  music. 

Be  careful  in  this,  as  in  all  other  exercises  with  the  ring,  to  draw  the 
BlioukliTs  well  back  and  keep  the  head  erect. 

No.  2.  Sarne  as  the  last,  but  using  the  left  hand,  with  the  left  foot 
forward. 


Figure  8. 


Figure  4. 


No.  3.  Join  both  hands  with  two  rings,  and  place  the  right  toe 
against  your  partner's  right  toe,  as  in  No.  1,  being  sure  to  keep  the 
foot  which  is  behind  at  right  angles  with  the  one  in  front  (which  I 


••-••'   / 


Figure  6. 


Figure  6. 


may  say  here,  is  to  be  looked  after  with  much  care  through  this  whole 
series,  whenever  it  is  possible),  then  pull  hard,  ten  times,  and  twist 
the  arms,  keeping  time  to  the  music. 

No.  4.     Exactly  the  same  as  .he  last,  but  with  the  left  foot  forward. 

No.  6.     Without  letting  go  the  rings,  turn  back  to  back,  pi 'ce  the 


.1 


■i. ' 


h: 


■  ii 


f^, 


outside  of  y()vir  left  foot  ufijaiiirtt  the  .sairic  of  your  partner,  in  tin-  Haiiie 
way  yo'i  would  push  a^aiust  th'  wall  cf  the  rooui,  and  pulling  hard 
in  ihv  position  rcpu'smtt'd  in  Fi^:  '•^,  iwist  liard  ten  times,  keeping 
time  to  the  rnusie. 

No.  6.     Same  as  the  hist,  but  with  tlie  right  foot  behind. 

No.  7.  Turn  face  to  face,  raise  the  hands  as  high  as  you  can  over 
the  head,  and,  standing  about  two  feet  and  a  lialf  apart,  bring  th(>  rings 
down  to  the  floor  without  bendirg  the  knees,  as  represented  in  Fi<^;  4, 
ten  times,  and  all  the  following  exercises  tc  n  times.  In  the  perform- 
ance of  this  you  must  not  bend  the  elbows,  which  you  can  avoid  doing 


Figure  7. 


Figure  8. 


by  carrying  the  rings  outward  at  each  side.  (In  the  ring  exercises, 
when  your  pupils,  standing  their  faces  toward  each  other,  turn  their 
backs,  see  that  they  do  not  let  go  the  rings). 

No.  8.  Standing  as  in  the  last  exercise,  but  only  two  feet  apart, 
place  the  rings  in  the  position  seen  in  Fig:  5,  Now  as  the  arms  on 
one  side  rise,  the  arms  on  the  other  side  fall,  keeping  time  to  the  music. 
Be  careful  not  to  bend  the  arms  at  the  elbows,  which  of  course  can 
be  prevented  in  this  as  in  many  oth  ,i  exercises,  by  carrying  the  hands 
outward  at  the  side.  In  this  exeri  ae  a  great  deal  of  forc(!  should  be 
used,  so  that  when  the  ring  is  car.ied  up  on  one  side,  it  goes  far  be- 
yond the  perpendicular  line,  the  bodies  of  the  players  bending  freely. 

No.  9.  Same  as  the  last,  except  the  two  rings  go  up  and  down 
simultaneously. 

No.  10.  Standing  as  in  the  last  two  exercises,  the  hands  hanging 
down  as  low  as  may  be,  and  keeping  them  in  the  same  relation  to 
each  other,  swing  them  from  side  to  side  as  far  as  you  can. 

No.  11,  Same  as  the  last,  except  that  instead  of  swinging  the 
hands  from  side  to  side,  they  make  a  complete  circle,  being  carried 
over  the  head,  as  well  as  down  between  tlie  bodies  of  the  players. 

No.  12.  Same  as  the  last,  except  the  circle  is  made  the  opposite 
way. 


ill  the  Nuiiie 
)ulliiig  liani 


ley,  kt 


'.•pilljr 

]. 

oil  can  over 
irigtlicriii<i;s 

■(I  ill  Fin;   1, 

llie  pcrforni- 
avoid  doing 


g  exercises, 
,  turn  their 

feet  apart, 
he  arms  on 

the  music, 
course  can 
;  the  hands 

should  be 
oes  far  be- 
ing freely. 

and  down 

Is  hanging 
relation  to 

inging  the 
ng  carried 
layers, 
e  opposite 


PHYSICAL  CULTURE. 


741 


No.  13.  Back  to  back,  as  seen  in  Fig.  6,  thrust  the  rings  up  with 
great  force,  each  player  keeping  his  two  arms  exactly  parallel. 

No.  14.  From  the  same  position  seen  in  Fig.  G,  thrust  the  ringa 
out  sidewisc,  as  in  all  the  other  exercises,  ten  times. 

No.  15.  Same  as  the  last,  except  the  rings  are  thrust  downward 
by  the  hips. 

No.  1(5.     The  last  three,  consectutively,  ten  times. 

No.  17.  Take  the  position  seen  in  Fig.  7 ;  your  partner  the  same. 
The  inside  of  your  left  foot  to  the  inside  of  his  left.  L»raw  your  left 
hand  as  far  back  past  your  left  side  as  possible,  dragging  your  partner's 
right  hand  after  it.  At  the  same  time  he  has  done  tlie  same  thing 
with  iiis  left.  Do  the  same  with  your  right  hands.  And  so  continue 
to  alternate.  Do  this  strongly,  pushing  your  hand  past  your  partner's 
side  as  far  as  possible,  at  the  same  time  pulling  his  hand  as  far  past 
yours  as  possible. 

No.  18.  Same  as  the  last,  except  the  right  foot  is  forward.  Be 
sure  in  this,  as  in  all  others,  that  your  two  feet  are  at  right  ang!'- 

No.  19.  Same  as  the  last  two,  except  the  feet  go  with  the  hnnds. 
Whenyou  thrust  your  right  hand  forward,  the  right  foot  goes  forward 
too.     When  the  left  hand  goes  forward,  the  left  foot  goes  with  it. 

If  this  be  well  done,  the  feet  and  hands  making  long  sweeps  to  the 


Figure  9. 


Figure  10. 


music,  it  not  only  presents  a  fine,  animated  appearance  to  the  specta- 
tors, but  brings  all  the  muscles  of  the  body  and  limbs  into  fine  play. 

No.  20.  Back  to  back,  touching  each  other's  heels.  Each  lunge 
out  with  the  right  foot  in  the  direction  the  toe  points,  the  feet  being 
at  right  angles,  and  raise  the  hands  over  the  head  so  they  touch,  thus 
reaching  the  position  seen  in  Fig.  8.  Now  back,  heels  together,  arms 
at  the  side,  lunge  out  with  the  left  feet  in  the  same  way,  and  thus 
alternate,  keeping  time  to  the  music. 

No.  21.  Standing  as  represented  in  Fig.  9,  your  partner  the  same, 
with  the  inside  of  his  left  foot  to  the  inside  of  your  left  foot,  and  hold- 
ing the  rings  as  shown  in  the  figure,  push  them  vigoruusly  toward 


mi 


f: 


74:a 


PllYPTCAL  CULTURE. 


your  partner,  BiinultuneouHly  thruatiiig  them  past  hia  body  as  far  as 
|U)rtsible.     H<!  puHlicH  them  buck  in  the  same  (luiiirier,  uiul  ho  on. 

No.  22.  Same  us  the  lu8t,  except  tlie  right  foot  is  pushed  forward, 
iu.Hti'ud  of  the  h-ft. 

No.  2'S.  Htand  back  to  buck,  heels  all  together;  both  step  out  side- 
\vi^<»'  ill  the  same  direction  as  far  as  you  can  reach,  urid  at  the  same 
instant  raise  the  hands  on  the  same  side  as  high  as  you  can,  then  re- 
turning to  the  upright  position,  hands  by  your  sides,  charge  out  at  the 
other  side  in  a  similar  manner.  When  this  has  been  done  both  ways, 
as  in  every  other  exercise,  ttm  times ;  the  leader  cries  "  alternately," 
and  you  continue  to  change  sideways  as  before,  only  in  opposite 
directions  as  represented  in  P^.  10 


figure  II. 


Figure  12. 


No.  24.  Standing  face  to  face,  two  feet  apart,  charge  sideways  aa 
in  the  last  exercise,  and  as  seen  in  Fig.  11.  In  alternation  with  this, 
charge  the  opposite  way.  After  the  regular  number  of  times,  the 
teacher  cries  "alternately,"  and  you  charge  out  sideways  with  your 
right  foot  in  opposite  ways,  as  seen  in  Fig".  12 ;  alternate  with  the  left 
foot. 

No.  25.  Standing  back  to  back,  charge,  your  faces  both  in  one  di- 
rection, with  bodies  fronting  the  same,  as  shown  in  Fig.  13.  When 
the  teacher  cries  '■'■change  I  "  you  must  change  sides  with  each  other, 
still  facing  in  the  same  direction.  Keep  time  to  the  music  with  your 
feet,  when  changing  sides,  and  as  soon  as  you  make  the  change,  go 
on  with  the  charging,  using,  of  course,  the  other  hands  and  feet. 

No.  26.  Joining  only  with  your  right  hands,  and  standing  apart 
far  enough  to  make  the  arms  straight  and  horizontal  between  you, 
charge  as  seen  in  Fig.  14 ;  the  left  hand  and  foot  the  same. 

No.  27.  Joining  with  both  hands,  charge  right  and  left  alternately, 
each  time,  as  represented  in  Fig,  14. 

No.  28.  Stand,  each  with  his  own  heels  together,  as  seen  in  Fig. 
15,  and  perform  the  exercise  ex^hjbited  in  the  figure.     As  the  hands 


PHYSICAL  CULTURE. 


743 


y  as  far  as 

HO  on. 

lid  forward, 

Rp  out  sidc- 
t  the  same 
an,  then  re- 
!  out  at  the 
both  ways, 
Iternately," 
n  opposite 


deways  as 
with  this, 
times,  the 
with  your 
ith  the  left 

in  one  di- 
P.  When 
ach  other, 
with  your 
hange,  go 
feet. 

ling  apart 
veen  you, 

Iternately, 

n  in  Fig. 
the  hands 


on  one  side  go  up,  the  hands  on  the  other  go  down.  So  alternate  the 
regular  number  of  times,  when  you  will  do  the  same  simultaneously, 
the  hands  on  both  sides  rising  and  falling  together. 


Figure  18. 


Figure  14. 


No.  29.  Standing  as  seen  in  Fig.  16,  except  that  the  inside  of  the 
right  foot  should  be  exhibited  as  pressing  against  the  inside  of  your 
partner's  right  foot,  you  draw  back  from  each  other  as  far  as  you  can, 


•• 


,*•.•' 


Figure  16. 


Figure  16. 


and  then  come  up,  touching  each  other's  cheats,  all  without  bending 
the  elbows. 
No.  30.     Same,  w^th  the  left  foot  forward. 


'■    9 


744 


PHYSICAL  CULTURE. 


No.  31.  Standing  as  Been  in  Fig.  17,  draw  far  away  from  earn 
other,  keeping  the  arms  precisely  horizontal.  Immediately  anproaeh- 
ing  each  other  again,  touch  the  shoulders  as  in  the  figure,  anci  so  con- 
tinue ten  times,  keeping  time  to  the  music. 

No.  32.     Same  as  the  last,  with  the  feet  changed. 


*»/■ 


Figure  17.  FiKure  18. 

No.  33.  Standing  face  to  face,  raise  the  hands  on  one  side  as  in 
Fig.  1 8.  As  these  hands  are  brought  down  to  the  side,  raise  those  on 
the  other  side  in  like  manner,  and  so  alternate  ten  tinu-s. 

No.  34.  Back  to  back,  and  raise  the  arms  on  one  side  as  in  Fig.  IS, 
but  carry  the  hands  completely  over  the  heads  and  down  on  the  other 
side  of  the  body.  Altcnate  with  the  arms  on  the  other  side,  ten 
tim«s. 


Figure  IK.  .  Figure  20. 

No.  35,  Carry  the  hands  all  over  together,  as  seen  in  i^.  IP. 
Change  thus  from  side  to  side,  twenty  times,  always  keeping  time  \o 
the  music. 

No.  36.     Turn  face  to  face,  and  now  back  to  back,  and  again  face 


PHYSICAL  CUT.TURE. 


745 


from  earn 
»i)proa(!li- 

UlU  HO  CUIi- 


to  faco,  ami  ho  continue  to  elnuige,  altornuting  the  nidvs  toward  whic^li 
yv)U  turn. 

No.  37.  Perform  the  exercise  Hceri  in  Fif.^.  20,  being  wure  that  you 
draw  the  arm  of  your  partner  directly  into  your  axilla  or  armpit 
Alter  alternating  twenty  times,  then  draw  the  arms  back  and  forth 
•iiiiiultancourtly,  ten  tirncA. 

No.  38.  Join  right  hands  with  your  partner  with  one  rirjg,  and 
itnud  apart  so  that  your  arms  are  straight  and  horizontal.  Advance 
your  riyht  foot  two  feet,  keeping  tin;  two  feet  at  a  right  angle.  Now 
jjiisli  your  chests  as  near  togetiier  as  you  can,  without  bending  yotir 
knees  or  elbows,  as  seen  in  Fi<r,  "21.  ISfow  drawing  the  arniH  back  to 
Mie  horizontal  on  the  next  beat  of  the  music,  carry  the  hands  down 
<in  low  n^  possible  without  bending  knees  or  elbows  on  the  next  beat. 
^  iw  back  to  the  horizontal,  and  then  up  as  high  as  possible,  and  so 
continue  ten  times. 

No.  39.  Same  with  the  left  hands,  the  left  foot  being  pushed  for- 
ward. 


side  as  in 
le  those  on 

in  Fiff.  18, 

I  the  other 

side,  ten 


Fig.  IP. 
g  time  \o 


gain  face 


1  iK»i  13  '^1.  Figure  22. 

No.  40.  Join  the  right  hands'  again,  holding  them  in  the  horizontal 
position.  Now  push  them  sidewise  as  far  as  possible  without  bend- 
ing knees  or  elbows.  On  the  next  beat  bring  the  arms  back  to  the 
straight  line  between  you,  and  now  carry  them  sidewise  the  other  way, 
and  so  contitme  ten  times.  ^       '. 

No.  41.     Left  hands  the  same. 

No.  42.  Join  right  hands  again.  Instead  of  thrusting  the  hands 
directly  upward,  or  sidewise,  carry  them  obliquely  upward,  and  after 
bringing  them  back  to  the  straight,  horizontal  line,  carry  i>liquely 
downward,  and  so  continue  ten  times,  being  careful  not  to  bend  ki.'^es 
or  elbows. 

No.  43.  Still  use  the  right  hands,  and  carry  them  obliquely  upward 
the  other  way,  and  downward  the  other  way. 

Nos.  44  and  45.     Same  with  the  left  hands. 


1 


':^\w»wm&'aMmmBii»Msmmisim^-- 


=7= 


746 


PHYSICAL  CULTURE. 


It' 


i.V' 


No.  46.  Back  to  back,  and  plif*  the  outside  of  the  left  foot  against 
the  outside  of  your  partner's  left  foot.  Right  foot  well  forward. 
Now  raise  the  hands  over  the.  head  as  seen  in  Fig,  22  (I  see  the  artist 
has  not  placed  the  outsides  of  the  left  feet  against  each  other,  as  he 
should  have  done),  and  draw  away  Stom  each  other,  bending  the  knee 


\-/: 


Figure  38.  Figure  M. 

of  the  leg  which  is  pushed  forward,  and  thus  sink  down  somewhat 
As  you  come  back,  touch  your  shoulders  against  those  of  your  part- 
ner, and  thus  repeat  ten  tiines. 

No.  47.    Same,  with  a  chancre  of  feet. 

In  the  last  two  exercises,  as  yon  draw  away,  you  must  not  pull  on 
the  rings  a  single  ounce.  If  this  be  forgotten,  your  backs  may  be 
hurt. 

No.  48.     Face  to  face,  join  the  rigit  hands,  and  place  the  tips  of 

the  right  toes  against  each  other,  and  the  left 
feet  at  right  angles  two  feet  behind.  Whirl 
the  right  hand?,  making  as  large  a  circle  as 
pos-sibje  without  bending  the  elbows  or  knees. 
After-whirling  ten  times  one  way,  then  whirl 
ten  times  the  other  way. 

No.  49.     Sa.ne  with  left  hands. 
No.  50.     Back  to  back,  two  feet  apart,  each 
with  his  own  heels  together.    Raise  the  hands 
as  high  as  possible  over  the  head,  and  bring 
them  down  as  seen  in  Fig:  23,  five  times. 

No.  51.     Join   the   right  hands,  and  turn 
your  right  side  toward  your  partner,  keeping 
the  right  arms  straight  between  you.     Both 
.  must  now  step  straight  forward  with  the  right 
Figure 25.  foot  a"  far  as  you  can  reach,  while  the  right 

arms  ".re  kept  horizontal,  as  seen  in  Fig.  24. 

No.  52.     Face  the  ppposite  way,  and  use  the  left  arms  and  feet  in 
the  same  manner. 


't  foot  against 

well  forward. 

see  the  artist 

other,  38  he 

ding  the  knee 


'* 


re  34. 

wn  somewhat 
;  of  your  part- 


ast  not  pull  on 
backs  may  be 

lace  the  tips  of 
ler,  and  the  left 
)ehind.  Whirl 
irge  a  circle  as 
Ibows  or  knees, 
vay,  then  whirl 

nds. 

feet  apart,  each 
laise  the  hands 
lead,  and  bring 
,  five  times, 
ands,  and  turn 
artner,  keeping 
en  you.  Both 
1  with  the  right 
while  the  right 

ms  and  feet  in 


PHYSIC/ L  CULTtTRE. 


747 


No.  53.  Stand  as  shown  in  Fig,  25.  Pull  your  arms  directly  for- 
ward, which  of  course  will  draw  your  partner's  arms  directly  back- 
wards. Then  he  draws  yours  backwards  in  like  manner,  and  so 
continue  ten  times. 

No.  54.  Back  to  back,  your  shoulders  touching  your  partner.  Arms 
perpendicular,  over  the  head.  Draw  your  right  arm  directly  forward. 
Simultaneously  with  this  your  partner  does  the  same  thing.  Now 
the  left  arms  the  same;  and  so  continue  to  alternate,  ten  times.  And 
last,  draw  both  of  your  arms  forward  ;  immediately  your  partner  does 
the  same,  and  so  continue  to  alternate,  ten  times. 

These  are  not  a  quarter  of  the  possible  exercises  with  the  rings ; 
but,  after  a  long  use  of  them,  with  much  study  and  innumerable 
experiments,  I  believe  this  series  gives  the  best  variety,  and  is  suffi- 
ciently extended.  Besides,  this  series  is  admirably  calculated  to  de- 
velop those  particular  muscles  which  are  almoat  universally  deficient 
in  the  people  of  the  United  States.  ^' 


Exercises   with  Wands. 

A  STRAIGHT,  smooth  stick,  one  inch  in  diameter  and  four  feet  long 
(three  feet  for  children),  with  round  ends,  is  known  in  this  gymnasium 
as  a  "  Wand,"  and  is  highly  prized.  It  is  used  to  cultivate  flexibility, 
and  is  equally  u.seful  to  persons  of  all  ages  and  degrees  of  strength. 

As  a  stift',  inflexible  condition  of  the  ligaments  and  muscles  con- 
nected with  the  shoulders  is  the  principal  obstacle  in  the  way  of 
beginners,  and  as  the  wand  is  the  best  known  means  to  remove  this 
stiffness,  it  should  be  made  prominent  during  the  first  few  weeks  or 
months  of  training. 

It  is  perhaps  unnecessary  to  say  that  the  symmetrical  development 
of  the  upper  half  of  the  body  turns  entirely  upon  the  freedom  with 
which  one  can  use  the  shoulder  joint.  This  is  sutliciently  obvious 
when  we  reflect  that  exercise  of  the  body  above  the  waist  depends 
■i:;)on  the  arms,  and  of  course  upon  the  degree  of  freedom  with  which 
' .  (•  can  use  the  arms. 

While  it  cannot  be  denied  that  certain  muscles  about  the  shoulders 
and  chest  may  be  developed  to  any  degree,  and  the  shoulders  remain 
drooping  and  stiff,  it  is  quite  as  undeniable  that  general  and  symmet- 
rical development  of  that  part  of  the  body  (which  is  almost  univer- 
sally distorted  and  deficient  among  Americans),  can  be  achieved  only 
by  complete  liberty  about  the  shoulder  joint,  through  which  as  a  ful- 
crum or  centre,  all  considerable  training  of  the  upper  part  of  the  body 
is  derived. 

I  had  pursued  the  study  of  Gymnastic  Culture  but  a  short  time, 
before  I  saw  the  great  importance  of  the  wand,  in  a  system  of  training 
adapted  to  the  American  people. 


N 


\k 


ii* 


748 


PHYSICAL  CULTUBE. 


I  have  invented  a  very  extended  series  of  these  exercises,  some  of 
which  a  e  here  described  and  illustrated. 

No.  1.  Divide  the  wand  into  three  equal  parts  with  the  hands,  and 
hold  it  as  represented  in  Fig.  1.  Thrust  it  downward  close  by  the 
legs  with  much  force,  and  again  bring  it  up  by  the  chin,  holding  the 
elbows  high,  as  seen  in  the  figure,  and  so  continue  twenty  times. 


Figure  _.  Figure  2. 

No.  2.  From  the  position  seen  in  Fig.  1,  carry  the  wand  directly 
upward  as  high  as  you  can  reach,  and  back  to  the  chin,  ten  times. 

No.  3.  From  the  highest  position  of  No.  2,  bring  the  wand  down 
to  the  knees  and  back  again,  twenty  times,  without  bending  the  elbows. 


Figure  8.  Figure  4. 

No.  4.     Holding  the  wand  high  over  the  head,  bring  it  down  on  the 
back  of  the  neck,  ten  times,  as  seen  in  Fig.  2. 

No.  5.     Same  as  the  last,  except  every  second  time  the  wand  is 


PHYSICAL  CULTURE 


749 


368,  some  of 

;  hands,  and 
;lose  by  the 
holding  the 
ti  mes. 


2. 


and  directly 
?n  times, 
wand  down 
J"  the  elbows. 


own  on  the 
le  wand  is 


brought  down  to  the  chin,  being  careful  that  every  time  that  the 
wiiiid  is  carried  upward,  it  is  carried  as  high  as  pos- 
sible, and  with  much  force. 

No.  6.  Hands  over  the  head,  but  this  time  at  the 
ciidri  of  the  wand,  as  seen  in  Fig.  3,  and  now  bring  it 
down  behind  as  seen  in  i<'ii»'.  4,  twenty  times,  being 
vera  careful  not  to  bend  the  elboivs. 

No.  7.  Same  as  last,  except  that  every  second  time 
the  wand  is  broug^*  'own  to  the  knees  in  front. 

No.  8.  Hold  1  /and  directly  overhead,  hands 
grasping  the  ends,  ^.  *  carry  it  from  side  to  side  {Fig. 
'<),  !)cirig  very  careful  not  to  bend  the  elbows,  and  yet 
the  wand  must  come  to  the  perpendicular  on  either 
side. 

No.  9.  Hold  the  wand  directly  in  front,  and  per- 
))endicular,  with  the  hands  in  the  middle  of  it,  six 
inches  apart,  and  the  arms  as  nearly  horizontal  as  pos- 
sible. Keeping  the  arms  stiff,  whirl  the  wand  from 
side  to  side  as  far  as  you  can. 

No.  10.  Standing  erect,  heels  together,  put  the  wand  out  with 
your  right  hand  midway  between  two  lines,  one  of  which  runs  directly 
iforward,  and  the  other  at  right  angles  with  this,  at  your  side  ;  which 
direction  we  shall  call  diagonally  forward.  Let  the  wand  rest  on  the 
door,  at  a  point  removed  as  far  from  your  feet  as  possible,  keeping 


Figure  6. 


I 


;■ 


Figure  6. 


Figure  7. 


your  body  and  the  wand  perpendicular,  and  the  arm  horizontal.  The. 
elbow  must  not  be  bent.  Step  out  as  seen  in  Fig,  6,  the  foot  passing 
behind  the  wand,  as  seen  in  the  figure.  In  doing  this  you  must  not 
bend  the  elbow,  nor  must  you  move  the  wand.  It  will  be  seen  that 
the  shoulders  scarcely  move,  the  motion  being  confined  to  the  legs  and 
lower  part  of  the  body.     Charge  thus  ten  times. 

No.  11.     Same  as  the  last,  but  wit'i  left  hand  and  foot. 

No.  12,  Stand  erect.  Carry  the  wand  out  with  the  left  hand  di- 
agonally  forward,  as  far  as  you  can  reach.     Step  out  to  the  wand 


^i 


v\ 


750 


PHYSICAL  CULTURE. 


with  the  left  foot.  Let  the  foot  remain  there.  Now  the  body  is  to 
rise  and  fall  as  far  as  possible.  {Fiff.  7).  Don't  bend  the  knee  of  the 
right  leg.     Keep  the  shoulders  and  head  well  back. 

No.  13.     Same  as  the  last,  on  the  right  side. 

No.  14.  Stand  as  seen  in  Fig:  8.  Thrust  the  arms  straight  for- 
ward, and  back  again  to  the  chest,  ten  times,  keeping  the  wand  all 
the  time  perpendicular. 

No.  15.  At  the  conclusion  of  the  last  exercise,  when  the  arms  are 
thrust  forward,  bring  the  wand  into  the  position  seen  in  Fig.  9.  Then 
carry  it  right  back  to  the  position  seen  in  front,  with  the  arms  straight 
and  horizontal.  Now  bring  it  down  on  the  left  side,  and  so  continue 
ten  times  to  each  side.  'r^ 

No.  16.     In  concluding  the  last,  when  the  arms  are  extended  in 


FigaraS. 


Figure  9. 


IlgDre  10. 


front,  bring  the  hands  and  wand  to  the  position  seen  in  Fig.  8.  Carry 
it  diagonally  forward  and  upward  on  the  left  side,  as  seen  in  Fig.  10. 
Bring  it  back  to  the  chest  again,  and  thrust  it  oat  on  the  right  side. 
Alternate  twenty  times. 

No.  17.  As  you  thrust  out  the  wand  on  the  right  side,  step  out  the 
foot  in  the  same  direction.  Be  sure  it  is  neither  forward  nor  at  the 
side,  but  diagonally  forward.  {Fig.  11).  Alternate  between  the  right 
and  left  side  twenty  times. 

No.  18.  Same  as  the  last,  except  that  the  wand  goes  to  the  right  as 
the  left  foot  charges  to  the  left,  and  the  left  arm  and  wand  to  the  left, 
while  the  right  foot  charges  to  the  right. 

No.  19.  Same  as  the  last,  except  when  the  right  foot  charges  di- 
agonally forward,  the  wand  is  made  to  point  diagonally  backwards 
over  the  left  shoulder,  and  vice  versa. 

No.  20.     Same  as  the  last,  except  when  the  right  foot  charges 


Pi''^', 


e  body  is  to 
knee  of  the 


jtraight  for- 
16  wand  all 

he  arnia  are 
'ig.  9.  Then 
rins  i»traigiit 
so  continue 


sxtended  in 


Ig.  8.  Cany 
1  in  Fiff.  10. 
e  right  side. 

step  out  the 
I  nor  at  the 
en  the  right 

the  right  as 
I  to  the  left, 

charges  di- 
backwards 

?ot  charges 


PHYSICAL  CULTURE. 


751 


diagonally  forward,  the  wand  is  made  to  point  diagonally  backward 
over  the  right  shoulder,  and  when  the  left  foot  charges  diagonally  for. 
ward,  the  wand  is  made  to  point  diagonally  backward,  over  the  left 
shoulder. 

No.  21.  Same  as  the  last,  except  the  feet  charge  diagonally  back- 
ward. As  the  left  foot  charges  thus,  the  wand  is  made  to  point  diag- 
onally forward,  on  the  right  side,  and  vice  versa.     (Fig.  12). 

No.  22.  Same  as  the  last,  except  when  the  left  foot  charges  diag- 
onally backward,  the  wand  is  made  to  point  diagonally  forward  on 
the  left  side,  and  when  the  right  foot  charges  diagonally  backward,  the 
wand  points  diagonally  forward,  on  the  right  side. 

No.  23.  Same  as  the  last,  except  when  the  left  foot  charges  diag- 
onally backward,  the  wand  points  diagonally  backward  on  the  sam<» 


Figure  IL 


Figure  12. 


side.  And  when  the  right  foot  charges  diagonally  backward,  the 
wand  points  diagonally  backward,  on  the  same  side. 

No.  24.  Same  as  the  last,  except  when  the  left  foot  charges  diag- 
onally backward,  oi  its  own  side,  the  wand  points  diagonally  back- 
ward on  the  right  side,  and  vice  versa. 

It  must  not  be  forgotten  that  in  all  these  compound  exercises,  ih- 
volving  the  action  of  the  arms  and  legs,  the  wand  is  always  held  at 
an  angle  of  forty-five  degrees  above  the  horizontal ;  and  that  in  every 
case  in  passing  from  one  charge  to  another,  the  wand  is  brought  to 
the  position  represented  in  F^.  8.  Without  this  it  would  be  im- 
possible to  keep  time  to  the  music.  Let  the  steps  be  as  long  as 
possible. 

No.  25.  "Wand  horizontal  over  the  head,  as  seen  in  Fig.  3.  As  in 
almost  all  the  wand  exercises,  be  careful  not  to  bend  the  elbows. 
Turn  the  wand  round  so  that  the  right  hand  comes  exactly  in  front, 
and  the  left  hind  exactly  behind.  Bring  the  left  in  front  and  the  right 
behind ;  so  change  twenty  times. 

No.  26.     Hold  the  wand  horizontal  over  the  head,  with  the  right 


762 


PHYSICAL  CULTURE. 


Sfrt 


m.j 


hand  in  front  and  the  left  one  behind.  Make,  by  the  side  of  the  body, 
the  motion  seen  in  paddling  a  caiioo.  Ea(;h  time  carry  the  wand 
so  far  back  that  it  shall  be  perpendicnlar.  Do  this  ten  times  on  the 
right  side;  then  ten  times  on  the  left;  then  alternately  ten  times. 
Each  time,  as  the  wand  is  brought  over  the  head,  it  must  be  made 
horizontal,  with  one  hand  exactly  in  front,  and  the  other  behind,  ami 
as  it  is  brought  behind  the  body,  it  must  be  made  perpendicnlar. 

No.  27.     Charge  diagonally  forward   with   the    right    foot  ;  wand 
ill  the  same  direction.     Left  foot  fliagonally  forward  ;  wiind  tix.  same 

Left  foot  diagonally  backward  ; 
wand  the  same.  Right  foct  diag- 
onally backward  ;  wand  the  same. 
Having  thus  gone  all  arouhd,  be- 
gin again  with  the  left  foot  and 
go  round  the  other  way  in  like 
manner. 
'  ■  iw.  \       No.  28.     With  both  hands  take 

hold  at  the  end  of  the  wand.  Hold 
it  horizontal  in  front.  Carry  it  di- 
rectly back\Vard  without  bending 
the  arms,  as  seen  in  Fiff.  13.  (I 
*'"""'  ^'^'  see  the  artist  has  tipped  the  figure 

so  far  that  the  centre  of  gravity  is  lost). 

No.  29.  Heels  together.  Wand  directly  in  front,  resting  on  the 
floor,  and  perpendicular.  Arm  straight.  Step  the  right  foot  forward  to 
the  wand,  and  back  to  the  other  foot,  five  times.  Left  foot  the  same. 
No.  30.  Step  the  right  foot  backward  as  far  as  you  can  reach 
(Fig:  14),  and  bring  it  back  to  the  other  foot,  ten  times.  Same  with 
the  left  foot. 

No.  31.     Carry  the  right  foot  forward  to  the  wand.     Returning,  do 


Figure  14. 


Figure  IS. 


not  stop  by  the  other  foot,  but  carry  it  backward  as  far  as  you  can 
reach.  Now  forward  to  the  wand  again.  Make  this  long  sweep  ten 
times.     Left  foot  the  same. 

No.  32.     Seizing  the  upper  end  of  the  wand  with  both  hands,  as 
seen  in  Fiff.  15,  carry  the  right  foot  forward  to  the  wand,  and  the  left 


PHYSICAL  CUI.TURE. 


753 


p  of  the  body, 
rry  the  wiuid 

times  on  the 
ly  ten  times. 
iiUHt  be  iiwule 
•r  behind,  and 
luHcniar. 
t  loot  ;  wand 
and  lixi  same. 
y  l)aclv\var(l ; 
yht  fot't  (imp- 
and  the  same. 
11  aronhd,  be- 
left  foot  and 

way   ill   hke 

th  hands  take 
wand.  Hold 
Carry  it  di- 
hout  bending 
1  Fiff.  13.  (I 
ped  the  figure 

eating  on  the 
[)ot  forward  to 
foot  the  same. 
Foa  can  reach 
L     Same  with 

Returning,  do 


ar  as  you  can 
ong  sweep  ten 

)oth  hands,  as 
d,  and  the  left 


foot  back  as  far  as  you  can  reach.  Change  them  at  a  single  jump, 
and  so  continue  ten  times. 

No.  33.  Hold  the  wand  in  the  position  seen  in  Fig:  9,  on  the  right 
side,  with  the  right  hand  at  the  lower  end,  and  the  left  hand  at  the 
upper.  Change  it  to  the  left  side,  with  the  left  hand  at  the  lower  end, 
and  the  right  hand  at  the  upper;  so  change  from  side  to  side,  ten 
times. 

No.  34.  Begin  the  same  as  in  the  last,  except  the  wand  is  held  on 
I  he  back  of  the  right  shoulder  instead  of  the  front.  Carry  it  now  to 
the  back  of  the  left,  and  so  alternate  ten  times. 

No,  35,  Beginning  at  the  front  of  the  right  shoulder,  as  in  No.  32, 
carry  it  to  the  front  of  the  left  shoulder.  Then  to  the  back  of  the  left 
shoulder,  and  now  to  the  back  of  the  right  shoulder.  Go  thus  around 
the  body  five  times. 

No.  36.  Begin  at  the  front  of  the  left  shoulder,  and  go  around  the 
body  the  other  way  five  times. 


Figure  16, 


lignre  17. 


No.  37.  Hold  the  wand  on  the  front  of  the  right  shoulder.  Carry 
it  to  the  back  of  the  left  shoulder.  Back  again  to  the  front  of  the 
right  shoulder.     Repeat  ten  times. 

No,  38.  Begin  at  the  front  of  the  left  shoulder,  and  alternate  with 
the  back  of  the  right  shoulder. 

No.  39,  Again  putting  the  wand  in  front,  on  the  floor,  perpendicu- 
lar, with  the  right  hand  seizing  the  upper  extremity,  and  the  arm 
straight,  step  the  right  foot  forward  to  the  wand.  Bring  it  back  to  the 
other  foot  Now  step  sideways  to  the  right  as  far  as  you  can  veach. 
Bring  it  back  to  the  other  foot  again ;  now  step  backward  as  far  as 
you  can  reach.  Bring  it  back  to  the  other  foot.  Still  using  the  right 
foot,  step  sideways  to  the  left  as  far  as  you  can  reach,  passing  it  by 
the  left  leg  behind  (Fig  16),  now  back  to  the  other  foot  again.  Pass 
it  to  the  left  again,  in  front  of  the  left  leg  {F^.  17),  and  bring  it  back 
to  the  other  foot.     Continue  this  round  five  times. 

95 


754 


PHYSICAL  CULTURE. 


No.  40.  Same  with  the  left  arm  and  leg,  five  times.  In  all  this  the 
wand  must  not  lose  its  perpendicularity. 

No.  41.  Stand  upright,  with  the  the  heels  together,  seize  the  wand 
at  its  middle,  with  the  right  hand,  and  hold  the  arm  horizontal  in 
front  —  wand  perpendicular.  Keeping  the  arm  in  the  horizontal  place, 
whirl  it  round  the  body,  making  a  complete  circle,  but  do  not  stir  the 
feet.     Same  with  the  left  hand,  ten  times. 

No.  42.  Grasp  the  middle  of  the  wand  with  both  hands,  and  whirl 
as  in  the  last,  as  far  as  you  can,  ten  times. 

No.  43.  Same  as  the  last,  except  the  wand  is  held  horizontal,  in- 
stead of  perpendicular. 

No.  44.  Seizing  the  wand  as  seen  in  Fig.  18,  step  backward  and 
forward  over  it  with  the  right  and  left  foot,  ten  times. 


FignreU. 


FiganU. 


No.  45.  Stand  upright,  heels  together,  grasp  the  wand  at  the  ex- 
treme ends  and  hold  it  behind  the  body,  keeping  the  arms  straight 
The  right  hand  high  up,  and  the  left  hand  low  down.  Now  swing 
the  left  hand  high  up,  and  the  right  low  down,  and  so  continue  tc 
change  the  relative  positions  of  the  end  of  the  wand,  without  bending 
the  elbow,  ten  times. 

No.  46.  Charge  the  right  foot  diagonally  forward,  as  seen  in  Fig, 
19,  five  times.  Now  the  left  foot  with  the  left  hand  raised  high,  five 
times.     Alternate  five  times. 

No.  47.  Same  as  the  last,  except  that  when  charging  with  the  right 
foot,  you  raise  the  left  hand  high,  and  vice  versa. 

The  wand  exercises  from  this  point  are  performed  in  couples,  and 
while  marching. 

No.  48.  Marching  as  represented  in  Fig.  20,  leap  sideways  as  far 
as  possible,  first  one  foot,  and  then  the  other,  without  losing  your 
relation  to  each  other. 

No.  49.  Putting  the  two  wands  together,  and  holding  them  as  rep- 
resented in  Fig.  21,  leap  sideways  as  before,  being  sure  to  keep  the 


^KKYrX^'.  .  -  :^l.^s.'(^- >:.i^ 


In  all  this  the 

jize  the  wand 

horizontal  in 

rizontal  place, 

lo  not  stir  the 

ids,  and  whirl 

horizontal,  in- 

lackward  and 


19. 

nd  at  the  ex> 
irms  straight 
Now  swing 
)  continue  to 
;hout  bending 

i  seen  in  Fiff, 
sed  high,  five 

with  the  right 

couples,  and 

deways  as  far 
;  losing  your 

;  them  as  rep- 
5  to  keep  the 


PHYSICAL  CULTURE. 


755 


Bhoulder.s  back,  and  so  leaping  together,  that  the  two  will  move  as  one 
person.  Be  sure  to  keep  the  arms  quite  perpendicular  over  the  shoulders. 


Figure  20.  Figure  21. 

No.  50.  One  person  walking  directly  behind  the  other,  take  hold  of 
the  extreme  ends  of  the  wands,  and  then  allow  the  hands  to  rest  on 
the  shoulders.     Marching  in  this  way,  at  the  word  of  command,  "  Up," 


Figure  22. 


Figure  28. 


raise  the  wands  as  high  as  you  can,  and  as  the  right  foot  goes  forward 
thrust  the  right  hand  as  far  forward  as  possible,  the  left  one  at  the  same 
time  being  pushed  as  far  back  as  possible  {Fiff.  22),  and  as  the  left  foot 
coraes  forward,  reverse  the  hands. 


i 


■wiH>vyj?^'T|ftliftitewi 


756 


PHYSICAL  CULTURE. 


No.  51.  Same  as  the  last,  except  the  right  hand  goes  Forward  witii 
the  left  foot,  and  the  left  hand  with  the  riglit  foot.  In  all  these  you 
must  not  bend  the  elbows,  except  when  you  are  told  to  bend  them. 

No.  52.  Still  keeping  your  arms  perpi-ndicular,  curry  both  of  your 
hands  forward  as  far  as  you  can  reach  with  your  right  foot,  and  as  you 
step  your  left  foot  forward,  carry  both  hands  as  far  back  as  you  can 
reach,  and  thus  continue  for  ten  steps. 

No.  63.  Same  as  the  last,  except  that  the  hands  go  forward  with 
the  left  foot,  and  backward  when  the  right  foot  goes  forward. 


FignraM. 


Figure  36. 


No.  54.  Bring  the  hands  to  the  shoulders,  and  as  the  right  foot 
steps  forward,  raise  the  right  hands  as  high  as  you  can  reach.  When 
the  left  foot  gc:a  forward  raise  the  left  hands,  and  bring  down  the 
right  hands,  and  so  continue  to  alternate  ten  times 

No.  55.  Same  as  the  last,  except  the  right  hands  go  up  as  the  left 
feet  go  forward,  and  the  left  hands  with  the  right  feet. 

No.  56.  The  two  hands  go  up  simultaneously  with  the  stepping 
forward  of  the  right  feet,  and  come  down  as  the  left  feet  go  forward. 

No.  57.  Same  as  the  last,  except  the  hands  go  up. as  the  left  feet 
go  forward,  and  down  as  the  right  feet  go  forward.  Be  sure  in  the 
last  fo'ir  exercises  that  the  arms  go  up  and  down  quite  ver«;ically. 

No.  58.  Put  the  two  wands  together,  and  take  hold  of  them  with 
one  hand,  as  represented  in  Mg:  23,  and  marching  side  by  side,  leap 
sideways  right  and  left,  keeping  the  wand  as  high  as  you  can  reach. 

No.  59.     Partners  change  sides  and  repeat  the  same. 

No.  60.  Carrying  the  wand  as  in  Fig;.  23,  as  you  step  forward  with 
the  right  foot,  bring  the  wand  down  so  as  to  strike;  your  right  leg  with 
the  hand,  and  then  as  your  left  foot  goes  forward,  carry  the  wand  back 
to  its  vertical  position,  and  so  continue  ten  times. 


PHYSICAL  CULTURE. 


767 


forwartl  with 
il)  tlicHe  you 
I'lid  them, 
both  of  your 
t,  and  as  you 
as  yuu  can 

forward  with 
ard. 


lie  right  foot 
ach.  When 
ig  down  the 

]p  as  the  left 

the  stepping 
go  forward. 
i  the  left  feet 

sure  in  the 
•rtically. 
)f  them  with 
by  side,  leap 

can  reach. 

forward  with 
iglit  leg  with 
16  wand  back 


No.  61.  Change  sides  with  your  partner,  and  do  the  same  again, 
only  bringing  your  wand  down  ^s  the  left  foot  goes  forward,  and  rais- 
ing it  as  the  right  foot  goes  forward. 

No.  62.  Cross  the  hands  on  the  two  wands  placed  side  by  side, 
but  instead  of  holding  them  over  the  head,  as  m  Fiff.  Jl,  let  them 
hung  down  in  front,  and  carrying  them  thus,  leap  from  side  to  side. 

No.  63,  Walking  one  hi  front  of  the  other,  and  extending  the  arms 
horizontally,  beiti^  careful  not  to  berul  the  elbows,  carry  the  right  for- 
ward as  far  as  possible  with  the  right  foot,  as  represented  in  Fif^.  24, 
and  simultaneously  with  this,  carry  the  left  foot  backward  as  far  as 
possible.  When  the  left  foot  comes  forward,  let  the  left  hand  come 
forward  too,  and  thus  alternate. 

No.  64.  Same  as  the  last,  except  that  the  right  hand  comes  for- 
ward with  the  left  foot,  and  vice  versa. 

No.  65.  The  same,  simultaneously  with  the  right  foot  and  with 
the  left  foot. 

Be  careful  in  the  performance  of  the  last  four,  that  you  keep  the 
arms  exactly  horizontal  from  first  to  last 

No.  66.  Walking  one  in  front  of  the  other,  with  the  wands  hang- 
ing  in  the  hands  on  either  side,  carry  one  up  as  high  as  you  can 
reach,  as  in  Fig.  25,  and  then  as  the  other  foot  goes  forward,  carry 
up  the  other  while  the  first  is  brought  down. 

No.  67.  Same  as  last,  except  the  right  arms  goes  up  as  the  left 
foot  goes  forward,  and  vice  versa. 

No.  68.  Simultaneously  up,  with  the  right  foot  forward,  ten  times, 
and  the  same  with  the  left  foot. 

It  is  perhaps  unnecessary  to  repeat  that  every  motion  with  the 
wands  is  to  be  done  to  music.  In  making  the  changes  from  one 
exercise  to  another,  this  rule  must  not  be  forgotten. 

It  must  not  be  forgotten  that  the  feet,  in  every  exercise,  are  to  be 
kept  at  right  angles  with  each  other. 


^  « 


Gymnastic  Crown. 


Bearing  burthens  on  the  head  results  in  an  erect  spine  and  an  elas- 
tic gait.  Observing  persons  who  have  visited  Switzerland,  Italy,  or 
the  Gulf  States,  have  observed  a  thousand  verifications  of  this 
physiological  law. 

Cognizant  of^he  value  of  this  feature  of  gymnastic  training,  I  have 
employed,  for  this  purpose,  within  the  last  twelve  yeans,  various  sorts 
of  weights,  but  have  recently  invented  an  iron  crown,  which  I  think 
completely  satisfactory.  The  accompanying  cut  gives  a  good  idea  of 
its  general  form.  I  have  them  made  to  weigh  from  three  to  one  hun- 
dred pounds.  The  crown  is  so  wadded  within,  it  rests  pleasantly  on 
the  entire  top  of  the  head,  and  yet  so  arranged  that  it  requires  skill 
to  balance  it.     It  la  beautifully  painted,  and  otherwise  ornamented. 


■ 


il 


I 


il;1; 


:kU 


S",' 


768 


PHYSICAL  CULTUKE. 


Tilt!  following  Hll^^)>)4MonH  are  important  in  wuiirinj?  the  crown  : 
Weur  it  live  to  liftmen  minutes,  inodiin^  and  cviMiiii^'     llold  tli"  body 

erect,  liip.s  uiid  MlionMerst  tlirown  lur 
buck,  and  the  crown  rutlier  on  the  I'roiit 
of  the  head,  as  Hhown  in  the  cut. 
Walking  up  and  down  staira  \\hile 
wearing  the  crown  is  good,  if  the  low- 
er extremities  are  not  too  much  fa- 
tigued by  it.  When  walking  through 
the  hnll  or  parlors,  turn  the  toes,  first, 
iiTward  as  far  as  possible  ;  second,  out* 
ward;  third,  walk  on  the  tips  of  the 
toes;  fourth,  on  the  hee.s;  fifth  on  the 
right  Iie«'l  and  left  toe  ;  sixth,  on  the  left 
heel  and  right  to(! ;  seventli,  vvnik  with- 
out bending  the  kn«'<s;  eighth,  bend 
the  kneerJ,  so  that  you  are  nearly  sit- 
ting on  tilt!  heels  while  walking;  ninth, 
walk  with  the  right  leg  bent  at  the 
knee,  rising  at  eact'  step  on  the  straight 
left  leg  ;  tenth,  walk  with  the  left  leg  bent,  rising  at  each  step  on  the 
straight  right  h;g. 

With  these  ten  different  modes  of  walking,  the  various  muscles  of 
the  back  will  receive  the  most  invigorating  exercise. 

All  persons,  of  both  sexes  and  of  ev  'ry  age,  who  have  round  should- 
ers or  weak  backs,  are  rapidly  improved  by  the  use  of  the  gymnastic 
crown. 


The  Pan-gymnastikon. 

The  Germanic  nationality  has  been  redeemed  from  political  and 
social  degreda.ion  by  gymnastics.  I  coifld  mention  a  score  of  emi- 
nent Germun  writers  and  patriots  who  freely  admit  that  the  physical 
invigoration  of  the  German  people,  through  the  universal  practice  of 
gymnastics,  was  the  foundation  of  the  subsequent  moral  revolution. 
1  he  soul  is  so  interwoven  with  and  dependent  upon  the  body, 
that  when  the  body  is  sick  the  soul  must  suffer  with  it.  •  If  the  foun- 
dation give  way,  the  superstruction  must  soon  fall  ;  and  while  the  ex- 
istence of  a  good  foundation  does  not  necessitate  a  superstruction,  the 
latter  cannot  exist  without  the  former. 

Gluttony,  drunkenness,  licentiousness,  and  other  vices  f.o  under- 
mined the  German  constitution,  that  adventurers  and  tyrants  found 
Germany  an  easy  prey.  Gutsmuth,  Jahn,  Eiselen,  Opiess,  and  their 
fellow-workers  turnecl  back  the  tide  of  physical  degeneration  and 
death.  Inspired  with  the  noblest  patriotic  instincts,  they  gave  their 
lives  to  the  introduction  of  gymnastics  as  kn  integral  part  of  the  na^ 


^ 


the  crown  : 
iltl  tli'«  body 
thrown  Car 
on  thf  front 
in  the  int. 
stairs  while 
,  if  the  low- 
0  ninch  fil- 
ing throngh 
e  toes,  firat, 
second,  out- 
tips  of  the 
fifth  on  the 
I,  on  the  left 
,  wallt  with- 
ighth,  bend 
;  nearly  sit- 
king ;  ninth, 
bent  at  the 
the  straight 
step  on  the 

muscles  of 

und  should- 
;  gymnastic 


olitical  and 
!ore  of  emi- 
:he  physical 
practice  of 
revolution, 
the  body, 
If  the  foun- 
'hile  the  ex- 
ruction,  the 

so  under- 
rants  found 
t*,  and  their 
ration  and 
gave  their 
;  of  the  na- 


PHYSICAL  CULTURE. 


7S9 


tionul  education.  They  clearly  saw  in  u  |)hysiful  redemption,  tho 
foundation  of  a  political  rinh-mption.  The  great  (ierman  heart  turns 
to-day  toward  these  great  gynuiustic  reformers  as  the  salvation  of 
their  noble  nationality. 

It  may  be  justly  claimed  that  among  all  the  great  and  good  patriots 
ulio  have  devoted  themselves  to  thi.H  nmmiMitous  task,  the  gr'-at  8chre- 
l)(T  of  Leipsic  was  the  njost  eminent.  H(!  was  a  volnininous  author, 
and  tli(!  most  remarkable  of  his  prodnetions  was  the  Pdii^ijinnastikun. 
He  was  in  the  habit  of  speaking  of  this  invention  and  the  book  describ- 
ing it  as  the  most  important  of  his  contributions  to  the  ct  ■ «;  of  physical 
culture. 

That  work  I  have  translated,  and  reproduced  the  108  cuts  complete. 
The  entire  work  with  the  cuts  is  published  in  my  work  known  as  the 
"  New  Ciymnastics,"  published  by  Ticknor  &  Fields,  Boston. 

I  will  here  say,  that  whoever  desires  to  put  up,  for  home  use,  a 
Pangymnastikon,  after  Schreber's  design  (and  without  doubt  it  is  the 
best  means  for  home  training  ever  devised),  can  obtain  detailed  de- 
scriptions of  this  apparatus,  by  sending  a  request  to  that  effect  to  Dr. 
I)io  Lewis,  Box  12,  Boston,  with  a  stamp  to  pay  the  return  postage. 
With  a  complete  illustrative  cut,  and  full  descriptions  in  text,  there 
will  be  no  difficulty  in  understanding  the  invention. 


School-Desks  and  Seats. 

A  KADiCAi,  change  in  school  furniture  is  nec'led.     The  seats  and 
desks  now  used  compel  an  attitude  which  results  in  a  stooping  form. 


Figure  1. 


Figure  2. 


The  other  day  I  stood  an  hour  in  the  street  and  saw  more  than  five 
hundred  persons  pass,  not  one  of  which  was  erect.     Bending  over  the 


!  [ 

i 


760 


PHYSICAL  CULTURE. 


desks  in  OTur  schools  would  make  us  crooked  if  we  were  made  of 
spring-steel.  The  desk  tops  should  be  so  arranged  that  it  can  be 
raised  nearly  to  the  perpendicular  before  the  face  of  the  pupil,  and  the 
book  held  in  such  a  position  which  compels  him  to  sit  with  head  and 
shoulders  well  drawn  back. 

Fig.  1  exhibits  a  fruitful  source  of  stooping  shoulders. 

Fig.  2  shows  a  better  desk  and  the  improved  position  of  the  pupiL 

Fig.  3  is  a  model  desk.     The  top  can  be  raised  to  any  desired 


Figure  3. 


Figured. 


height,  or  let  down  to  nearly  the  horizontal  for  writing  exercises.  On 
the  desk  top  will  be  seen  a  bar  which  supports  the  book.  This  can 
be  moved  at  pleasure  and  has  a  pair  of  fingers  which  will  hold  the 
book  in  any  position. 

Fig.  4  shows  two  support-bars,  an  arrangement  which  must  prove 
most  convenient  to  students  of  the  languages,  and  to  those  who  have 
occasion  to  consult  a  dictionary  while  reading.  The  seat  is  easily  ad- 
justed to  any  desired  height. 

The  new  Book-holder,  patented  Dec.  9,  1862,  is  destined  to  play  an 
important  part  in  the  prevention  of  the  rou-id-shoulder  deformity,  and 
its  certainty  to  produce  erect  forms  will  be  ,^een  upon  an  examination 
of  the  cut.  It  may  be  used  upon  the  ordinary  desk,  and  is  made  to 
hold  one,  two  or  three  books  in  a  much  better  position  than  by  the 
desk.  It  is  exceedingly  light  and  pretty.  The  inclination  can  easily 
be  altered  by  raising  the  hook  attached  to  the  strap.  The  fingers,  im- 
perfectly shown,  keep  the  book  open,  and  thus  dispenses  with  the  use 
of  the  hands.  There  is  no  chance  in  its  use  to  sit  stooping  without 
bringing  the  face  in  direct  contact  with  the  book.  When  we  remem- 
ber how  many  years  children  are  engaged  over  their  books,  the  great 
importance  of  this  invention  will  be  appreciated.  It  is  cheap,  and  not 
liable  to  get  out  of  order.  Those  wishing  to  procure  such  a  holder 
can  send  to  Dr.  Warren,  Bostoa 


re  made  of 
it  it  can  be 
upil,  and  the 
ith  head  and 


of  the  pupiL 
any  desired 


Brcises.  On 
{.  This  can 
irili  hold  the 

must  prove 
se  who  have 
is  easily  ad- 

d  to  play  an 
formity,  and 
examination 
I  is  made  to 
than  by  the 
•n  can  easily 
!  fingers,  im- 
with  the  use 
)ing  without 
we  remem- 
fs,  the  great 
eap,  and  not 
eh  a  holder 


History  of  Gymnastics  in  the  United  States. 

I  DO  not  purpose  a  general  history  of  the  Physical  Culture  Move- 
ment in  this  country.  I  shall  speak  of  only  one  feature.  I  refer  to 
the  efforts  to  introduce  physical  education  into  young  ladies'  semi- 
naries. A  consciousness  of  itb  need  was  deeply  felt.  Thoughtful  ed- 
ucators know  that  education  meant  a  preparation  for  the  duties  of 
life ;  and  they  saw  the  graduates  of  these  institutions,  pass  from  the 
school  into  hopeless  invalidism,  not  in  rare  instances,  but  as  a  rule.  As 
tiie  phrase  goes,  their  ^*  education  was  finished,"  but  thei/  too  were 
finished.     Their  spines  were  unable  to  support  their  learned  heads. 

Anxious  fathers  and  mothers  besought  school  managers  to  give 
their  daugliters'  bodies  a  chance  for  life.  Willing  to  respond,  they 
announced,  "  Physical  culture  receives,  in  our  institution,  careful  at- 
tention," etc.  Uenerally  they  had  no  conception  of  what  was  meant 
by  physical  culture,  and  of  course  accomplished  nothing.  The  girls 
under  their  charge  who  needed  two  or  three  hours  of  daily  unre- 
strained, romping,  laughing,  and  vigorous  muscle  training,  were  made  to 
walk  in  solemn  procession  through  the  school  grounds  under  a  picket 
guard  of  maiden  ladies,  on  proper  days,  and  once  or  twice  a  week 
they  were  conducted  through  a  series  of  dull  calisthenic  arm-motions, 
under  corsets  and  long  dresses.  No  wonder  they  "  got  through"  with 
pale  faces,  drooping  shoulders,  and  ruined  health. 

I  hazzard  nothing  in  saying  that  the  physical  training  given  in  ninety- 
nine  hundredths  of  the  female  seminaries  in  the  country  has  no 
value.  How  much  benefit  would  be  derived  from  musical  training  in 
these  same  schools  if  they  employed  a  person  who  had  no  comprehen- 
sion of  harmony  ;  or  of  mathematics,  who  had  never  learned  the 
multiplication  table ;  or  of  reading  and  spelling,  who  did  not  know  the 
alphabet  ?  Physical  education  must  be  placed  on  the  same  basis  as 
moral  and  intellectual  training,  and  competent  teachers  employed; 
otherwise  it  will  as  certainly  fail  as  would  the  efforts  to  introduce 
^pianno  music,  without  a  teacher  who  knew  how  the  touch  the  keys  so 
as  to  bring  forth  harmonious  sounds. 

Parents  and  teachers  are  beginning  to  understand  this.  Patrons  of 
Bchools  now  loudly  demand  that  a  three  years  course  they  give  their 
daughters  shall  improve,  shall  educate,  instead  of  spoil  their  bodies. 
A  true  change  has  begun.  The  graduates  of  the  Normal  Institute  for 
Physical  Education  are  in  eager  demand. 

Only  two  years  agt.,  nie  principal  of  one  of  the  most  celebrated 
ladies'  seminaries  in  the  country  wrote  me  a  letter,  of  which  the  follow- 
ing is  an  extract:  "  I  wish  you  would  indicate  the  day  on  which  yoa 
can  give  me  an  hour  or  two  with  the  least  inconvenience  to  youiselt 
1  am  determined  to  introduce  your  entire  system,  and  as  I  know  noth- 
ing of  it,  you  must  give  me  a  good  lesson."  He  thought  it  was  a 
science  which  could  be  learned  in  two  hours.  Two  years  have 
passed  away,  and  the  same  institution  employs  a  lady  teacher,  thor- 

96 


1 


I',' 


)t 


'] 


h't 


tit 


I 


762 


PHYSICAL  CULTURE. 


oughly  trained,  from  my  school,  at  an  expense  of  $650  per  year.  Un. 
der  her  management  all  the  young  ladies  of  the  institution  devote  more 
than  an  hour  daily  to  thorough  bodily  training.  What  is  now  wanted 
is  ten  thousand  teachers.  Young  men  and  women  can  enter  no  pro- 
fession  more  favorable,  useful,  and  profitable.  Those  who  would  pre- 
pare  for  this  important  work,  should  come  to  Boston,  either  on  the 
second  of  January  or  the  fifth  of  July,  and  enter  the  Normal  Institute 
from  which  they  can,  with  average  capacity,  graduate  in  ten  weeks, 
prepared  to  enter  a  noble  and  remunerative  profession. 

I  cannot  close  this  brief  consideration  of  the  history  of  our  efforts  to 
introduce  gymnastics  into  ladies'  seminaries,  without  alluding  to  one 
or  two  successful  attempts. 

Rev.  George  Gannett,  Pemberton  Square,  Boston,  has  a  first-class 
seminary  for  young  ladies.  He  has  recently  added  a  large  hall  to  his 
already  extensive  establishment,  with  almost  sole  reference  to  physi- 
cal training;  and  he  is  pushing  the  work  with  commendable  zeal. 
During  more  than  two  years  I  have  had  charge  of  this  important  de- 
partment in  Mr.  Gannett's  institution,  and  can  say  that  his  earnest- 
ness is  constantly  increasing. 

The  Maplewood  Institute  at  Pittsfield,  Mass.,  under  the  charge  of 
Rev.  Mr.  Spear,  is  carrying  on  the  same  work  with  energy. 

The  fine  private  school  located  at  West  Newton,  Mass.,  under  the 
management  of  N.  T.  Allen,  Esq.,  is  thoroughly  alive  in  this  vital  de- 
partment During  more  than  two  years  I  have  had  supervision  of 
physical  education  in  Mr.  Allen's  school. 

Graduates  of  the  Normal  School  for  physical  education  are  en- 
gaged in  many  of  the  first  young  ladies'  seminary  in  the  country. 
The  friends  of  a  true  educatiou  have  occasion  to  rejoice  and  take 
couraga 


er  year.  Un. 
)n  devote  more 
is  now  wanted 
i  enter  no  pro- 
/ho  would  prc- 
,  either  on  the 
Ktnal  Institute 
in  ten  weeks, 

f  our  efforts  to 
liuding  to  one 

as  a  first-class 
irge  hall  to  his 
■ence  to  physi- 
nendable  zeal, 
important  de- 
it  his  earnest- 

the  charge  of 

■gy- 

ass.,  under  the 
n  this  vital  de- 
supervision  of 

3ation  are  en- 
I  the  country, 
oice  and  take 


PRESCRIPTIONS.-RECIPES. 


I  • 


These  prescriptiona  are  numbered,  and  referred  to  by  corresponding 
numbers  in  the  treatment  of  the  various  diseases.  This  arrangement 
saves  the  trouble  of  writing  out  each  prescription  every  time  it  is 
wanted  under  the  several  disorders.  When  there  are  several  recipes, 
each  of  which  is  suitable  in  a  certain  f  age  of  a  complaint,  this  plan 
affords  the  means  of  referring  to  them  all  in  a  little  space,  by  simply 
giving  their  numbers.  The  doses  named  are  always  for  grown  per- 
sons^ unless  it  is  otherwise  stated. 

Great  pains  have  been  taken  in  preparing  these  prescriptions.  A 
considerable  portion  of  them  are  the  favorite  recipes  of  the  most  dis- 
tinguished physicians,  the  world  over. 

The  classification  of  these  recipes  under  separate  heads,  is  necessa- 
rily very  imperfect,  and  has  been  attempted  only  to  make  it  more 
easy  for  me  to  refer  to  them  while  writing  the  book.  The  classifica- 
tion could  only  be  applied  to  a  part  of  them,  however ;  the  rest  are 
indiscriminately  mixed. 


■i 


L 


\        '  Pukes.     Emetics. 

1.  Pulverized  Ipecac,  1  scruple;  pulverized  cayenne,  10  grains;  water,  2 
ounces.     Mix.     To  be  taken  at  a  draught. 

2.  Pulverized  Lobelia,  1  oz. ;  pulv.  blood  root,  J  oz. ;  pulv.  seueka,  1  scru- 
ple ;  pulv.  ipecac,  6  drams ;  pulv.  cayenne,  4  scruples.  Mix,  An  excellent 
emetic  in  all  cases  where  one  is  required.  Dose.  —  One-half  teaspoonful  in 
Warm  water,  and  repeat  every  fifteen  minutes  three  or  four  times. 

3.  Wine  of  Antimony,  1  dram ;  wine  of  ipecac,  1  oz.    Mix. 

4.  Tartar  Emetic,  1  grain  ;  pulverized  ipecac,  1  scruple.  Mix.  To  be 
taken  in  a  wine-glassful  of  sweetened  water.  ^x 

Purges.     Cathartics. 

6.  Precipitated  Sulphur,  15  grains ;  magnesia,  1  scruple.  Mix.  To  be 
taken  each  night  at  bedtime,  for  costiveness  and  bleeding  piles. 

6.  Confection  of  Senna,  2  ozs. ;  cream  of  tartar,  1  oz. ;  sulphur,  1  oz. ; 
tyrup  of  ginger  enough  to  make  a  stiff  paste.  Mix.  A  piece  as  large  as  a 
nutmeg  is  to  be  taken  as  oflen  as  necessary  to  keep  the  bowels  open.  One  of 
the  very  best  remedies  for  piles. 


764 


PRESCRIPTIONS.  —  RECIPES. 


7.  Rocheile  Salu,  2  drains ;  bi-carbonate  of  soda,  2  scruples ;  water,  ^ 
pint  Mix.  To  this  mixture  add  35  grains  of  tartaric  acid,  and  take  the 
whole  foaming.     This  is  the  recipe  for  Seidlitz  powders. 

8.  Calcined  Magnesia,  1  dram;  water,  2  ozs.  Mix.  To  be  taken  at  a 
draught. 

9.  Sulphate  of  Magnetia,  (ep!»om  salts),  2  drams ;  freshly  roasted  coffee 
in  coarse  powder,  2  scruples ;  hot  water,  4  ozs.  Mix  and  boil  for  three  minutest, 
and  strain.  This  may  be  sweetened,  and  taken  every  rning  for  habitual  cos- 
tiveness,  or  repeated  once  in  three  hours,  if  an  immediute  effect  is  desired. 

10.  Castor  Oil,  1  oz. ;  the  yolk  of  one  egg;  put  together,  and  add,  simple 
syrup,  ^  oz. ;  peppermint  water,  2  ozs.  Mix.  To  be  taken  at  a  draught,  atler 
being  well  stirred  or  shaken. 

1 1.  Sulphur,  1  dram ;  cream  of  tartar,  2  drams.  Mix.  To  be  taken  in 
syrup  or  molasses. 

12.  Rhubarb,  10  gnuns ;  calcined  magnesia,  ^  dram.  Mix.  To  be  taken 
in  syrup  or  molasses. 

18.  Powdered  Senna,  -J  dram  ;  powdered  jalap,  10  grains ;  powdered  cloves, 
10  grains ;  Mix.     To  be  taken  in  sweetened  water. 

14.  Powdered  Jalap,  10  grains;  cream  of  tartar,  2  drams.  Mix.  To  be 
taken  in  syrup  or  molasses. 

15.  Fluid  Extract  of  Senna  and  Jalap,  2  drams;  infusion  of  cloves,  2 
ozs.     Mix.     To  be  taken  at  a  draught 

16.  Castor  Oil,  1  dessert  spoonful ;  oil  of  turpentine,  1  dessert  spoonful. 
Mix.  , 

17.  Castor  Oil,  I  dessert  spoonful ;  magnesia,  1  dessert  spoonful.  Rub 
together  into  a  paste.  By  this  combination,  the  taste  of  the  oil  is  almost  en- 
tirely  concealed,  and  children  will  take  it  without  opposition. 

13.  Sulphate  of  Magnesia,  1  oz. ;  cream  of  tartar,  1  oz. ;  pure  water, 
1  pint     Mix.     A  wine-glossful  occasionally. 

19.  Compound  Extract  of  Colocynth,  ^  dram;  blue  pill,  8  grains.  Mix, 
and  divide  into  8  pills. 

20.  Epsom  Salts,  2  ozs. ;  tartar  en  ..etc,  1  grain ;  spearmint  water,  1  pint. 
Mix. 

21.  Senna,  3  drams  ;  salts,  ^  dram  ;  manna,  ^  dram  ;  fennel  seed,  1  dram ; 
boiling  water,  ^  pint  Macerate  for  one  hour  in  a  covered  vessel,  and  strain. 
Take  a  teacupful  once  in  four  hours,  till  it  operates. 

22.  Moes,  2  scruples  ;  carbonate  of  potassa,  15  grains  ;  decoction  of  barley, 
^  pint     Mix,  and  rub  together. 

23.  Sulphur,  1  teaspoonful ;  cream  of  tartar,  10  grains ;  saltpetre,  5  grains. 
Mix.     To  be  taken  at  a  dose. 


Mix.     One  dessert  spoonful, 


24.  Manna,     2  drams  ;  fennel  water,  1  oz. 
aa  a  cathartic  for  an  infant 

25.  Compound  Infusion  of  Senna,  4  ozs. ;  caraway  water,  2  ozs. ;  tartrate 
of  potassa,  2  drams ;  manna,  1  dram.  Mix.  A  tablespoonful  for  a  child,  to 
relieve  costiveness. 

26.  Calcined  Magnesia,  1  scruple  ;  pulverized  rhubarb,  1  scruple ;  pulver- 
ized ifiecac,  1  grain.     Mix.     Give  one-fourth  of  this  daily. 


S!tMm3MJJKl«VJkM>m.lWUlAX,«J'lulllimii..mmn 


iples ;  water,  ^ 
1,  and  take  the 

i  be  taken  at  a 

'  roasted  coffee 
r  tliree  minutes, 
for  liabitunl  cos- 
is  desired. 

and  add,  simple 
a  draught,  after 


spoonful.     Rub 
1  is  almost  en- 


E. ;  pure  water, 

grains.      Mix, 

water,  1  pint. 

1  seed,  1  dram ; 
sel,  and  strain. 

ction  of  baric/, 

petre,  6  grains. 

issert  spoonful, 

i  ozs. ;  tartrate 
for  a  child,  to 

ruple;  pulv«r- 


I'KESCnil'TIONS.  —  RKCn'ES. 


765 


27.  Epsom  Salts,  2  drams  ;  dissolve  in  pure  water,  1  oz.  Then  add  sweet 
«|)irit3  of  nitre,  2  drams;  laudanum,  10  drops.  Dose.  — A  teiutpooiiful,  to  be 
repeated  according  to  circumstances. 

28.  Pulverized  Rhubarb,  1  scruple  ;  leptandrin,  10  grs. ;  calcined  magnesia, 
2  scruples  ;  pulverized  cinnamon,  10  grains.  Mix.  Tiiree  or  four  gi-ains  every 
tliird  hour,  to  a  child  of  six  months. 

2n.  Compound  Ejctract  of  Colocynth,  \  dram  ;  extract  of  jalap,  15  grains. 
Alix.     Make  12  pills.     Two  or  three  pills  will  produce  active  operation  of  th« 

bowels. 

."().  Pulverised  Senna,  2  drams ;  bicarbonate  of  potassa,  2  ozs. ;  pulver. 
i/((l  caycime,  10  grains ;  j)ulverized  jalap,  1  dram.  Mix.  Divide  into  12 
|iaii -.     One  part  for  an  adult  every  four  hours  till  it  operates. 

31.  Pulverized  Gamboge,  12  grs.;  pulv.  scammony,  12  grs.;  claterium,  2 
}rrs. ;  croton  oil,  8  drops ;  ext.  of  stramonium,  3  grs.  Mix.  Make  12  pills. 
Uiie  pill  is  a  dose,  repeated  every  hour  until  it  operates. 

32.  Pulverized  Scammony,  12  grs. ;  pulv.  gamboge,  12  grs. ;  pulv.  colocynth, 
8  grs. ;  castile  soap,  4  grs. ;  oil  of  anise,  5  drops.  Mix.  Make  12  pills.  One 
[)ill,  repeated  every  three  hours  till  it  operates. 

33.  Pulverized  Scammony,  6  grs.;  croton  oil,  4  drops  ;  pulv.  loaf  sugar,  Ifi 
teaspoonfuls.  Rub  well  together  in  a  mortar.  Give  one  teaspoonful  every 
hoiu*  or  two,  to  a  child  7  years  old,  till  it  operates. 

84.  Leptandrin,  1  dram ;  podophyllin,  1  scruple ;  scutillarine,  2  drams ; 
pulv.  cayenne,  1  scruple  ;  pulv.  loaf  sugar,  4  ozs.  Rub  together  for  some  time 
in  a  mortar.     Dose  for  an  adult,  .ji^  of  the  above. 

35.  Pulverized  Rhubarb,  2  scruples  ;  bicarbonate  of  potassa,  1  scruple ;  ext. 
of  nux  vomica,  5  grs.     Mix.     Make  20  pills.     One  pill  twice  a  day. 

36.  Leptandrin,  1  dram ;  podophyllin,  1  scruple ;  apocynin,  1  scruple ; 
ext.  nux  vomica,  6  grs. ;  castile  soap,  1  dram.  Make  30  pills.  One  pill  every 
night. 

37.  Sweet  Tinct.  of  Rhubarb,  4  ozs. ;  bicarbonate  of  soda,  2  drams.  Mix. 
From  a  teaspoonful  to  a  tablespoonful,  as  occasion  may  require.  ^ 

38.  Pulverized  Rhubarb,  2  ozs. ;  bicarbonate  of  potassa,  1  oz.  Mix.  Of 
this  take  enough  to  produce  one  movement  of  the  bowels  per  day. 

31).  Leptandrin,  30  grs. ;  podophyllin,  10  grs. ;  pulv.  cayenne,  10  grs. ;  ext. 
.1UX  vomica,  6  grs.;  quinine,  12  grs.  Mix.  Make  24  pills.  One,  two,  or 
three  times  a  day. 

40.  Podophyllin,  15  grs. ;  kptandrin,  2  scruples  ;  cream  of  tartar,  5  scru- 
ples.   Mix.     Divide  into  10  powders.     One  is  a  dose. 

41.  Comp.  Powder "vf  Jalap,  1  oz.;  cream  of  tartar,  1  oz.    Mix.     One  tear    | 
spoonful  is  a  dose,  to  ba  taken  in  sweetened  water. 

42.  Pulverized  Charcoal,  1 J  drams ;  pulverized  rhubarb,  2  scruples ;  pul- 
verized ipecac,  6  grains;  extract  of  hyoscyamus,  12  grs.  Mix.  Divide  into 
12  portions.     Give  one  every  three  or  four  hours. 

43.  Pulverized  Blood-root,  1  dram  ;  pulv.  rhubarb,  1  dram  ;  castile  soap,  2 
scruples.  Mix,  and  divide  into  32  pills.  Take  one  morning  and  night.  Ex- 
cellent for  costiveness. 


i 


766 


PRESCRIPTIONS.-  UEtlPES. 


44.  RocheUe,  14  drams  ;  magnesia,  11  drams;  powdered  charcoal,  8  dnima. 
Mix.  Dose. — A  heaping  tcaspoonful  in  dyspepsia  and  costive  icso,  with  foul 
breath,  etc. 

45.  Pidi-erized  Rhubarb,  8  grs. ;  pulv.  guaiacum,  8  grs. ;  galbanum,  2  grs. ; 
piilv.  ipecac,  2  grs.  Mix.  Make  8  pills.  Take  one  to  two  pills  night  and 
morning.     For  a  weak  gtomacb,  and  a  bilious  condition. 

Tonic  and  Cathartic. 

46.  PodophyUin,  4  grs. ;  Icptandrin,  8  grs. ;  quinine,  8  grs. ;  ext.  nux  vom- 
ica, 2  sfrs.  Mix.  Make  1 0  i)iils.  One,  two,  or  three  pills,  at  bed  time,  accord 
ing  to  the  requirements  of  tlie  case. 

47.  Sulphate  of  Iron,  1  scruple  ;  pulverized  aloes,  2  scruples.  Mix,  and 
make  into  20  pills.  One  pill  twice  a  day.  An  excellent  remedy,  in  chlorosis, 
when  the  bowels  are  confined. 

48.  Carbonate  of  Iron,  1  dram ;  pulverized  rhubarb,  ^  dram ;  pulver- 
ized aloes,  ^  dram  ;  extract  of  hops,  ^  dram.  Mix.  Make  30  pills.  One  pill 
three  times  a  day. 

49.  Fluid  Extract  of  Senna,  1  dram ;  compound  fluid  extract  of  gentian, 
^  dram  ;  fluid  extract  of  ginger,  ^  dram  ;  aromatic  spirits  of  ammonia,  j  dram. 
Mix.     To  be  taken  in  a  wine-glassful  of  sweetened  water. 

50.  Aromatic  Syrup  of  Rhubarb,  1  oz. ;  tincture  of  Colombo,  1  oz.  Mix. 
Dose.  —  Two  teaspoonfuls  three  times  a  day. 

51.  Compound  Infusion  of  Cfentian,  6  ozs. ;  epsom  salts,  4  drams ;  diluted 
sulphuric  acid,  1 6  drops.     Mix.     A  table  spoonful  every  six  hours. 

52.  Blue  Pill,  10  grs.;  pulv.  gum  arabic,  5  grs.;  magnesia,  1  dram; 
white  sugar,  5  grs. ;  comp.  infusion  of  gentian,  1  ^  ozs. ;  water,  1 J  ozs. ;  tinct. 
of  ginger,  1^  ozs.  Mix.  From  a  teaspoonful  to  a  tablespoonful  to  bo  taken 
night  and  morning. 

53.  Pulverized  Peruvian  Dark,  1  oz. ;  pulv.  rhubarb,  J  dram  ;  pulv.  muri- 
ate of  ammonia,  1  dram.  Mix.  Divide  into  eight  powders.  Take  one  three 
times  a  day. 

54.  Oxide  of  Zinc,  2  drams ;  magnes.,  }  oz. ;  quinine,  1  scruple.  Mix. 
Divide  into  32  powders.     Take  one  four  times  a  day. 

55.  Aloes,  1  oz. ;  gentian,  1  oz. ;  orange  peel,  1  oz. ;  juniper  berries,  1  oz. ; 
aniseed,  bruised,  1  oz. ;  gin,  1  pint.  Mix.  Macerate  two  weeks,  and  striin. 
Dose.  —  A  tablespoonfiil.     Good  for  bilious  habits. 


Carmiuative  Physic. 

56.  Manna,  1  oz. ;  aniseed,  bruised,  1  dram ;  boiling  water,  ^  pint.  Mix. 
Let  the  mixture  stand  for  half  an  hour,  then  strain,  and  add  three  drams  of 
carbonate  of  magnesia  so  as  to  make  a  perfect  mixture.  Take  a  wine-glass 
full  every  two  or  three  hours,  till  it  operates.  For  the  drum-head  state  of  the 
bowels. 

57.  Thoroughwort,  2  ozs. ;  ginger  and  cloves,  each,  ^  oz. ;  ext  dandelion, 
4  ozs.;  water,  1^  pints.  Boil  to  one-third,  and  add  sugar,  1^  pounds,  and 
brandy,  ^  pint.     An  excellent  cordial  cathartic  to  act  upon  the  liver. 


larcoal,  8  drums. 
vb  1CS8,  with  foul 

iillMinum,  2  grs. ; 
pills  night  and 


;  ext.  nux  vom- 
)C(1  tinu',  ucTOid 

iples.  Mix,  and 
edy,  in  chlorosis, 

dram ;   pulver- 
pills.     One  pill 

Ltract  of  gentian, 
mnionia,  i  dram. 

ibo,  1  oz.    Mix. 

i  drams ;  diluted 
Durs. 

pesia,  1  dram ; 
T,  1 J  0Z8. ;  tinet. 
nful  to  bo  taken 


am ;  pulv.  muri- 
Take  one  three 


[  scruple.     Mix. 

;r  berries,  1  oz.; 
ieks,  and  strain. 


r,  ^  pint.  Mix. 
three  drams  of 
ike  a  wine-glass 
ead  state  of  the 

;  ext  dandelion, 
1^  pounds,  and 
liver. 


PRESCRIPTIONS.  —RECIPES. 


767 


Tonics. 

.^8.  Chamomile  Flowen,  \  oz. ;  cold  water,  1  pint.  Macerate  for  one  hour 
and  strain.     A  wine-glassful  to  be  taken  several  times  a  day. 

59.  Sulphate  of  Quinine,  15  grains;  diluted  sulphuiic  acid,  15  drops; 
compound  tincture  of  cardiun.,  3  drums ;  tincture  of  hops,  3  drains  ;  compound, 

\  infusion  of  roses,  6  oza.     Mix.     A  tea-spoonful  two  or  three  times  a  day,  io 
chlorosis. 

60.  Diluttd  Sulphuric  Acid,  2  drams  ;  syrup  of  orange  peel,  2  ozs. ;  cinna- 
mon wuter.  1  t,f..  Mix.  A  teaspoonful  or  two  in  a  wine-glass  of  water  two 
jr  three  time'  a  day. 

61.  Carbonate  of  Iron,  1  dram ;  extract  of  gentian,  1  dram.  Mix.  Make 
30  pills.     One  pill  two  or  three jtimes  a  day. 

62.  Sulphate  of  Quinine,  12  grains;  aromatic  sulphuric  acid,  24  drops; 
syrnp,  1  oz. ;  ])eppermint  water,  1  oz.  Mix.  In  intermittent  fever,  take  one 
tablespoonful  once  in  three  hours.  Ordinarily,  one  teaspoonful  is  a  suthcient 
dose. 

63.  Compound  Infntion  of  Gentian,  8  ozs. ;  nitro-muriatio  acid,  30  drops. 
Mix.     Tiike  one  tables|)<)onful  three  times  a  day.  .  •'      . 

64.  Bicarbonate  of  Soda,  J  oz. ;  compound  infusion  of  gentian,  4  ozs. ; 
tincture  of  Colombo,  1  oz. ;  syrup  of  orange  peel,  ^  oz.  Mix.  Take  a  table- 
siKKjnful  three  times  a  day. 

C5.  Sulphate  of  Quinine,  1  scruple  ;  alcohol,  4  ozs. ;  sulphuric  acid,  6 
drops ;  Madeira  wine,  1  quart.     Mix.     Two  wine-glassfuls  a  day. 

66.  Rasped  Quassia,  2  drams  ;  cold  water,  1  pint.  Macerate  twelve  hours, 
and  strain. 

67.  Quinine,  1  scruple ;  alcohol,  4  ozs. ;  sulphuric  acid,  5  drops.  Mix. 
Take  a  teaspoonful  three  times  a  day. 

68.  Arseniate  of  Iron,  3  grains ;  extract  of  gentian,  2  drams ;  pulver- 
ized liquorice,  1  dram.  Mix.  Make  20  pills.  Take  one  pill  three  times  a 
day.  If  the  eye-lids  become  inflamed,  discontinue  for  a  few  days,  and  then 
begin  again. 

69.  Soji  Water,  3  ozs. ;  quinine,  10  grains  ;  diluted  sulphuric  acid,  10  drops ; 
■imple  syrup,  1  oz.     Mix.     A  teaspoonful  every  two  or  three  hours. 

70.  Quinine,  10  grains ;  diluted  sulphuric  acid,  10  drops ;  white  sugar, 
4  drams  ;  cinnamon  water,  4  ozs. ;  tincture  of  kino,  2  drams.  Mix.  One  tear 
ipoonful  every  three  hours. 

71.  Tartrate  of  Iron,  40  grains ;  soft  water,  2  ozs. ;  syrup  of  ginger,  ^  oz. 
Mix.    20  to  40  drops  every  three  hours. 

72.  Potattio-tart.  Iron,  4  scruples  ;  quinine,  4  scruples ;  alcoholic  ext.  of 
black  cohosh,  4  scruples.     Mix.     Make  48  pills. 

73.  Hose  Water,  6  ozs. ;  syrup  of  orange  peel,  1  oz. ;  muriated  tinct.  of 
iron,  1  oz.  Mix.  For  an  adult,  one  teaspoonful  in  a  wine-glass  of  water 
after  each  meal. 

74.  Precipitated  Carbonate  of  Iron,  30  drama ;  ext.  of  conium,  15  drams  t 


■ 


■i\' 


i       1 

SI 


ii 


768 


PRESCRIPTIONS.  —  RECIPES. 


1 


«yrup  of  balsam   of  Tolu,  6  ozs. ;  oil  of  cinnamon,  12  drops  ;  oil  of  lemon,  12    ' 
drops  ;  alcohol,  2  ozs.;  water,  1  pint ;  brandy,  \  pint;  loaf  sugar,  4  ozs.     Mix 
Giye  from  one  to  three  tablespoonfuls  three  or  four  times  a  day,  in  insanity. 

75.  Citrate  of  Iron,  1  dram  ;  sul])hate  of  quinine,  1  scruple ;  ext.  of  nm 
vomica,  8  grs.     Mix.     Make  32  pills.     One  pill  tiireu  times  a  day. 

76.  Nitric  Acid,  1  dram ;  hydrochloric  acid,  ^  dram  ;  comp.  infusion  of 
gentian,  1^  ozs.     Mix.     One  tcaspoonful  in  water  is  a  dose. 

77.  Sulph.  Quinine,  1  dram  ;  tartaric  acid,  6  grs. ;  water,  1  drop.  Mix. 
Make  30  pills.     Dose.  —  One  pill,  to  be  repeated  as  often  as  needed. 

78.  Diluted  Nitric  Add,  4  drams ;  diluted  muriatic  acid,  4  drams  ;  synif 
of  orange  peel,  1  dran: ;  water,  1  ^  ozs.     Mix.     One  tcaspoonful  in  a  wiut 

glass  of  water,  taken  beibre  meals. 

i' 

General  and  Nerve  Tonics. 

79.  Valerianate  of  Quinine,  ^  dram ;  ext.  of  black  coiiosh,  1  dram ;  est. 
of  ladies  slipper,  2  drams.  Mix.  Make  60  pills.  Take  one  pill,  every  one, 
two,  three,  or  four  hours,  according  to  tlie  urgency  of  tiie  case. 

80.  Iron  hy  Hydrogen,  24  grs. ;  sulphate  of  morphia,  1  gr. ;  ext.  of  nux 
vomica,  5  grs.    Mix.    Make  24  pills.     For  an  adult,  one  pill  tlu^e  times  a  day. 

81.  Ext.  of  Scvdlcap,  2  drams  ;  ext.  of  chamomile,  2  drams  ;  ext.  of  boneset, 
1  dram ;  quinine,  1  dram  ;  pulv.  cayenne,  1  scruple ;  oil  of  valerian,  }  dram. 
Beat  well  together  and  make  90  pills.  For  an  adult,  one  pill  every  two  or 
three  hours. 

82.  White  Vitriol,  1  dram ;  ext  of  nux  vomica,  8  grs.  Mix.  Make  32 
pills.     One  pill  three  times  a  day. 

83.  Strychnia,  2  grs.;  ext  of  aconite,  16  grs. ;  ext  of  hyoscyamus,  16  grs.; 
quinine,  ^  dram.     Mix.     Make  32  pills.     One  pill  three  times  a  day. 

84.  Citrate  of  Iron,  1  dram  ;  trisnitrate  of  bismuth,  1  dram  ;  sulphate  of 
quinia,  1  scruple ;  ext  of  nux  vomica,  6  grs.  Mix.  Make  32  pills.  Take 
one  pill  three  times  a  day. 

Nerve  Tonics  and  Antispasmodics. 

85.  Strychnine,  2  grs. ;  ext  belladonna,  5  grs. ;  alcoholic  extract  of  black 
cohosh,  2  scruples.     Mix.     Make  40  pilb.    One  pill  four  times  a  day. 

86.  Strychnine,  2  grs. ;  diluted  phosphoric  acid,  1  oz. ;  peppermint  water, 
3  pints.  Dissolve  the  strycbn,  je  in  the  acid  ;  then  add  the.  peppermint  water. 
A  tablespoonful  to  be  taken  three  times  a  day,  in  palsy,  dyspepsia,  neuralgia, 
and  in  most  states  of  the  nervous  system  requiring  tone.  Also  in  fever  and 
ague. 

87.  High  Cranberry  Bark,  1  oz. ;  skunk  cabbage  root,  J  oz. ;  scullcap, 
J  oz. ;  cardamom  seeds,  2  drams  ;  pulv.  cayenne,  2  drams.  Put  these  to  a  pint 
of  wine,  shake  well  every  day  for  three  or  four  days.  A  tablespoonful  four 
times  a  day. 

88.  Distilled  Water,  2  ozs. ;  valerianic  acid,  1  oz. ;  subcarbonate  of  am- 
monia enough  to  neutralize  the  acid ;  then  add  alcoholic  ext  of  valerian,  2 
scruple*.     A  teaspoonful  three  times  a  day.     For  Neuralgia. 


LUMJllJBHUm 


1 


oil  of  lemon,  12 
nr,  4  OZ8.  Mix 
,  in  insanity. 

)le  ;  ext.  of  nux 
lay. 

imp.  infusion  of 

,  1  drop.  Mix. 
•edcd. 

4  tlmms ;  8yni|- 
int'ul  in  a  wine 


h,  1  dram;  ezt 
I  pill,  every  one, 

[T. ;  ext.  of  nux 
tree  times  a  day. 

1  ext.  of  boneset, 
alerian,  V  dram, 
ill  every  two  or 

Edix.     Make  32 

lyamus,  16  grs. ; 
a  day. 

un ;  sulphate  of 
32  pills.    Take 


38. 

extract  of  black 
i  a  day. 

ppermint  water, 
ppermint  water, 
epsia,  neuralgia, 
so  in  fever  and 

^  oz. ;  scullcap, 
t  these  to  a  pint 
)lespoonfuI  lour 

irbonate  of  am- 
of  valerian,  2 


PRESCRIPTIONS.  —  RECIPES. 


769 


89.  Ext.  of  Valerian,  12  grs. ;  ext.  of  hyoscyamus,  12  grs. ;  oxide  of 
zinc,  21  grs.     Mix,     Make  12  pills.     One  pill  twice  a  day. 

(10.  Sulphate  of  Morphia,  2  grs. ;  cyanide  of  potassium,  4  grs. ;  ext.  of 
viilerian,  4  grs.     Make  24  pills.     One  pill  three  times  a  day. 

01.  Ext.  of  Hyoscyamus,  J  dram;  sjlphatc  of  morphia,  3  grs.;  strych- 
nine, 2  grs. ;  pulv.  cayenne,  ^  dram  ;  sulphate  of  7'i\  \  15  grs.  Make  30  pills. 
Take  one  four  times  a  day.     Excellent  in  neuralgia. 

It2.  Ext,  of  Hyoscyamus,  J  dram ;  valerianate  of  zinc,  1  scruple.  Mix. 
Make  30  pills.     Take  one,  two  or  tiirec  times  a  day,  for  neuralgia  of  the  face. 

•J3.  Ext.  of  Hyoscyamus,  \  dram ;  valerianate  of  iron,  1  dram.  Mix. 
Make  30  pills.  Give  from  one  to  three  a  day.  For  neuralgia,  in  its  various 
forms. 

94.  IXnct.  of  Black  Cohosh,  2  ozs. ;  tinct.  of  scullcap,  2  ozs.  Mix.  One 
tca>*poonfuJ  from  two  to  five  times  a  day. 

95.  Alcoholic  Ext.  of  St.  Ignatius's  Bean,  30  grs. ;  pulv.  gum  arable,  10 
grs.    Make  into  40  pills.     Take  one  pill  three  times  a  day. 

96.  Simple  Syrup,  1  oz.;  prussic  acid,  1  drop.  Mix.  A  tcaspoonful  morn- 
ing and  evening.  If  no  dizziness  or  sickness  is  produced  within  forty-eight 
hours,  repeat  the  dose  three  times  a  day.  This  is  for  a  child  six  months 
old ;  add  one  drop  more  of  the  acid  for  each  additional  year  of  the  child's  age. 

97.  Comp.  Pill  of  Galbanum,  1  dram  ;  comp.  pill  of  valerian,  1  dram.  Mix. 
Divide  into  40  pills.     One  or  two  pills  tliree  times  a  day. 

98.  SulphcUe  of  Zinc,  1  dram ;  comp.  galbanum  pill,  ^  dram ;  ext.  of 
hyoscyamus,  1  scruple.  Mix.  Make  32  pills.  One  pill  three  times  a  day. 
For  St.  Vitus's  dance. 

99.  Dioscorein,  12  grs.;  pulv.  camphor,  4  grs.;  pulv.  cayenne,  12  grs.; 
white  sugai-,  1  scruple.  Mix.  Divide  into  four  powders.  Give  one  every  15 
minutes. 

100.  Bxt.  of  High  Granbtrry  Bark,  1  scruple;  cypripedin,  1  scruple; 
aletridin,  1  scruple ;  pulv.  cayenne,  1  scruple.  Mix.  Make  20  pills.  Take 
one  pill  an  hour  after  each  meal. 

Alteratives  and  Tonics. 

101.  Iodide  of  Potassium,  1  oz. ;  compound  infusion  of  gentian,  or  infusion 
of  quassia,  6  ozs.  Dose.  —  A  tablespoonful,  for  secondary  and  tertiary  syphi- 
lis, and  other  complaints.     A  teaspoonful  for  a  child. 

102.  Iodide  of  Iron,  \  dram ;  compound  tincture  of  Colombo,  1  oz. ;  pure 
water,  7  ozs.    Mix.     A  tablespoonful  three  times  a  day. 

103.  Syrup  of  Iodide  of  Iron,  1  oz.  Thirty  drops  three  times  a  day,  in 
wat^r.  An  excellent  remedy  in  chlorosis,  and  tdl  other  low  states  of  the  blood 
connected  with  scrofula. 

Expectorants  and  Oongh  Preparations. 

104.  Tartar  Emetic,  1  grain ;  boiling  water,  10  drams.  Mix.  Take  one 
teaspoonful  every  two  hours. 

97 


770 


PRE8CK1PTION8  —  RECIPES 


:i,'/ ' 


105.  Infuiion  of  Senega,  4  ozb.  ;  syrup  of  ipecac,  1  dram  ;  syrup  of  Hquill.i, 
S  drams  ;  tartar  emetic,  1,^  graiiiH.     Mix.     A  tcaspounful  every  *en  minulert. 

106.  Tincture  of  Lobelia,  ^  oz. ;  syrup  of  squills,  \  oz.  Mix.  Twenty 
drops  four  or  five  times  a  day  fur  a  child  two  years  old- 

107.  Peppermint  Water,  G  ozs. ;  epsom  salts,  1  oz. ;  tartar  emetic,  1  grain. 
Mix.     Two  tablespoonfuls  every  four  hours. 

108.  Hydrocyanic  Acid,  25  drops ;  wine  of  ipecac,  2  drams ;  syrup  of 
tolu,  1  oz. ;  soft  water,  3  ozs.  Mix.  A  teaspoonful  four  or  Ave  times  a  day. 
An  excellent  remedy  in  hooping  cough. 

1 09.  Tinct.  Bhod-root,  1  oz. ;  laudanum,  2  drams  ;  wine  of  ipecac,  4  Araan ; 
t  t'up  of  tolu,  2  ozs.     Mix.     Dose  from  30  to  60  drops  four  times  a  day. 

110.  Tinct.  Mood-root,  1  oz. ;  sulphate  of  morphia,  1}  grains;  tinct.  digi< 
talis,  \  oz. ;  wine  of  antimony,  j^  oz. ;  oil  of  wintergreen,  10  drops.  Mix.  Doi-e 
from  20  to  40  drops  twice  or  three  times  a  day.  Excellent  for  u  hard,  dry 
cough. 

111.  Tinct.  of  Lobelia,  \  oz. ;  tinct.  of  blood-root,  2  ozs. ;  oil  of  spearmint, 
^  dram  ;  molasses,  5  ozs.     Take  one-half  a  teaspoonful  as  oflen  as  needed. 

11?  Syrup  of  Tolu,  1  oz. ;  syrup  of  squills,  J  oz. ;  wine  of  ipecac,  2  drs. ; 
paregoric,  3  drs. ;  mucilage  of  gum  arabic,  \^  ozs.  Mix.  Take  a  teaspoonful 
occasionally. 

113.  Tinct.  Blood  Root,  2  drams  ;  syrup  of  tolu,  1  oz. ;  mucilage  of  gum 
arabic,  3  ozs. ;  diluted  hydrocyanic  acid,  40  drops  ;  sulphate  of  morphia,  2  grs. 
Mix.     Dose,  from  one  to  two  teaspoonfuls. 

Carminatives. 

114.  Bruised  Cloves,  2  drams;  boiling  water,  1  pint.  Macerate  for  mo 
hours  in  a  covered  vesaeli  and  strain.     A  wine-glasaful  to  be  taken  occation- 

ally. 

115.  Camp.  THnct.  of  Cardamom,  2  ozs.;  comp.  tinct  of  lavender,  2  ozs.; 
comp.  tinct.  of  gentian,  2  ozs.  Mix.  One  teaspoonful  at  a  time,  as  occasion 
may  require. 

Narcotics  and  Anodynes. 

116.  Extract  of  Hyoscyamus,  1  scruple ;  gum  camphor,  1  scruple  ;  Dover's 
powder,  1  scruple.  Mix,  and  make  into  20  pills.  Dose.  —  One  twice  a  day, 
for  painful  menstruation. 

117.  Powdered  Camphor,  12  grains;  powdered  castile  soap,  12  grains; 
powdered  opium,  12  grains ;  syrup,  2  scruples.  Mix.  Make  into  12  pills. 
Take  one  every  hour  till  the  effects  of  opium  are  experienced. 

118.  Laudanum,  ^  oz. ;  wine  of  ipecac,  ^  oz. ;  spirifas  of  nitric  aether,  |  oz. 
Mix.     One  teaspoonful  every  hour,  till  narcotic  effects  are  observed. 

119.  Camphor,  2  drams;  chloroform,  1  dram;  the  yolk  of  an  egg.  Mix, 
and  rub  together;  and  then  add,  tincture  of  opium,  1  oz. ;  aromatic  spirits  of 
ammonia,  1  oz.  Mix  well.  Take  one  teaspoonful  every  hour  until  it  proves 
anodyne. 

120.  Camph  •  ^  dram;  extract  of  opium,  6  grains;  mudlage  of  gum 
arabic,  2  scruples.     ]Make  10  pills. 


syrup  of  »quilU, 
■y  ♦en  rcinutv)). 

Mix.     Twenty 

'  emetic,  1  grain, 

rams ;  syrup  of 
fivu  timed  a  day. 

ipecac,  4  drams ; 
nes  a  day. 

ains ;  tinct.  digi- 
ps.  Mix.  Dot-e 
:  for  b  hard,  dry 

oil  of  spearmint, 
a  as  needed. 

of  ipecac,  2  drg. ; 
ike  a  teaspoonful 

mucilage  of  gum 
f  morphia,  2  grs. 


lacerate  for  two 
!  taken  occafiion* 

lavender,  2  ozs. ; 
time,  as  occasion 


jcruple ;  Dover's 
>ne  twice  a  day, 

!oap,  12  grains; 
ee  into  12  pills. 

itric  aether,  \  oz. 
rved. 

P  an  egg.  Mix, 
omatic  spirits  of 
ir  until  it  proves 

nucilage  of  gum 


l»RK8CRIPTION8.  —  RECIPES. 


771 


121.  Chloroform,  2  ounces;  compound  sulphuric  ether,  2  uM. ;  laudanum, 
2  ozH. ;  tinct.  cayenne,  1|  ozs.;  hydro<-yunic  acid,  diluted,  ^  oz.  Mix.  Dose. 
—  Half  a  tenspoonful  every  three  hours  till  anodyne  effects  are  experienced. 

122.  Ext.  of  lieUadnnna,  10  grx. ;  hydrocyanic  acid,  40  drops;  tinct 
Colombo,  1  oz. ;  simple  syrup,  1  oz. ;  sod  water,  2  ozs.  Mix.  One  teaspoonful 
three  or  four  times  a  day.  Excellent  in  gastralgia  and  irritable  dyspepsia. 
Also  in  lUHthma. 

123.  Ext.  of  BfUadonna,  6  grs.;  pulv.  ipecac,  10  grs.;  confection  of  roses, 
2  grs.     Mix.     Make  i!>)  pills.     Take  1  pill  twice  a  day. 

Diaphoretics  and  Sedatives. 

124.  Tinct.  of  American  Hellebore,  1  dram  ;  tinct  of  black  cohosh,  2  ozs. 
Mix.    Take  one  teas|>oonful  from  three  to  six  times  a  day.     Excellent  for 

Niumlgia. 

1 2.5.  Pulverized  Gum  Arabic,  1  scruple  ;  soft  water,  2  ozs. ;  sweet  spirits  of 
nitre,  ^  oz. ;  tinct  of  veratrum  viride,  20  drops.  Mix.  Give  half  a  teaspoon- 
ful every  half  hour. 

12C.  Pulv.  Blood-root,  2  drams;  pulv.  golden  seal,  2  drams;  pulv.  sumach 
berries,  2  drams  ;  pulv.  bayberry  bark,  2  drams.  Mix.  Make  an  infusion  in 
a  pint  of  hot  water,  and  give  a  tablespoonful  every  half  hour.  To  produce 
periipiration. 

127.  Pulverized  Camphor,  2  grs.,  pulv.  nitrate  of  potash,  2  grs.;  pulv- 
oi)iiim,  1  gr.  Mix.  Make  two  powders.  Take  one  on  going  to  bed,  in 
rheuiuatiiim. 

Diuretics. 

128.  Juncture  of  IHgitalit,  1  oz. ;  syrup  of  squills,  1  oz.  Mix.  Ten 
drops  for  a  child  7  years  old  every  four  hours. 

129.  Nitrate  of  Potassa,  2  scruples ;  water,  1  quart.    Mix.     Flavor  to 

suit 

130.  Infusion  of  Digitalii,  4  ozs.;  acetate  of  potash,  2  drams;  sweet 
spirits  of  nitre,  2  drams ;  cinnamon  water,  1^  ozs.  Mix.  A  tablespoonful 
every  four  or  five  hours. 

131.  Spirits  of  Mindererut,  2  ozs.;  sweet  spirits  of  nitre,  1  oz.  Mix. 
Take  one  teasjHwnful  every  three  hours. 

Refrigerants. 

132.  Oream  of  Tartar,  2  scruples;  water,  1  quart.  Mix.  Flavor  to 
suit. 

133.  Bicarbonate  of  Soda,  SO  grains;  water,  6  ozs.  Mix.  To  this  mix- 
ture add  25  grains  of  tartaric  acid,  and  tak«  the  whole  foaming. 

Stimulants. 

134.  Muriate  of  Ammonia,  1  oz. ;  soft  watei,  9  ozs.  Mix.  Take  one 
table  spoonful  three  or  four  times  a  day. 


T  '  » 


772 


I'KKSCUII'TIONH.  — KKCIl'ES. 


ISS.  Aromatic  Sjn'riti  of  Ammonia,  2  drams;  ether,  1  dram;  lauiliuuiin, 
20  (lru|)M ;  Hpiriu  of  camphor,  1  drum.  Mix.  lluli'  u  tcuapoonful  an  ut'tca  im 
re(iuin;d. 


Alteratives. 


Mix. 


Mix. 


1.S6.     Proto-iodide  of  Mercuiy,  10  grains  ;  extract  of  opium,  6  grains. 
Make  20  pilln.     Toko  one  ]iill  night  and  morning. 

l.'J7.     Jiiniodide  of  Mercury,  f)  grains  ;  extract  of  conium,  2  Bcruples. 
Maive  20  pills.     Take  one  pill  niglit  and  morning. 

I  ."JS.  Compourul  Infusion  of  Sariaparilla,  1  pint ;  iodide  of  iwtassium, 
^  (>/..     Mix.     Take  a  teaspoonful  atler  each  meal. 

1  .'iO.  Compound  Infusion  of  Sarsaparilla,  1  pint ;  corrosive  sublimate, 
4  grains.     Mix.     Take  a  teaspoonful  four  times  a  dny. 

1 40.  Compound  Infusion  of  Gentian,  4  ozs. ;  iodide  of  potassium,  ^  oz. 
Mix.     One  teas|)oonful  after  each  meal. 

141.  Iodide  of  Arsenic,  5  grains;  soft  water,  1  pint.  Mix.  One  tea- 
s]>oonful  three  times  a  day. 

142.  Blue  Pill,  12  grains;  pulverized  ipecac,  3  grains;  extract  of  hyos- 
cyamus,  4  grains.  Mix.  Divide  into  12  parts,  one  to  be  given  every  three 
hours. 

143.  Pulverized  Elood  Root,  1    scruple ;   iodide  of  arsenic,  2   grs. ;  ex- 


Mix.      Make  40  pills. 


One  pill  three  times  a 

Mix.     Thirty  dropg 

Mix 


tract  of  cicuta,  2  scruples, 
day. 

144.  Iodide  of  Potassium,  1    dram ;   water,  ^  oz. 
to  a  child  7  years  old,  every  hour. 

145.  Comp,  Syrup  of  StiUingia,  1  pint;  iodide  of  potassium,  1  oz. 
A  tablespoonful  after  each  meal. 

146.  Fluid  Ext.  of  Sarsaparilla,  4  ozs.;  fluid  ext.  of  pipsissewa,  1  oz. ; 
water,  1  quart ;  iodide  of  jKttassium,  2  ozs.  Mix.  Take  a  tablespoonful  three 
times  a  day. 

147.  Bicarbonate  of  Potatsa,  8  drams  ;  water,  4  ozs.  IMix.  Add  a  table- 
spoonful of  the  solution  to  the  same  quantity  of  lemon  juice,  previously  mixed 
with  a  tablespoonful  of  water.     To  be  tnken  foaming,  several  times  a  day. 

148.  Blu^  Pill,  j[  dram;  extract  of  henbane,  1  Bcrui)le.  Make  10  pills. 
One  pill  at  night. 

149.  Mercury  with  Chalk,  ^  dram;  extract  of  conium,  1  scruple.  Make 
into  8  pills.     TaLe  one  pill  night  and  morning. 

1.50.  Corrosivs  Sublimate,  4  grains ;  extract  opium,  5  grains.  Mix,  and 
make  into  20  pills.     Take  one  pill  night  and  morning. 

151.  Iodide  of  Potassium,  1  dram;  syrup  of  sarsaparilla,  4  oza.  Mix. 
Take  two  teaspoonfuls  three  times  a  day. 

Astringents. 

152.  Sugar  of  Lead,  2  scruples  ;  opium,  1  scruple ;  conserve  of  red  roses, 
.cruple.     Beat  into  a  mass,  which  is  to  be  divided  into  30  pills.     Take  one 

every  hour,  until  narcotic  effects  are  observed. 


PRESCRIPTIONS.  —  RECIPES. 


773 


drum  ;  laiiiliiniiin, 
x^nful  an  oi'tun  iw 


n,  6  grains.    Mix. 

2  scruples.     Mix. 

lide  of  i>otassium, 

rrosive  subliiuate, 

f  potassium,  ^  oz. 

Mix.     One  tea- 

;  extract  of  hyoa- 
given  every  three 

senic,  2  grs. ;  ex- 
pill  three  times  a 

3x.     Thirty  drops 

Bsium,  1  oz.    Mix. 

pipsissewa,  1  oz. ; 
tablespoonful  three 

Slix.  Add  a  tablc- 
',  previously  mixed 
1  times  a  day. 

s.     Make  10  pills. 
,  1  scruple.     Make 
grains.     Mix,  and 
rilla,  4  0Z8.     Mix.     i 


iserve  of  red  roses, 
0  pills.     Take  one 


1  .'>3.  Dover' t  Poioder,  ^  dram  ;  prepared  clialk,  1  scruple.  Mix,  and  divide 
into  12  equal  powdcn. 

1 54.  Ohalk  Mixture,  4  oza. ;  tinct.  of  catechu,  ^  oz. ;  laudanum,  1  dram. 
Mix.     1)()H<',  ill  diarrhuBU,  two  tu  four  teaHpouiifuls  three  times  a  day. 

l.'i.'i.  Oil  of  Turpentine,  I  dram ;  muciluj^o  of  gum  arubi(^,  1  dram  j  simple 
Hyrup,  \  oz. ;  «'iiumiuon  water,  2  ozh.     Mix.     To  be  taken  at  u  dniught. 

loG.  Sugar  of  Lead,  IC  grains;  prepared  chalk,  1  dra:n;  pulverized  ipecac, 
4  grains;  pulverized  opium,  2  gniina.  Mix.  Divide  inlj  16  portions,  one  to 
bt)  given  every  three  or  four  hours. 

157.  Sugar  of  Lead,  8  grains;  vinegar,  8  drops;  white  sugar,  I  dram; 
fiofl  water,  1  oz.  Mix.  A  teaspoouful  threo  or  four  times  a  day,  until  the  dis- 
charges are  abated. 

158.  Prepared  Chalk,  ^  dram ;  pulverized  ipecac,  3  grains.  Mix.  Make 
12  powders.     Give  one,  two  or  three  times  a  day. 

159.  Pulverized  Catechu,  2  drams;  bruised  cinnamon,  ^  dram;  boiling 
water,  5  oz-<.  Steep  in  a  covered  vessel  for  one  hour,  and  strain.  A  teospoonful 
every  two,  three,  or  four  hours,  according  to  age,  nature  of  the  case,  etc. 

160.  S)ft  Water,  1  oz. ;  sugar  of  lead,  5  grains;  vinegar,  6  drops;  loaf 
sugar,  3  drams.     Mix.     A  teospoonful  every  hour  or  two. 

161.  Tinct.  of  Catechu,  \  oz. ;  laudanum,  2  drs. ;  spirits  of  camphor,  2  drs.; 
tinct  of  myrrhoB,  2  drs. ;  tinct.  of  cayenne,  2  drs.  Mix.  Dose,  Irom  half  a 
teospoonful  to  a  teospoonful,  for  diorrhooo. 

162.  St/rup  of  Orange  Peel,  1  oz. ;  acetate  of  morphia,  2  grs.;  tinct  of 
cinnamon,  6  drs. ;  tinct.  cardamom,  2  drs.  Mix.  Dote.  —  A  teospoonful.  A 
valuable  remedy  in  diarrhoeo. 

'  Counter-irritants. 

1 63.  Tincture  of  Spanish  Flies,  1  oz. ;  olive  oil,  2  ozs. ;  alcohol,  ^  pint. 
Mix.  To  be  applied  externally,  watching  the  effect,  so  os  not  to  produce  a 
bhster. 

164.  Water  of  Ammonia,  1  dram;  olive  oil,  1  oz.    Mix.    Apply  to  the  skin. 

165.  Mustard  Powder,  1  tablespoonful.  Mix  with  a  little  water  to  make 
a  thick  paste.  Then  spread  upon  a  piece  of  brown  paper  or  cotton  cloth, 
and  cover  its  surface  with  a  piece  of  thin  muslin  to  prevent  the  mustard  from 
sticking  to  the  flesh.  Place  it  upon  the  sore  or  painful  part,  and  keep  it  on 
fifteen  or  twenty  minutes,  or  till  o  good  degree  of  redness  is  produced. 

166.  Vinegar  of  Spanish  Flies,  1  oz. ;  spirits  of  camphor,  1  oz.  Mix. 
To  be  rubbed  gently  upon  the  skin.  If  applied  freely,  and  rubbed  thoroughly 
in,  it  may  produce  a  blister. 

167.  Yellow  Wax,  Rosin,  Lord,  each,  6  drams.  Melt  over  a  slow  fire,  ond 
then  stir  in  slowly,  when  at  a  very  moderate  degree  of  warmth,  1^  drams  of 
pulv.  Spanish  flies,  to  make  an  ointment 

168.  Water  of  Ammonia,  strong,  1  oz. ;  alcohol,  1  oz.  Mix.  Wet  a  piece 
of  cotton  cloth,  and  lay  it  upon  the  poinful  port,  and  cover  it  with  flannel  to 
prevent  evaporation. 


I 

; 


ammammamamm 


mmam^m 


774 


PRESCRIPTIONS.  —RECIPES. 


Ointments. 


extract  of  belladonna,  1  oz. ;  extract  of 
Mix.     For  external  use. 

Mix.    To  be  rubbed 


169.  Mercurial  Ointment.  1  oz. 
henbane,  1  oz. ;  camphr.,  lO  grains. 

1 70.  Extract  of  Belladonna,  J  dram ;   lard,  J  oz. 
m  the  neck  of  the  womb  in  painful  menstruation. 

171.  Pruttic  Acid,  2  drams  ;  sugar  of  lead,  1  dram ;  cocoa-nut  oil,  ^  0B.| 
lard,  1  oz.     Make  an  ointment. 

172.  Neapolitan  Ointment,  2  drams ;  extract  of  belladonna,  1  dram.    Mix, 

173.  Extract  of  Belladonna,  15  grains ;  lard,  1  oz.     Mix. 

1 74.  Sulphuret  of  Lime,  1  dram ;  camphor,  in  powder,  15  grains ;  lard, 
1  az.     Make  an  ointment.  ^ 

175.  Elder-Flower  Ointment,  1  oz. ;   oxide  of  zinc,  1  dram.    Make  an 
ointment. 

176.  Oxide  of  Zinc,  1  dram ;  spermaceti  ointment,  1  oz.    Mix. 

177.  Napthaline,  2   scruples     lard,   1   oz.      Make   an  ointment    To  be 
spread  upon  linen,  and  applied  to  the  diseased  skin  night  and  morning. 

178.  Mild  Nitrate  of  Mercury  Ointment,  3  drams  ;  sugar  of  lead,  16  grains; 
rose-water  ointment,  1  oz. 

179.  Laudanum,  ^  dram ;  sulphur,  ^  dram  ;  oxide  of  zinc,  1  dram ;  oil  of 
almonds,  1  oz. ;  lard,  3  ozs.     Make  an  ointment.   ' 

180.  Olive  Oil,  4  ozs, ;  white  wax,  2  drams.    Melt  these  together,  and 
then  add  honey,  2  drams  ;  croton  oil,  20  drops. 

181.  Elder-Flower    Ointment,  1   oz.  •    pulverized  blue  vitriol,  1  scrapie. 
Make  an  ointment. 

182.  Purified  Beeves'  Marrow,  or  lard,  6  drams ;  oil  of  sweet  almonds,  2 
drams  ;  pulverized  Peruvian  bark,  1  dram.     Mix. 

183.  Pulverized  Sulphate  of  Copper.  10  grs}  extract  of  Spanish  flies,  5 
grs. ;  lard,  I  oz.     Mix.     Bub  into  the  scalp. 

184.  Iodide  of  Lead,  1  dram;  lard,  2  ozs.    Mix.    To  be  robbed  on  the 

surface. 

185. 
186. 
187. 
188. 
189. 


Mix. 


Iodide  of  Potassium,  1  dram ;  lard,  2  ozs.    Mix. 

BasUicon  Ointment,  1  oz. ;  red  precipitate,  1  dram. 

Iodide  of  Potassium,  ^  dram  ;  lard,  1  oz.     Mix. 

Veratria,  4  grs. ;  lard,  5  drams.     Mix. 

Tobacco  Leaves  (fresh  and  sliced),  10  ozs.;  diluted  acetic  acid,  4  pints? 
basilicon  ointment,  13  ozs.  Boil  the  tobacco  in  the  acid,  strain,  and  evaporate 
the  decoction  to  six  ounces.  Add  this  to  the  basilicon  ointment,  heated,  and 
stir  till  cold.     For  gathered  breasts. 


Liniments. 

1 90.     Sweet  Oil,  1  oz. ;  strong  water  of  ammonia,  1  oz. 
rubbed  on  with  a  piece  of  flannel. 


Mix.     To  be 


J 


-  ii 


(.AJ^jivj 


1 


PRESCRIPTIONS.  —RECIPES. 


773 


oz. ;  extract  of 

To  b<3  rubbed 

Ek^nut  oil,  i  oe.| 

i,  1  dram.   Mix, 

L5  grains;  lard, 
ram.    Make  aa 

Mix. 

fitment.  To  ba 
lorning. 

'lead,  16  grains; 
t,  1  dram ;  oil  of 
se  together,  and 
itriol,  1  scrapie, 
iweet  almonds,  2 
'  Spanish  flies,  5 
e  nibbed  on  the 

Mix. 


Btic  acid,  4  pints; 
in,  and  evaporate 
nent,  heated,  and 


Mix.     To  be 


191.  Zime   Fartr,  2  ozs. ;  flax  seed  oil,  2  ozs.    Mix.     Apply  outwardly. 

192.  Olive  Oil,  1  oz. ;  solution  of  potassa,  2  drams ;  strong  mercurial 
ointment,  1  dram.     Mix. 

193.  Olive  Oil,  4  ozs. ;  oil  of  amber,  2  drams ;  oil  of  rosemary,  2  drama. 
Mix. 

194.  Spirits  of  Turpentine,  1  oz,  j  linseed  oil,  1  oz. ;  lime  water,  1  oe. 
Mix.     For  external  use. 

195.  Oil  of  Hemlock,  2  drams;  oil  of  origanum,  1  dram;  camphor,  1  dram; 
opium,  1  dram  ;  alcohol,  4  ozs.    Mix.  ^ 

196.  Soap  Liniment,  2  or.s.;  chloroform,  1  dram.     Mix, 

197.  TYnc^.  q/" -4comte-roo<,  J  oz. ;  opium  liniment,  J  oz.  Mix.  For  neu 
ralgia,  etc.     Apply  a  tea-spoonful  to  the  painful  part. 

198.  White  Soap,  12  ore. ;  camphor,  6  ozs. ;  oil  of  rosemary,  1^  ozs. ;  alco- 
hol, 4  pints;  opium,  3  ozs.  Mix  exii  filter.  An  excellent  liniment,  acting 
at  times  like  a  charm  in  the  remov.i  of  local  pains, 

199.  Sulphuric  Acid,  1  drrjn ;  spirits  of  turpentine,  1  dram ;  olive  oil, 
3  drams.  Mix  the  oil  and  spirits  of  turpentine  first,  then  gradually  add  the 
sulphuric  acid.  A  valuable  liniment  for  chilblainB.  To  be  rubbed  on  two  or 
three  times  a  day.  ^ 

Washes,  Lotions,  Gargles,  etc. 

200  Bruised  White  Oak  Bark,  1  oz, ;  water,  1 J  pints.  Boil  down  to  a 
pint,  and  strain.     To  be  used  as  a  wash. 

201.  Borat"  o/  Soda  or  Borax,  2  dramj ;  water,  4  ozs.  Mix.  To  be  used 
as  a  lotion. 

202.  Alum,  2  drams ;  water,  4  ozs.    Mix.     To  be  used  as  a  lotion, 

203.  Tannin,  1  scruple  ;  water,  4  ozs.     Mix,     For  external  use. 

204.  Biborate  of  Soda,  J  oz. ;  rose  water,  6  ozs. ;  sulphate  of  morphia, 
6  graint>.     Mix.     To  be  used  as  a  wash  in  itching  of  the  female  privities. 

205.  <JKlorinated  Soda,  1  oz,;  water,  12  ozs.  Mix.  Rinse  the  mouth  with 
it  two  ov  three  times  a  day,  but  do  not  swallow. 

207.  Bote  Water,  5  ozs-;  sugar  of  lead,  8  grains  ;  sulphate  of  zinc,  8  gra. 
Mix. 

208.  Bose  Water,  4  J  dzs.  ;  nitrate  of  silver,  2  grains.     Mix. 

209.  Sulphate  of  Zinc,  8  grains  ;  tannin,  1  scruple  ;  water,  5  oz.s.    Mix. 

210.  Chloride    f  Zinc,  6  grains  ;  soft  water,  2  ozs.    Mix, 

211.  Nitrate  of  Silver,  10  grains  ;  soft  water,  1  oz.     Mix,  » 

212.  Corrosive  Sublimate,  i  grains  ;  soft  water,  1  pint.     Mix. 

213.  Alcohol,  1  pint;  soft  soap  of  potash,  1  pint.  Dissolve  and  hlter,  then 
add  oil  of  citron,  1  oz.  Mix.  It  will  answer  a  good  purpose  if  the  oil  of 
citron  be  omitted. 

214.  Nitrate  of  Silver,  2  scruples ;  nitric  acid,  12  drops ;  soft  water,  1  oz. 
Mix.    Apply  with  a  piece  of  lint  tied  to  the  end  of  a  stick. 


/ 


'IVi 


F> 


-|i 


3!E: 


76 


PRESCRIPTIONS.  —  RECIPES. 


215.  Copperat,  1  oz. ;  soft  water,  1  pint.    Mix. 

216.  Alcohol,  \)[  ozs. ;  rose  water,  4  ozs.     Mix. 

217.  Corrotive  Sublimate,  6  grains;  spirits  of  rosemary,  1  oz. ;  alcohol, 

1  oz. ;  emulsion  of  bitter  almonds,  6  ozs.     Mix. 

218.  Solution  of  Sugar  of  Lead,  12  drops ;  laudanum^  1  dram ;  water,  4  ozs. 
Mix.     To  be  applied  externally  only. 

219.  Nitrate  of  Silver,  1 J  drams  ;  soft  water,  1  oz.    Mix. 

220.  White  Vitriol,  1  dram  ;  rose  water,  3  ozs.     Mix.    Apply  outwardly. 

221.  Hydrocyanic  Acid,  4  drams;  sugar  of  lead,  15  grains;  alcoboi,  4 
dlrams  ;  water,  7  ozs.     Mix.     Apply  ex*  ^mally. 

222.  Corrosive  Sublimate,  5  grains  ;  almond  mixture,  |  pint.  Mix.  Apply 
externally. 

223.  Rose  Water,  4  ozs. ;  pulverized  borax,  J  oz. ;  sulphate  of  morphine^ 
6  grains.     Mix.     To  be  applied  to  the  parts  many  tintes  a  day. 

224.  Sugar  of  Lead,  2  drams ;  laudanum,  1  dram ;  soft  water,  ^  pint. 
Mix.     For  external  une. 

225.  Corrosive  SublimcUe,  5  grains ;  cologne,  2  ozs. ;  soft  water,  6  ozs. 
Mix.     For  external  use  only. 

226.  Acid  Nitrate  of  Mercury,  1  dram ;  soft  water,  4  ozs.  Mix.  Apply 
every  second  day. 

227.  Sugar  of  Lead,  3  grains ;  soft  water,  I  oz.  Mix.  As  a  wash  in 
inflammation  of  the  mouth  in  infants. 

228.  Mucilage  of  Gum  Arabic,  1  oz. ;  syrup  of  orange  peel,  ^  oz. ;  chloride 
of  lime,  15  grains.     Mix. 

229.  Decoction  of  Peruvian  Bark,  S  ozs. ;  syrup  of  orange  peel,  1  oz. ; 
chloride  of  soda,  1  oz.     Mix. 

230.  Creosote,  4  drops ;  mucilage  of  gum  arable,  \  oz. ;  camphor  water, 
8  ozs.    Mix. 

231.  Vinegar,  1  dram ;  alcohol,  3  drams ;  simple  syrup,  1  oz. ;  water,  3  ozs. 
Mix. 

232.  White  Oak  Bark,  1  oz. ;  water,  1  pint  Boil  away  one  quarter,  and 
eti^'n  ;  then  add  alum,  1  scruple.  Apply  to  the  parts  wiUi  a  soft  spoage,  or 
dossil  of  lint,  several  times  a  day. 

233.  HydrocUoric  Acid,  \  dram ;  honey,  1  oz. ;  rose  water,  1  oz.  Mix, 
A-pply  three  or  four  times  a  day. 

234.  Sulphate  of  Copper,  ^  dram ;  soft  water,  1  oz.  Mix.  To  be  ap" 
plied  twice  a  day  to  the  ulcers  in  gangrene  of  the  mouth. 

235.  White  Vitriol,  1  dram  ;  soft  water,  2  drams.    Mix.    Then  add  honey, 

2  drams  ;  tincture  of  myrrh,  2  drams.     To  be  applied  twice  a  day  to  the  ulcers 
in  gangrene  of  the  mouth. 

236.  Creosote,  1  dram ;  alcohol,  1  dram.  Mix.  To  be  applied,  with  a 
camel's  hair  pencil,  to  the  gangrenous  ulcers  o£  the  atouth  after  running  a 
lancet  through  the  sloughs.  - 

237.  Acid  Nitrate  of  Mercury,  ^  dram  ;  soft  water,  1  oz.  Mix.  To  be  in- 
iected  into  the  throat  with  the  nhower  syringe,  or  applied  to  ulcers  with  a  pencil 


PRESCRIPTIONS.  —  RECIPES. 


777 


1  oz. ;  alcohol, 
\ ;  water,  4  ozs. 


ly  outwardly, 
ns ;  alcohoi,  4r 


e  quarter,  and 
ioft  sponge,  or 

',  1  oz.    Mix. 

u    To  be  ap> 

en  add  honey, 
f  to  the  ulcers 

)plied,  with  a 
«r  running  a 

X.     To  be  in- 
with  a  pencil 


Jtote    Water,  4  ozs. ;  sugar  of  lead,  2  drams.     Mix.     For  external 


238. 
use. 

239.  Sou  Water,  2  ozs. ;  sugar  of  lead,  1  scruple.    Mix.    For  external 

use. 

240.  Tincture  of  Arnica,  J  oz. ;  cold  water,  4  ozs.  Mix.  For  external 
use. 

241.  Tinct.  Blood-root,  2  ozs.;  solution  chloride  of  Soda,  2  ozs.;  tinct 
henbane,  2  ozs.     Mix. 

242.  Bucket  of  Warm  Water;  cayenne  pepper,  pulverized,  1  tablespoonful ; 
ground  mustard,  2  tablespoonfuls.     Mix.     As  a  foot  bath  in  suppression,  etc. 

243.  Chlorate  of  Potash,  J  oz. ;  strong  hydrochloric  acid,  40  drops  ;  water, 
I  pint.  Mix.  An  excellent  wash  for  chronic  fetid  ulcers,  —  soon  converting  a 
foul  ulcer  to  a  healthy-looking  one.    A  good  gargle. 

244.  Powdered  Golden  Seal,  1  dram ;  powdered  cranesbill,  1  dram ;  pow- 
dered witch-hazel  bark,  1  dram.  Mix.  Pour  upon  these  half  a  pint  of  boiling 
water.  Let  them  stand  till  cold.  To  swab  an  ulcerated  throat  in  scarlet  fever, 
and  for  other  purposes. 

245.  Pulv.  Cayenne,  1  dnim ;  salt,  1  dram  ;  boiling  water,  1  gill.  Mix,  and 
let  them  stand  fifteen  minutes.  Then  add  one  gill  of  vinegar.  Let  them  stand 
an  hour,  and  strain.  Put  a  teaspoonful  in  a  child's  mouth  once  an  hour,  in  ma- 
lignant scarlet  fever. 

Injections.  >        ^ 

246.  Castor  Oil,  1  gill;  pulv.  cayenne,  10  grs. ;  molasses,  I  gill;  table 
salt,  1  teaspoonful ;  warm  water,  1  pint.     Mix. 

247.  Senna  Leaves,  2  drams.  Steep  in  a  pint  of  water.  Then  add  one 
ounce  of  epsom  salts,  and  strain.  A  quarter  of  this  may  also  be  taken  as  a 
brisk  purge. 

248.  Castor  Oil,  2  ozs.;  tinct.  prickly  ash  bark,  \  oz. ;  comp.  tinct  of 
Virginia  snake  root,  2  drams ;  infusion  of  boneset  and  senna,  equal  parts,  ^  pint. 
Mix- 

249.  Castor  Oil,  1  oz. ;  salts  of  tartar,  ^  oz. ;  warm  water,  1  pint     Mix. 

250.  Epsom  Salts,  1  oz. ;  senna  leaves,  ^  oz. ;  pulv.  cayenne,  10  grs.; 
boiling  water,  1  pint  Let  the  water  stand  upon  the  senna  and  cayenne  15 
minutes.    Then  pour  it  off,  and  add  the  salts. 

251.  Thoronghwort,  1  oz. ;  senna,  1  oz. ;  lobelia,  \  dram ;  cayenne,  10 
grs. ;  epsom  salts,  1  table-spoonful ;  molasses,  \  pint ;  boiling  water,  1  pint 
Make  a  strong  decoction  of  the  herbs,  and  then  add  the  salt  and  molasses. 

252.  Wine  of  Ipecac,  1  oz. ;  spirits  of  turpentine,  1  oz. ;  castor  oil,  1  oz  ; 
molasses,  J  pint ;  warm  water,  J  pint    Mix. 

253.  Flax  Seed  Tea,  J  pint ;  laudanum,  40  drops.    Mix. 

254.  Nitrate  of  Silver  Crystals,  10  grains ;  corrosive  sublimate,  5  grs. » 
sugar  of  lead,  1^  drams  ;  white  vitriol,  1^  drams;  soft  water,  6  ounces.  Mix. 
An  injection  for  certain  forms  of  whites,  etc. 

255.  Bruised  Galls,  \  oz. ;  two  large  poppy  heads ;  water,  1  pint.  Boil  a 
quarter  of  an  hour,  and  strain.     For  piles. 

98 


H 


!•*■  ' 


Si  r 


778 


PRESCRIPTIONS  —  RECIPES. 


256.  Common  Sab,  1  oz. ;  chamomile  flowers,  ^  oz. ;  pulv.  aloes,  1  dram. 
Boil  the  chamomile  and  aloes  five  minutes,  in  one  pint  of  water,  then  strain,  and 
«dd  the  salt. 

Hair  Oils,  Washes,  etc. 

257.  Cologne,  2  ozs. ;  tincture  of  Spanish  flies,  2  drams  ;  oil  of  rosemary, 
10  drops;  oil  of  lavender,  10  drops.  Mix.  Apply  cautiously.  If  soreness 
of  the  scalp  is  produced,  omit  for  a  short  time. 

258.  Cattor  Oil,  2^  pounds ;  strongest  alcohol,  2^  pints ;  pulv.  SpanJHh 
flies,  ^  oz. ;  oil  of  burgamot,  2^  ozs. ;  otto  of  roses,  20  drops.  Mix.  Let  them 
stand  for  a  few  days,  and  filter.  A  superior  preparation  for  keeping  the  hair 
&om  falling,  and  to  prevent  dandruff. 

259.  Tinet.  Benzoin,  camp.,  2  drams  ;  tinct  Spanish  flies,  2  drams  ;  castor 
oil,  6  ozs.;  oil  burgamot,  1  dram;  oil  of  cassia  or  verbena,  15  drops;  strong 
alcohol,  9\  ozs.    Mix.     As  a  hair  wash,  better  even  than  the  above. 

260.  halted  Lime,  2  drams ;  bicarbonate  of  soda,  3  drams ;  lard,  2  ozs. 
Mix. 

261.  Slaked  Lime,  1  oz. ;  bicarbonate  of  potassa,  2  ozs. ;  charcoal  in  pow- 
der, 1  dram.  Mix.  Apply  to  the  parts,  and  wash  off  when  dry.  Keep  in 
well  stopped  bottles. 

262.  Slaked  Lime,  4  ozs.;  orris  powder,  1^  ozs.  Mix.  Apply  to  the 
parts,  and  wash  off  when  dry. 

263.  Spanith  White,  \  pound ;  litharge,  \  pound ;  slaked  lime,  ^  pound. 
Mix.  Pulverize  in  a  mortar.  To  be  kept  dry.  When  used,  mix  with  water 
to  a  paste  the  thickness  of  cream.  Spread  on  the  hair  and  lay  over  it  a  wet 
cloth  over  night 

264.  Sulphur,  1  oz. ;  sugar  of  lead,  1  oz. ;  rose  water,  4  ozs.  Mix.  Ap- 
ply to  the  hair. 

265.  Nitrate  of  Silver,  1  dram ;  nitric  acid,  1  dram ;  soft  water,  1  pint ; 
sap  green,  3  drams ;  pulverized  gum  arabic,  1  dram.    Mix.    Keep  well  corked. 

266.  Hydrotulphuret  of  Ammonia,  1  oz. ;  liquor  potassa,  3  drams;  soil 
water,  1  oz.  Mix.  Apply  this  with  a  tooth  brush  15  or  20  minutes.  Then 
brush  the  hair  over  with  the  following :  —  nitrate  of  silver,  1  dram ;  soft  water, 
2  ozs. ;  using  a  clean  comb  to  separate  the  hair. 

Miscellaneous. 

267.  Wine  of  Spurred  Rye,  2  ozs.  Dote.  —  One  teaspoonful  three  times 
a  day.     For  profuse  menstruation  from  a  relaxed  state  of  the  womb. 

268.  Sulphate  of  Iron,  1  dram;  sub-carbonate  of  potash,  1  dram.  Mix, 
and  make  into  38  pills.  One  pill  twice  a  day,  and  gradually  increasing  to  four 
a  day,  in  chlorosis. 

269.  Sulphate  of  Iron,  1  dram ;  extract  of  hops  15  grains ;  extract  of 
poppies,  15  grains ;  oil  of  cinnamon,  15  drops.  M'l,  and  make  into  24  pills. 
One  pill  two  or  three  times  a  day. 

270.  Oxide  of  Zinc,  2  drams ;  ext.  of  cicuta,  3  scruples.  Mix.  Make 
48  pills. 


ilv.  aloes,  1  dram, 
er,  then  strain,  and 


oil  of  rosemary, 
usly.     If  soreness 

ts;  pulv.  Spanish 

Mix.     Let  them 

keeping  the  hair 

J,  2  drams  ;  castor 
15  drops;  strong 
above. 

Euns;  lard,  2  ozs. 

;  charcoal  in  pow> 
Q  dry.      Keep  in 

c.     Apply  to  the 

(d  lime,  i  pound. 

I,  mix  with  water 

lay  over  it  a  wet 

ozs.    Mix.    Ap- 

ift  water,  1  pint ; 
if  eep  well  corked. 

a,  3  drams;  sofl 
'  mmutes.  Then 
Iram ;  soft  water, 


inful  three  times 
vomb. 

I  1  dram.     Mix, 
Qcreasing  to  four 

lins;  extract  of 
ike  into  24  pills. 

I.     Mix.     Make 


PRESCRIPTIONS.  —  RECIPES. 


779 


271.  Pulverized  Sainn,  1  scruple ;  sulphate  of  copper,  1  scruple.  To  be 
sprinkled  on  venereal  lumps  or  tumors,  called  condylomata,  on  the  female  geni' 
tais,  or  elsewhere. 

272.  Balsam  of  Copaiva,  1  oz. ,  v,..  of  cubebs,  2  dram.'? ;  laudanum,  1 
dram ;  mucilage  of  gum  arable,  2  ozn. ;  sweet  spirits  of  nitre,  |  oz. ;  com|)ound 
spirits  of  lavender,  3  drams ;  camphor  water,  4  ozs. ;  white  sugar,  2  drams ; 
oil  of  partridge-berry,  5  drops.  Mix.  Take  a  table-spoonful  three  or  four 
times  a  day.     For  gonorrhoea. 

273.  Balsam  of  Copaiva,  1  oz. ;  pulverized  cubebs,  2  ozs. ;  essence  of  pep- 
permint, 30  dropii.     Moke  a  thick  paste,  like  dough. 

274.  Pulverized  Borax,  1  oz. ;  pulverized  white  sugar,  1  oz.  Mix.  A  little 
to  be  dissolved  on  the  tongue. 

275.  Pulverized  Borax,  J  oz. ;  honey,  4  ozs.     Mix. 

276.  Hydrochloric  Acid,  1  dram  ;  honey,  1  oz.  Mix.  For  touching  large 
curdy  patches  in  sore  mouth  of  children. 

277.  Pulverized  Ipecac,  3  grains  ;  precipitated  sulphur,  2  scruples ;  extract 
of  hyoscyamus,  6  grains.  Mix.  Divide  into  12  parts.  One  to  be  taken  every 
three  or  four  hours. 

278.  Pulverized  Belladonnct-root,  5  grains ,  compound  ipecac,  powder,  10 
grains ;  precipitated  sulphur,  ^  dram ;  white  sugar,  2  scruples.  Mix.  Make 
20  powders.     One  every  three  hours  to  a  child  two  years  old. 

279.  Pulverized  Alum,  25  grains;  extract  of  cicuta,  12  grains;  syrup  of 
red  poppies,  2  drams  ;  spearmint  water,  3  ozs.  Mix.  A  dessert-spoonful  every 
six  hours  for  a  child  two  or  three  years  old. 

280.  Camphor,  1  dram ;  sulphuric  ether,  1  oz.  Mix,  Ten  drops  every 
half  hour. 

281.  Pulverized  Rhubarb,  1  scruple ;  mercury  with  chalk,  10  grains ; 
aromatic  powder,  5  grains.  Mix.  Divide  into  10  powders.  One  every  four 
or  five  hours. 

282.  Pulv,  Blood-root,  1^  to  1  oz. ;  chloride  of  zinc,  J  to  2  ozs. ;  wate>^ 
2  ozs.     Add  enough  wheat  flour  to  make  a  paste  as  thick  as  molasses. 

283.  Sal.    Volatile,  ^  dram ;  camphor  water,  1  oz.     Mix. 

284.  Tinct.  of  .  \'ux  Vomica,  j^  oz. ;  tinct.  aconite,  2  drams ;  volatile  tinct. 
ftf  guaiacum,  2  drams.     Mix.  "  Thirty  drops  every  three  hours. 

285.  Tinct.  af  Black  Cohosh,  2  ozs. ;  tinct.  of  digitalis,  2  drams.  Mix. 
( )iie  teaspoonful  from  two  to  five  times  a  day. 

28(5.  Barberry  Bark,  1  oz. ;  pipsissewa  herb,  2  ozs. ;  wild  cherry  bark,  1 
oz. ;  bitter-root,  1  oz.  Mix.  Infuse  for  several  hours  in  4  pints  of  water 
One  tablespoonful  three  or  four  times  a  day. 

287.  fforse  Radish  Root,  1  oz. ;  bayberry  bark,  1  oz.;  barberry  bark, 
1  oz. ;  wild  cherry  bark,  1  oz. ;  prickly  asii  bark,  1  oz.  Reduce  the  whole  to  a 
coarse  p«  wder,  and  infuse  for  several  hours  in  4  pints  of  cider.  A  tableapoon* 
ful  three  or  four  times  a  day. 

288.  Mercury,  95  parts ;  balsam  of  storax,  48  parts  ;  diacalon  plaster,  312 
parts;  w^x,  rosin,  turpentine,  each,  16  parts;  ammonia,  bdellium,  each,  5  parts; 
olibanam  and  myrrh,  each,  5  parts;  saflfron,  3  parts;  spirits  of  lavender,  2  parts. 
Mix,  and  spread. 


X 


780 


PRESCRIPTIONS.  —  RECIPES. 


m 


289.  Populin,  20  grs. ;  sanguinarin,  10  grs. ;  pulv.  white  sugar,  30  grs. 
Rub  well  together,  and  divide  into  16  powders.  Take  one  fou^  times  a  day. 
At  the  same  time  use  prescription  73. 

290.  Ptelein,  24  grs. ;  hydrastin,  24  grs. ;  ext.  of  belladonna,  3  grs. ;  est. 
of  nux  vomica,  2  grs.    Mix.     Make  24  pills.     Take  one  three  times  a  day. 

291.  Strychnia,  2  grs. ;  pulv.  cantharides,  4  grs. ;  pulv.  arnica  leaves, 
1  dram.     Mix.     Divide  into  32  powders.     One  to  be  taken  three  times  a  day. 

292.  Wine  of  Colchicum  Seeds,  1  oz. ;  fluid  ext.  of  dandelion,  1  oz.  Mix, 
One  teaspoonful  three  times  a  day. 

293.  Willow  Bark,  1  oz. ;  "  liling  water,  1  pint.  Boil  for  ten  minutes,  and 
strain.     Zhse.  —  A  wine-glass  full  once  in  three  hours. 

294.  Canada  Baltam,  1  dram ;  slaked  lime,  1  dram.  Mix,  to  form  a 
paste.     An  excellent  remedy  for  tooth  ache,  when  pressed  into  the  cavity. 

295.  Tinct.  Black  Cohosh,  1  oz. ;  iodide  of  potassium,  2  drams ;  syrup  of 
ipecac,  1  oz. ;  spring  water,  2  ozs.  Mix.  A  teaspoonful  three  or  four  times  a 
day,  in  rheumatism  and  cell-dropsy. 


7\nct.  Mack  Cohosh, 
1  dram. 


1   oz. ; 
Mix. 


296. 
dram ;  tinct  cayenne, 
for  dropsy. 

297.     Solution    Chloride  of  Soda, 


tinct.  myrrh,  6   drams ;   laudanum,  1 
Take  30  or  40  drops  four  times  a  day, 

6  drops ;  water,  2  ozs.  Mix.  To  be 
taken  at  a  draught.  A  sure  remedy  for  offensive  breath  from  deranged  stom- 
ach. 

298.  Cream  of  Tartar,  ^  oz. ;  fresh  lemon  peel,  bruised,  4  ozs. ;  Loaf 
sugar,  4  ozs. ;  boiling  water,  3  pints.     Mix,  and,  after  standing  a  while,  strain. 

299.  Citric  Acid,  ^  dram ;  bi-carbonate  of  potassa,  ^  dram ;  lemon  syrup, 

1  oz. ;  soft  water,  6  ozs. ;  epsom  salts,  1  oz.     Mix.     Two  table  spoonfuls,  to  be 
repeated  every  four  hours,  if  necessary. 

300.  Bard  Wood  Ashes,  1  quart ;  common  soot,  ^  gill ;  water,  6  pints. 
Digest,  settle,  and  filter.  Take  one  tablespoonful  three  times  a  day,  in  acidity 
of  stomach. 

301.  Peppermint  Water,  1^  ozs. ;  wine  of  colchicum  oot,  ^  oz. ;  sulphate 
of  morphia,  1  gr. ;  magnesia,  1  scruple.  Dose.  —  One  leaspoonful  three  or 
four  times  a  day.     Excellent  for  rheumatism. 

302.  Cream  of  Tartar,  1^  ozs. ;    sulphate   potassa,  J  oz. ;   pulv.  squills, 

2  drs. ;  tartar  emetic,  2  grs.     A  teaspoonful  of  this  mixture  to  be  taken  four  or 
five  times  a  day,  in  dropsy. 

303.  Pulv,  Alum,  ^  dram ;  white  precipitate,  1  grain.  Rub  these  well  to- 
gether, and  place  the  powder  in  a  bottle ;  then  add  1 J  drams  of  glycerine. 
Shake  the  bottle  until  the  mixture  is  of  the  consistence  of  cream,  and  repeat  the 
shaking  whenever  it  is  about  to  be  applied  to  the  skin.  For  external  use  in 
erysipelas. 

304.  Copaiva,  5  drams ;  yolk  of  one  egg ;  gum  of  extract  of  opiium,  one 
grain ;  water  7  ounces.  Mix.  To  be  used  as  an  injection  several  times  a  day  in 
gonorrhoea. 

305.  Tannin,  3  grains  ;  ext.  belladonna,  |  grain  ;  ext  conium,  2  V  grains  ; 
infusion  of  senna,  3  ozs. ;  fennel  water  and  syrup  of  marshmallow,  each  1  ^  oza. 
Mix.  A  tablespoonful  to  be  taken  every  two  hours,  in  chronic  bronchitis,  and 
other  complaints. 


PRESCRIPTIONS— RECIPES. 


781 


sugar,  30  grs. 
)u^  tioies  a  day. 

na,  3  grs. ;  ext. 
times  a  day. 

arnica  leaves, 
te  times  a  day. 

3n,  1  oz.     MijL 

m  minutes,  and 

lix,  to  form  a 
he  cavity. 

rams ;  syrup  of 
or  four  times  a 

;  laudanum,  1 
jr  times  a  day. 

Mix.    To  be 
leranged  stom- 

4  0Z8. ;   Loaf 
a  while,  strain. 

;  lemon  syrup, 
spoonfuls,  to  be 

water,  6  pints, 
day,  in  acidity 

oz, ;  sulphate 
onful  three  or 

pulv.  squills, 
;  taken  four  or 

these  well  to- 

of  glycerine. 

and  repeat  the 

eternal  use  in 

}f  opipm,  one 
times  a  day  in 

tn,  2  V  grains  ; 
,  each  1  ^  oz». 
ironchitis,  and 


306.  Glycerine,  1  dram ;  tannin,  1  dram.  Di.'isolve  the  tannin  in  the  gly. 
cerine.     E.\cellent  for  sore  nipples,  and  for  chaps  and  excoriations  generally. 

307.  Collodion,  1  oz. ;  Venice  turpentine,  J  oz. ;  castor  oil,  2  drams.  Mix. 
To  bu  applied  outwardly,  ibr  chilblains  and  chaps.  For  cancer,  manganic  acid. 
Not  iis  painful  as  other  caustics. 

.'!08.  Sulphate  of  Copper,  2  grains ;  wine  of  opium,  1  dram ;  soft  water  2 
(lra:ns.  Mix.  Apply  freely  with  a  soft  camel  hair  brush,  three  times  a  day,  for 
l>ui-uicnt  ophthalmia. 

?>()'.).  Pure  Acetic  Acid,  2  drams ;  soft  water  3  ozs. ;  simple  syrup,  3  drams. 
]\Ii.\.  A  teaspoonful  is  to  be  taken  every  three  hours,  in  scarlet  fiever,  at  the 
-nine  time  using  sheet  baths  with  tepid  water. 

3 1 0.  Compound  tincture  of  Peruvian  Hark,  4  ozs. ;  citrate  of  iron  44  grains ; 
cilric  acid,  20  grains.  Dissolve  the  citric  acid  in  the  tincture,  and  then  the 
citrate  of  iron.     After  a  few  days,  filter.     Dose,  one  to  two  teaspoonfuls. 

311.  No.  1.  Gallic  acid,  10  grains  ;  dissolve  in  alcohol,  2  drams;  water,  6 
drams.  No.  2.  Crystals  of  Nitrate  of  Silver,  \  dram ;  water  ^  oz.  Dissolve 
and  add  strong  liquor  of  ammonia,  till  it  becomes  clear ;  then  add  powdered  gum 
arable,  and  dilute,  if  necessary,  to  6  drams.  This  will  color  black ;  to  color 
brotcii,  reduce  it.  An  excellent  hair-dye.  Use  the  common  directions,  where 
there  is  a  No.  1  and  No.  2.  - ,  .    . 

312.  Epsom  Salts,  2  drams  ;  magnesia,  1  scruple ;  syrup  of  ginger,  1  dram ; 
spearmint  water,  1 1  drams.  Mix.  To  be  taken  at  a  draught.  This  will  be 
retained  by  the  stomach,  T/hen  most  other  things  are  rejected. 

313.  Diluted  Nitro-Muriatic  Acid,  2  drams  ;  sweet  spirits  of  nitre,  2  drams ; 
simple  syrup,  J  oz.,  water  7J  ozs.  Mix.  Two  tablespoonfuls  are  to  be  taken 
tiiree  times  a  day.  Excellent  in  dyspepsia,  with  nasty  tongue,  and  inactive 
liver. 

314.  Rose  Leaves,  1  scruple ;  boiling  water,  8  ozs. ;  diluted  nitric  acid,  2^ 
drams.    Mix.     After  standing  half  an  hour,  strain,  and  use  as  a  wash  for  ulcers. 

815.  White  Vitriol,  1  dram  ;  water,  1  pint.  Mix.  To  be  used  as  a  wash  for 
ulcers,  etc 

316.  Citrate  of  Iron  and  Strychnine,  1  dram ;  syrup  of  orange  peel,  2  ozs. ; 
soft  water,  j^  pint.  Mix.  Give  one  teaspoonful  three  times  a  day  in  neuralgia, 
and  in  other  cases  in  which  a  nerve  tonic  is  needed. 

317.  Aloes  and  Soap  Pill,  10  grains.  Divide  into  two  pills ;  or,  compound 
pill  of  aloes,  10  grs.    Divide  into  two  pills. 

318.  Compound  Colocynth  PiU,  2  J  scruples  ;  castile  soap,  9  grs. ;  oil  of  anise^ 
2  drops.    Mix,  and  make  12  pills.     Two  to  be  taken  at  bed-time. 

319.  Compound  tincture  of  Senna,  2  drams ;  epsom  salts  2  drams  ;  diluted 
sulphuric  acid,  8  drops  ;  spirits  of  nitric  ether,  J  dram  ;  infusion  of  rhubarb,  10 
drams.    Mix,    To  be  taken  at  a  draught. 

320.  Sulphate  of  Iron,  2  grs. ;  epsom  salts,  2  scruples  ;  diluted  sulphuric  acid, 
10  drops ;  compound  tincture,  1  dram  ;  syrup  of  poppies,  1  ^  drams ;  pimento 
water,  9  drams.     To  be  taken  at  a  draught  twice  a  day. 

321.  Pulverized  Rhubarb,  12  grains ;  carbonate  of  magnesia,  10  grains ;  aro- 
matic spirit  of  ammonia  ^  dram ;  syrup  of  ginger,  1  dram ;  spearmint  water,  10 
drams.     Mix.     To  be  taken  at  a  draught. 

322.  Comp.  infusion  ^^nna,  5  drams;  infusion  rhubarb,  5  drams:  comp 


■ 


ii' 


782 


PRESCRIPTIONS.— RP-CIPB8. 


P^, 


tincture  cnrdamom,  ^  dram  ;  syrup,  1^  drams.    Mix.   To  be  taken  at  a  draught, 
by  dyspeptic  penwns. 

323.  Carbonate  of  Soda,  10  grs. ;  aromatic  spirit  of  ammonia,  J  dram  ;  tinc- 
ture of  oranfre  peel,  1  dram  ;  syrup  of  orange  peel,  1  dram  ;  compound  infuHioa 
of  gentian,  10  drams.     Mi.\.    To  be  taken  at  a  draught  twice  a  day. 

324.  Trisnitrate  of  Bismuth,  1  dram ;  comp.  tragicanth  powder,  2  drnms  j 
compoimd  tincture  cardamom,  J  ounce ;  tincture  of  ginger,  ^  oimce  ;  8])fiiriniiit 
water,  7  ounces.   Mix.  Two  tablespoonfuls  to  be  taken  tirice  a  day,  in  dyspepsia. 

324.  Trisnitrate  of  Bismuth,  6  grs. ;  bicarbonate  of  soda,  C  grains;  puh  pr- 
ized cayenne,  1  grain.  Mix.  This  quantity  to  be  taken  twice  a  day,  in  dysjicp^ 
sia,  with  acidity  of  the  stomach. 

325.  Solution  of  Acetate  of  Ammonia,  \  ounce  ;  tincture  of  orange  peel,  1 
dram ;  syrup  of  orange  peel,  1  dram  ;  tincture  of  cayenne,  20  drops  ;  comp.  infu- 
sion of  orange  peel,  6  drams.  Mix.  The  whole  to  be  taken  to  relieve  head- 
ache, after  intoxication. 

826.  Magnesia,  15  grains ;  solution  of  potassa;,  15  drops  ;  comp.  tincture  of 
senna,  1  dram ;  comp.  infusion  of  senna,  6  drams ;  syrup  of  ginger,  1  dram ; 
comp.  infusion  of  orange  peel,  ^  ounce.  Mix.  Taken  at  a  draught,  as  an 
aperient,  in  sick  and  billious  headaches. 

327.  Aromatic  Spirit  of  Ammonia,  1  dram  ;  tincture  of  columbo,  1  dram ) 
infusion  of  columbo,  10  drams ;  syrup  of  poppies,  1  dram.  Mix.  To  be  takei> 
at  a  draught,  three  times  a  day. 

328.  Diluted  Sulphuric  Acid,  15  drops  ;  diluted  hydrochloric  acid,  10  drops ; 
tincture  of  orange  peel,  1  dram ;  comp.  infusion  of  gentian,  6  drams ;  syrup  of 
poppies,  1  dram.  To  be  taken  at  a  draught,  three  times  a  day,  half  an  hour 
before  meals. 

829.  Diluted  Nitric  Acid,  12  drcps  ;  diluted  hydrochloric  acid,  8  drops;  in- 
fusion of  cascarilla,  11  drams;  syrup  of  poppies,  1  dram.  Mix.  To  be  taken 
at  a  draught,  twice  a  day. 

330.  Blue  Pill,  4  grs. ;  comp.  pill  of  rhubarb,  4  grs. ;  ext.  hyoscyamus,  2  grs. 
Mix.    Make  two  pills ;  one  pi'l  to  be  taken  at  night. 

831.  Uxt.  Hyoscyamus,  2\  gi-s. ;  pulv.  camphor,  2J  gra.  Mix.  Make  two 
pills ;  one  to  be  taken  when  the  pain  is  most  severe,  in  nervous  headache. 

832.  Comp.  TVagacanth  Powder,  8  grs. ;  oil  of  lemon,  8  drops ;  camphor 
water,  11  drams  ;  comp.  tinct.  cardamom,  ^  dram ;  tinct  hyoscyamus,  ^  dram; 
chloroform,  1 5  drops.     Mix. 

333.  TVnct.  Hyoscyamus,  J  dram ;  aromatic  spirit  of  ammonia,  i  dram  ;  syrup 
of  orange  peel,  ^  dram  ;  peppermint  water,  10  drams.  Mix.  In  nervous  and 
hysterical  cases. 

334.  Soap  Liniment,  2^  ozs. ;  liquor  ammonia,  ^  dr. ;  laudanum,  ^  oz.  Mix. 
Make  a  liniment. 

335.  Comp.  Pitt  of  Oolocynth,  7  grs. ;  ext.  of  colchicum,  2  grs. ;  oil  of  cara- 
way, 1  drop.  Mix,  and  make  two  pills.  Tc  be  taken  at  bed-time  iu  rheumatic 
headaches. 

336.  Chloride  of  Zinc,  6  ozs. ;  pulv.  bloodroot,  2  ozs. ;  myrtle  wax,  1  oz. ; 
water  of  extract  of  opium,  6  drams ;  extract  of  conium,  6  drams.  Mix,  and 
«uike  an  ointment. 


J. ^_ 


en  at  a  draught, 

a,  J  dram  ;  tinc- 
iipound  infusion 
day. 

•wdfr,  2  drnms ; 
nee ;  ppfiinniiit 
ly,  in  dyspepsia. 

grains;  pulvor- 
day,  in  dysp(>[v 

orange  perl,  1 
ip8 ;  comp.  int'u. 
o  relieve  head- 

mp.  tincture  of 
inger,  1  dram; 
draught,  as  an 

imbo,  1  dram  ( 
.     To  be  take» 

acid,  10  drops ; 
•ams ;  syrup  of 
r,  half  an  hour 

id,  8  drops ;  in- 
To  be  taken 

scyamus,  2  grs. 

X.  Make  two 
eadache. 

■ops ;  camphor 
Eunus,  i  dram; 

i  dram ;  syrup 
n  nerrous  and 

im,  ^  oz.  Mix. 

.;  oil  of  cara- 
3  iu  rheumatic 

le  wax,  I  oz. ; 
IS.     Mix,  and 


PRESCRIPTIONS— RECIPES. 


783 


837.  Iodide  of  Lead,  1  scruple ;  glycerine,  1  dram  ;  spermaceti  ointment,  2 
ozA.    Make  an  ointment. 

3.'i8.  Rhubarb  Pulv.,  ^  oz. ;  spearmint  herb,  pulv.  ^  oz. ;  pulv.  casrarilla,  \ 
oz. ;  i)ulv.  bicarbonate  of  potassa,  ^  oz. ;  pulv.  wild  cherry  i)nrk,  J  oz. ;  Mix, 
iinil  pour  on  oms  quart  of  iiot  water.  Let  this  stand  till  cold,  and  add  half  a 
piut  of  brandy.     Dose  half  a  wineglassful. 

339.  Ext.  Belladonna,  6  grains  ;  pulv.  ipecac,  10  grains  ;  confection  of  roses, 
2  grains.     Mix.     Make  30  pills,  one  pill  to  bo  taken  twice  a  day. 

340.  Dioscorein,  T 2  grains ;  pulv.  .mphor,  4  grains ;  pulv.  cayenne,  1 2  grains ; 
wliite  sugar,  1  scruple.  Mix.  Divide  into  four  powders.  Give  one  every  fifteen 
minutes. 

341.  Leptandrin,  12  grains  ;  geranium,  12  grains  ;  myricin,  12  grains.  Mix. 
Divide  into  twelve  powders,  of  which  one  may  be  given  three  or  four  times  a 
day. 

342.  Quinine,  }  dram;  pulv.  catechu,  1  dram  ;  pulv.  opium,  15  grains.  Mix. 
Make  32  pills.     Give  one  pill  three  times  a  day. 

343.  C  .npound  St/rup  of  Rhubarb  and  Potassa,  4  ozs. ;  tincture  of  prickly 
ash  l)erries,  1  oz. ;  essence  of  peppermint,  1  dram ;  paregoric,  4  drams.  Mix. 
A  liiblcspoonful  should  be  given  every  hour  until  it  operates  gently  on  the 

bowels. 

344.  Pulv.  Camphor,  ^  dram ;  pulv.  opium,  16  grains  ;  pulv.  cayenne,  \  dram. 
Mix.    Make  IG  pills ;  one  every  hour,  in  cholera. 

345.  Rhubarb,  4  ozs. ;  black  cohosh  root,  2  ozs. ;  wild  cherry  bark,  2  ozs. ; 
gciaiiliim,  2  ozs.,  coarsely  powder  them,  and  mix.  Add  two  pints  of  brandy 
iukI  two  pints  of  water.  Let  the  mixture  stand  five  or  six  days,  stirring  often, 
and  then  strain.  Add  four  pints  of  water  to  the  dregs,  boil  slowly  to  two  pints, 
strain,  and  add  to  this  the  previous  tincture.  Sweeten  with  loaf  sugar.  Take 
a  tablespoonful  every  one,  two,  or  three  hours. 

346.  Beth  Root,  1  oz. ;  geranium,  1  oz. ;  blackberry  root,  1  oz. ;  wild  chen-y 
bark,  1  oz. ;  cinnamon,  1  oz.  Powder  the  whole,  and  add  to  them  1  ^  pints 
brandy,  and  1  ^  pints  water.  Let  them  stand  several  days,  stirring  frequently. 
Add  sweetening  if  preferred.  Dose.  One  or  two  teaspoonfuls  every  two  or 
three  hours. 

347.  Raspberry  Leaves,  1  oz. ;  geranium,  1  oz. ;  blackberry  root,  1  oz. ;  lep- 
tandra  root,  1  oz.  Mix,  and  make  three  pints  of  strong  decoction.  Dose.  A 
teaepoonful  every  hour.     Suitable  for  a  gargle. 

848.  Sugar  of  Lead,  24  grains  inegar,  1  dram ;  syrop  of  poppies,  1 
oz. ;  rose  water,  3  ozs. ;  soft  water,  •±  ozs.  Mix.  Dose,  one  or  two  table- 
spoonfuls.  ,  -     -         -    ■ 

349.  Potassio-tartrate  of  iron,  J-  oz. ;  syrup  of  orange  peel,  1  oz. ;  water,  4 
oz.    Mix.     Take  two  teaspoonfuls  three  times  a  day. 

350.  Geranium,  golden  seal,  marshmallcw,  wild  indigo  root,  rosemary,  each 
half  an  ounce.  Mix,  and  make  one  pint  of  strong  infusion.  Aft«r  straining, 
add  two  drams  powdered  borax,  and  one  gill  of  honey.  An  excellent  astringent 
gargle. 

351.  Dover's  Powder,  15  grains;  leptandrin,  5  grains.  Mix.  Divide  into 
ten  powders.    One  every  three  hours,  for  a  child. 


\' 


■   i 


N 


■  f..«fciaiEK;^ 


^ 


784 


i'KEBCHlPTlONS.— UECIPES. 


85y  iJover't  Powder,  15  grains  ,  calomel,  fi  grains.  Mir  Divide  into  ten 
powders.     Give  one  every  three  houm  to  a  child  in  croup. 

353.  Hydrochlorati  of  ammonia,  X  oz. ;  diluted  acetic  acid,  ^  oz. ;  alcohol,  \ 
oz. ;  camphorated  mixture,  15  ozs.  Mix.  A  good  scattering  wash  for  hydro* 
cele,  etc. 

354.  Chloride  of  soda,  nitrate  of  {ratash,  and  hydrochlorate  of  ammonia, 
equal  parts,  and  water  enough  to  dissolvs  *bem.  Mix.  An  excellent  freeaing 
mixture. 


k  V 


f    , 


.-> 


Divide  into  ten 

i  oz. ;  alcohol,  } 
wasli  for  hj'dro' 

ato  of  ammonia, 
xcellent  freeaing 


CONCLUSION  OF 

HOMCEOPATHIC    REMEDIES. 

ORGANS  OF  CIRCULATION. 


Tub  heart,  its  appendages  and  valves;  the  pericktdium,  or  membrane 
tht  covers  the  heart ;  the  nerves  that  are  distributed  to  the  organ,  as 
well  as  the  arteries  and  veins,  —  are  embraced  in  the  organs  of  circula- 


tion. 


Inflammation  of  the  Heart. — Endocarditis. 


When  a  sharp  pain  is  sometimes  felt  in  the  region  of  the  iiflh  rib,  with 
quick  pulse,  flushed  face,  and  hurried  respiration,  there  are  indications  of 
Endocarditis.  Aconite  in  the  usual  dose  may  be  given  every  hour  until 
the  frequency  of  the  pulso  is  diminished ;  Veral.  n'ride,  if  Aconite 
fails  to  reduce  the  pulso  in  twenty-four  hours.  If  tho  diuouso  has 
hecn  brought  on  by  ii  shock  or  injury,  Arnica ;  if  from  excosaive 
pricf,  Ignalia;  if  from  cold,  Arsenicum;  if  it  is  tho  sequel  of  in- 
llammatory  rheumatism,  Pulsatilla;  if  tho  diseuso  terminates  in 
dropsy  of  the  pericardium  or  chest,  Ajna  mdUjica.  Lot  tho  diet  be 
simple,  and  easy  of  digestion.  , 

Inflammation  of  the  Perioardium. — Pericarditis. 

Acute  Inflammation  of  the  pericardium  is  denotetl  by  symptoms 
much  the  same  as  those  attendant  on  Endocarditis,  and  mny  be  brought 
on  by  a  cold,  a  sudden  check  of  perspiration,  or  simultaneously  with  a 
sudden  attack  of  inflammatory  rheumatism.  Aconite  repeated  every  hour. 
Puhatilla  or  Bryonia  may  follow  in  the  usual  dose,  and  be  repeated 
every  hour  until  a  change  occurs.  The  pcriciirdium,  being  a  serous 
membnine,  is  liable  to  a  profuse  collection  of  serum  about  tho  heart. 
Apis  melUfica  m  the  usual  dose  every  two  hours  will  bo  likely  to  give 
relief;  Apocynum  and  Helleborua  nig.  are  also  remedies  that  maybe 
employed  in  curing  this  trouble.  If  tho  heart  palpittites  severely, 
give  Pulsatilla  or  JDigitaMs.  Diet  simple  and  nutritious,  and  free 
from  any  exciting  stimulants. 

Chronic  Infiammation  of  the  Pericardium  has  similar  symptoms, 
but  not  80  severe.  It  often  attends  tho  gout,  and  is  treated  with  the 
same  remedies.  Oolchicum  is  a  valuable  remedy,  and  may  bo  given 
three  times  a  day,  in  usual  doses.     Sulphur  is  often  useful. 

Chronic  Pericarditis  may  sometimes  bo  cured  by  Oalcareaor  Lycopo- 
dium.  Aurum  muriaticumoMd  Spigelia  are  called  into  requisition  when 

786 


:  ,;uy.,.^^^«'.»y.is-  r-^-lffjf^  - 


786 


OUQANS  or  CIROULATIUN 


r«v' 


there  is  irregularity  o^  the  heart's  action,  Ar$enioum  when  there  is  a  burn- 
ing sensation  accompanying  the  |>ain.  Diet,  if  the  stomach  will  bear  it, 
may  be  quite  generous. 

Dilatation  of  the  Oavities  of  the  Heart. 

This  trouble  is  manifest  from  a  more  perceptible  action  of  the  heart, 
than  is  normal ;  its  motion  being  more  violent.  Laehetia  when  there  la  a 
(lis|)OAition  to  sigh  ;  Belladonna  if  there  is  a  tendency  of  blood  to  the  head ; 
Digitalis  if  thoro  is  n  quick,  full  pulse  ;  or  Verat.  viride;  Aconite  if 
there  is  fever ;  Pulsatilla  if  there  \»  rheuinutiHta  uf  the  joints  nt  tlio 
same  time. 

Imperfect  Aotion  of  the  Valves  of  the  Heart.. 

A  difficulty  such  as  this  is  not  denoted  by  any  one  set  of  symptoms , 
but  it  may  give  rise  to  various  sufferings,  such  as  fainting,  rush  of  blood 
to  the  head,  apoplexy,  and  convulsions.  Fainting  requires  PtUsattUa, 
OMna,  Bryonia,  and  Bhut.  Rush  of  blood  to  the  head,  Belladonna  ;  apo- 
plexy, Aconite,  Belladonna,  and  cold  application  to  the  head ;  convulsions 
require  Chamomilla,  Belladonna,  Hyo»cyamu,a,  and  Digitalis.  Whichever 
remedy  is  selected  may  be  given  every  half-hour  until  relief  is  obtained, 
or  change.  Spasmodic  pain?  aI)out  the  heart  from  8om«  sudden 
excitement,  Gehemium.  ' 

Aneurism  of  the  Aorta. 

This  is  a  rupture  of  some  of  the  coats  of  the  great  artery,  and  which 
BO  weakens  the  rest  that  they  lose  theirtenacity,  and  bulge  out  so  as 
to  impair  its  function.  It  often  is  very  painful,  and  pulsates  in  a 
frightful  manner.  Aconite,  Bryonia,  Digitalis,  Zinc,  Lachesis,  and 
Ithu&  tox.  iuo  remedies  that  may  be  consulted.  Either  will  relieve, 
under  certaiu  conditions.  The  usual  dose  may  be  repeated  every  two 
hours. 

Inflammation  of  the  Arteries  may  be  relieved  by  the  persistent  use 
of  Aconite,  and  inflammation  of  the  veins  by  Phosphorus,  Ilamame- 
lis,  or  Bhus  tox.  Arteritis  and  Phlebitis  are  both  formidable  diseases, 
and  require  the  attendance  or  care  of  a  physician. 


-:.^4 


■  r  lil  ttt.Ti>iiB»ii..t  T,ir  I  >  .u 


1  there  !•  a  bum- 
oach  will  bear  it, 


rt. 

Ion  of  the  heart, 
1  when  there  is  ■ 
ood  to  the  head ; 
•ide ;  Aconite  if 
ho  joints  lit  tho 


DISEASES  OF  THE  URINARY  ORGANS. 


it  of  aymptoms , 
g,  rush  of  blood 
luires  Pulsatilla, 
ielladonna  ;  apo- 
!ad;  convulsions 
alia.  Whichever 
jiief  is  obtained, 
1  some  suddcD 


rtery,  and  which 
bulgo  out  80  as 
id  pulsates  in  a 
7,  Lachesia,  and 
ler  will  relieve, 
eated  every  two 

16  persistent  use 
orua,  Ilamame- 
idable  diseases, 


The  urinary  apparatus  includes  the  bladder  anc^.  kidneys,  and  their 
appendages,  all  of  which  are  subject  to  inflammation. 

Inflammation  of  the  Bladder.  -  Oystitia. 

"When  urination  becomes  painful  and  difficult,  and  the  orifice  of  the 
bladder  seems  to  be  insufficient  for  voiding  the  urine,  we  have  indi- 
cations of  inflammation  of  the  bladder ;  and  also  when  there  is 
frequent  inclination  to  urinate,  with  ability  to  pass  but  little  at  a 
time.  Aconite  may  be  given  at  first  if  fever  attend  the  difficulty ; 
Belladonna  might  follow  Aconite  if  there  should  be  any  congestion  ; 
Cantharis,  however,  is  one  of  the  best  remedies,  if  there  is  tenes- 
mus or  straining.  Cannabis  saliva,  also,  is  a  good  remedy,  and 
with  old  people  Arsenicum  is  often  beneficial.  It  is  well  to  drink 
mucilaginous  drinks,  and  subsist  mostly  on  gruel,  until  the  severe 
symptoms  subside.  All  this  trouble  may  pass  from  the  acute  to  the 
chronic  form  of  the  disease,  and  be  an  entailed  difficulty.  The  best 
way  to  prevent  it  is  to  have  the  first  acute  stage  well  attended  to. 
The  frequent  desire  to  urinate,  which  we  sometimes  find  in  aged 
persons,  may  be  due  to  chronic  inflammation  of  the  neck  of  the 
bladder.  Sulphur,  given  every  night,  may  mitigate  the  disease 
materially ;  and  so  also  a  decided  benefit  may  be  gained  from  the 
use  of  Uonium  maculatum.  The  same  diet  found  beneficial  for  the 
acute  form  of  this  disease  will  be  found  beneficial  for  the  chronic. 


Strangury. 

This  affection  consists  in  being  unable  to  void  the  urine,  and  is 
believed  to  be  the  result  of  inflammation  of  the  neck  of  the  bladder, 
or  some  mechanical  pressure  upon  the  urethra.  It  often  proves  to 
be  quite  painful,  and  attended  with  fever.  A.conite  may  be  given 
every  hour  when  the  skin  is  hot,  dry,  and  feverish,  or  /Spirits  of 
Camphor  in  drop  doses  every  twenty  minutes  until  relieved.  Hyos- 
cyamus,  if  the  stoppage  appears  to  be  unattended  with  fever; 
Cantharis,  if  there  is  an  ineffectual  urging  to  urinate ;  and  Can- 
nabis, also,  when  there  is  inability  to  evacuate  the  bladder.     Dose 

and  administration,  four  globules  every  hour. 

78T 


788 


DISEASES   OF   THE   UBINARV   ORGANS. 


Stone. 

"When  one  is  voiding  urine,  and  some  obstacle  to  its  passage  suddenly 
interferes,  and  the  stream  is  cut  short,  we  may  infer  that  a  stone  has  inter- 
posed at  the  orifice  of  the  bladder.  The  symptoms  are  like  those  of 
strangury.  Oftentimes  there  is  pain  in  passing  urine,  inclination  to  pass  it 
often,  and  straining  to  keep  tha  stream  flowing.  Against  the  ill  effects  of 
stone  in  the  bladder,  Cantharia  or  Cannabis  are  among  the  prominent 
remedies.  Lycopodium,  Calcarea,  and  Phosphorus  are  also  good  remedies. 
Tlie  two  remedies  first  named  may  be  given  in  drop  doses  every  hour,  and 
tli<>  three  last  only  three  times  a  da}'.  The  patient  should  drink  soft  water, 
niid  live  upon  a  moderate  uou-medicinal  diet,  avoiding  malt  and  distilled 
ii>liiors  as  a  beverage. 

Qraveh  '     _ 

This  is  indicated  by  violent,  cutting,  intermittent  pains  in  the  region  of 
one  or  the  other  hip  and  kidney,  extending  down  the  ureter  to  the  groin 
or  down  the  thigh,  frequent  but  scanty  urine,  fever,  and  nausea.  The  most 
useful  remedies,  in  the  order  of  their  importance,  are  Uva  urei,  Belladonna, 
Cfiamomilla,  and  Ifitrum,  repeated  often. 

Betention  of  Urine. 

This  difficulty  results  from  fever  or  some  local  irritation,  and  consists 
simply  in  disinclination  to  evacuate  the  bladder,  not  from  inability  on  ac- 
count of  inflammation,  or  some  obstmction,  but  because  there  is  an  irre- 
sistible proneness  to  retain  the  urinary  secretion,  either  from  nervous 
weakness  or  spasm  of  the  neck  of  the  bladder.  The  rem  iies  found  most 
aseful  are  Cina,  Spigelia,  Ilyoscyamus,  Belladonna,  and  Mhus  iox.  Either 
of  these  maj'  be  given  and  repeated  until  the  patient  is  relieved.  Hyoacy- 
amus  and  Cina  are  preferable.     With  old  people,  Arsenicum  or  Secale. 

Suppression  of  Urine. 

In  some  fevers  the  kidneys  do  not  perform  their  office,  and  the  urinarj" 
secretion  is  suppressed  and  thrown  back  upon  the  system  ;  and,  as  a  conse- 
quence, the  blood  fails  of  being  defecated,  and  the  result,  in  a  short  time, 
must  prove  quite  disastrous.  A  dose  of  /Sulphur  may  sometimes  overcome 
this  difficulty,  and  set  the  organs  of  secretion  at  work.  Baptisia,  Nitrum, 
Pulsatilla,  JBryonia,  Elms,  CantliaHs,  and  anj'  of  the  remedies  that  act 
spcoifically  upon  the  renal  region,  will  be  likely  to  afford  relief.  The 
reni.'dies  may  be  repeated  every  two  hours,  and  the  diet  should  be  muci- 
lagiuous  drinks. 

Incontinence  of  Urine. 

Some  persons  cannot  help  urinating  at  once  ns  soon  as  the  bladder  fills. 
Their  incontinence  becomes  manifest  when  no  opi)()rtiuiity  offers  for  im- 
mediate resort  to  the  water-closet,  and  in  many  instanci's  becomes  painfully 
mortifying,  and  renders  the  victim  an  object  of  syinpatliy.  Mercurius 
vivus  may  be  given  in  the  usual  dose,  three  times  a  day.  If,  after  a  trial 
of  a  few  days,  the  patient  is  not  imi)roved,  give  Opium,  China,  Calcarea, 
Causticum,  and  Sulphur  in  the  snme  way. 

Wetting  tlie  Bed.  —  Nocturnal  Enuresis. 

Children  addicted  to  this  habit  iVom  some  diseased  condition  may  be  cured 
by  daily  doses  oiSvlphur,  or  Carbo  aninialia,  or  perhaps  Silicea,  or  CavMicuv\ 


f 


passage  suddenly 
I  stone  has  inter* 
(te  like  those  of 
ination  to  pass  it 
t  the  ill  effects  of 
g  the  prominent 
0  good  remedies, 
every  hour,  and 
drink  soft  water, 
aalt  and  distilled 


s  in  the  region  of 
•eter  to  the  groin 
lusea.  The  most 
urei,  Belladonna^ 


ion,  and  consists 
n  inability  on  ac- 
there  is  an  irre- 
er  from  nervous 
iies  found  most 
Jhua  iox.  Either 
ilieved.  Hyoscy- 
im  or  Secale. 


,  and  the  urinar}' 
and,  as  a  eonse- 
;,  in  a  short  time, 
netimes  overcome 
iaptisia,  Mtrum, 
■emedies  that  act 
ford  relief.  The 
should  be  muci- 


the  bladder  fills, 
ity  offers  for  im- 
)ecome3  painfully 
atliy.  Mercurius 
,     If,  after  a  trial 

China,  Calcarea, 


tion  may  be  cured 
cea,  or  Gausticum 


DISEASES  OF  THE  URINARY  ORGANS. 


789 


But  some  children  get  the  habit  and  become  confirmed  in  it  from  no  phys- 
ical cause  whatever  ;  and,  if  no  measures  are  taken  to  reform  them,  they 
will  grow  up  under  the  impression  that  they  cannot  help  it.  Th'i  best 
way  to  treat  such  is  to  impress  upon  them  that  they  can  and  must  banish 
the  habit.  Let  them  be  impressed  even  to  shame  and  a  threat  of  chastise- 
ment if  they  keep  up  the  practice ;  and,  in  most  cases,  this  is  all  that  is 
necessary.  , 

Diabetes.  —  Immoderate  Flow  of  Sweet  Urine. 

There  is  no  disease  that  resists  more  stub'^ornly  the  action  of  remedies 
than  Diabetes.  It  consists  iu  a  copious  se  .Jon  of  sweet  urine,  that  con- 
tains many  grains  of  solid  material  passing  away  from  the  tissues  every 
twenty-four  hours.  This  disease  will  emaciate  a  fleshy  subject  in  six  weeks, 
and  give  him  a  pale  and  sickly  look.  The  disease  has  been  palliated,  but 
never  cured  permanently  that  we  find  any  record  of;  and  yet  PhJ8pt}oric 
acid,  given  three  times  a  day,  has  diminished  the  amount  of  the  secretion 
from  twelve  to  two  quarts  in  twenty-four  hours ;  and  apparently  this 
remedy,  with  Nitrate  of  uranium,  has  effected  temporary  curea.  Muri- 
atic a".id,  SuJphur,  and  Kali  curb,  have  also  been  esteemed  as 
valuable  remedies,  all  of  which  may  be  given  in  the  usual  doses,  three 
times  a  day. 

Bloody  Urine. 

As  gravel  is  believed  to  be  one  of  the  causes  of  this  difficulty,  and  in- 
flammation of  the  bladder  is  believed  to  be  another,  the  same  remedies 
applicable  to  the  one  will  serve  for  the  oth'er.  Arsenicum  may,  however,  be 
added  to  the  remedies,  particularly  if  there  is  any  burning  at  the  neck 
of  the  bladder  and  tenesmus. 

Inflammation  of  the  Kidneys.     ,  /^'      ' 

When  there  is  pain  in  the  back,  and  increased  flow  of  urine,  and  a  desire 
to  urinate  frequently,  and  sometimes  severe  pain  in  the  hip  and  side, 
nausea,  vomiting,  and  fever,  there  is  undoubtedly  inflammation  of  the 
kidneys.  In  the  treatment  of  this  painful  difficulty,  we  find  jLniiai 
the  best  remedy  if  the  inflammation  has  been  pk-oduced  by  a  mechan- 
ical injury.  If  from  a  cold,  lihus  tox.  or  Nux  vomica.  If  there  is 
much  fever,  Aconite;  chilliness  down  the  spine,  Belladonna.  When 
there  is  obstinate  vomiting,  Bismuth.  The  patient  should  lie  in  bed, 
and  not  try  to  exercise  much  till  the  inflammation  passes  oft'.  The 
medicine  should  be  given  every  hour  or  two  hours,  according  to  the 
severity  of  the  inflammation. 


'■M  ' 


DISEASES  OF  THE  ORGANS  OF  QENERAnON. 


Thb  organs  of  generation  in  the  male  are  the  penis,  testes,  and  their 
appendages.  Those  of  the  female  are  the  vulva,  vagina,  womb,  ovaries, 
and  their  appendages. 

Inflammation  of  the  Urethra. 

The  urntlmi  is  the  common  passage  through  which  the  urine  passes  from 
the  bladder,  and  the  semen  fi-om  the  testes.  When  it  becomes  inflamed 
from  cold,  or  as  the  sequel  of  some  acute  disease,  Pulsatilla,  Cannabis, 
Mercuritis  viv. ,  or  Sulphur  may  cure  the  difficulty  by  being  given  every  two 
or  three  hours.  One  remedy  only  must  be  given  ;  if  this  Mis,  try  another; 
but  if  the  disease  is  the  result  of  impure  connection,  and  is  the  Gonorrhoea 
(or  Clap) ,  give  Cantharis,  and  afterwards  Cannabis.  If  there  is  painfcd 
smarting,  give  these  remedies  every  hour  in  alternation  until  the  discharge 
seases.  Give  Ptdsatilla,  also,  every  hour,  if  the  other  remedies  fail,  and  use 
a  solution  of  Hamamdia  in  water  as  an  injection 


Syphilis. 

Nearly  allied  to  Gonorrhoea  is  Syphilis ;  only  the  Utter  is  a  more  formi- 
dable result  of  impure  connection,  whii.h  inoculates  t'jie  blood.  It  becomes 
manifest  in  dischai^e  from  the  urethra,  obancres,  buboes,  etc.  When  there 
is  a  purulent  discharge  ftam  the  urethra,  Mercurius  viv.  may  be  given  per- 
sistently for  several  days,  and  this  may  arrest  the  further  progress  of  the 
disease ;  but  should  it  not,  and  chancres  make  their  appearance  on  the 
prepuce  or  foreskin,  or  on  the  glans,  burn  them  with  Nitric  acid,  full 
strength  of  the  stores,  and  then  give  Mercurius  corrosivus  every  six  hours 
for  several  days ;  dressing  the  ?oros  with  lint  wet  with  cold  water  and 
Calendula.  If  the  chanoi:  j  b<jal,  ,t  is  well  and  good  •  if  they  do  not,  give 
Mercurius  iodatus  three  timts  9  driy.  Let  the  patient  avoid  drinking  any 
intoxicating  beverage  whatever,  and  abstain  fh)m  all  medicinal  articles  of 
diet. 

InflamBMUon  of  the  Testicles, 

Sometimes  a  suppression  of  Gonorrhoea  will  cause  inflammation  and 
swelling  of  the  testicles.     Both  may  be  implicated,  and  become  exceedingly 
painful  and  enormously  swollen.     For  the  first  stage  before  the  swelling, 
790 


noir. 


istes,  and  their 
womb,  ovaries, 


ine  passes  from 
comes  inflamed 
Ula,  Cannabis, 
jiven  every  two 
Is,  try  another; 
the  Gonorrhcea 
::here  is  painfol 
I  the  discharge 
ies  fail,  and  use 


3  a  more  formic 
d.  It  becomes 
5.  When  there 
y  be  given  per- 
progress  of  the 
earance  on  the 
iTrtrtc  acid,  full 
every  six  hours 
;old  water  and 
ley  do  not,  give 
(i  drinking  any 
sinal  articles  of 


lammation  and 
me  exceedingly 
•e  the  swelling, 


Aconite  may  be  given  eT3ry  two  hoars  to  reduce  the  general  febrile  condi- 
tion of  the  system.  Afterwards  Arnica  may  be  given  to  remove  the  sore- 
ness, and  Pulaatilla  to  remove  the  swelling.  Either  of  these  remedies 
may  be  given  every  day,  three  times,  until  the  object  for  which  they  are 
given  is  accomplished.  Let  the  patient  lie  in  bed,  and  apply  warm  com- 
presses to  th€  part.  Let  him  subsist  upon  a  spare  diet,  and  drink  no 
exciting  drinks.  Let  him  wait  with  patience  for  a  subsidence  of  the 
swelling  and  inflammation. 

* '   ' '  . " " '  - 

.    Dropsy  of  the  ^Gtotam,— Hydrocele. 

Sometimes  inflammation  of  the  testes  will  result  in  Hydrocele,  and  th« 
scrotum  will  become  filled  with  water.  Helleboru*  nig.,  Apia  mel.,  and 
Arsenicum  are  remedies  that  have  been  employed  to  cure  the  difficulty ; 
but  sometimes  remedies  prove  unavailing,  and  the  water  has  to  be  drawn 
off  by  a  trochar,  in  which  event  consult  an  experienced  surgeon.  But 
try  the  remedies  first,  and  give  each  named  in  succession  (provided  the 
first  or  second  does  not  prove  effectual),  every  three  hours  during  the  day. 

■/  Inflammation  of  the  Vulva. 

This  may  occur  from  acrid  Leucorrhoea,  or  cold,  or  from  Gonor- 
rhoea ;  and,  from  whatever  cause,  it  requires  the  application  of  warm 
water  and  compresses,  and  a  dose  of  Aconite  or  Belladonna  every 
hour  until  relieved. 


Inflammation  of  the  Vagina. 

The  vagina  is  lined  by  a  mucous  membrane,  which  sometimes  becomes 
inflamed ;  and  when  from  a  cold,  producing  an  ordinary  catarrh,  give 
Nux  vomica  or  Sulphur,  night  and  morning,  until  better.  If  from 
chronic  irritation  of  the  membrane  there  is  a  Leuchorrhoeal  discharge 
from  the  vagina,  give  S^na  night  and  morning.  If  this  fails,  give  Galea- 
rea  carb. ;  and,  if  this  fails,  give  Sulphur  in  the  same  way.  Leucorrhoea 
may  be  occasioned  by  falling  of  the  womb,  which  irritates  the  mucous 
membrane  of  the  vagina,  in  which  event  S^ia  or  Niix  may  be  given 
every  night,  with  full  prospect  of  a  cure. 


Inflammation  of  the  Wombi       ^ 

This  painful  malady  is  often  the  result  of  protracted  labor,  and  is 
known  by  great  thirst,  pain  over  the  region  of  the  womb,  and  great  ten- 
derness of  the  touch.  Arsenicum,  given  every  three  hours  at  first,  and 
followed  by  Belladonna,  generally  proves  successful ;  but  Bryonia  and 
Rhus  tax.  or  Verat.  virtae  may  be  resorted  to,  and  repeated  every 
three  hours,  if  found  necessary.  Inflammation  of  the  womb  is  a 
painful  difficulty  and  a  dangerous  one,  and  should  be  treated  with 
great  care.  Warm  bran  poultices,  if  the  patient  can  bear  them,  may 
be  applied  while  giving  the  remedies. 


.■.fc/'''-.<3i*<j?*fc';. 


792 


DISEASES  OF  THE  UROANS  S)i   GEMERAnON. 


Falling  of  the  Womb.      ;     '    ., 

The  womh  is  said  to  rail,  when  from  debility,  or  a  relaxed  condition  ot 
its  ligaments,  it  sinks  down  into  the  vagina ;  and  this  is  indicated  by  pain 
in  the  back,  and  a  dragging  sensation  over  the  hips,  and  bearing-down 
pains.  These  are  often  attended  with  headaches  and  other  derangements, 
which  must  be  conndered.  Nux  vomica,  every  night,  is  one  of  the  most 
valuable  remedies  for  prolapsus  uteri.  Sulphur  sometimes  does  well.  Sepia 
every  morning  has  often  cured  and  relieved  the  headache,  nausea,  and 
other  concomitant  symptoms.  Calcarea  haj  relieved  when  the  pain  is 
most  prominent  about  the  hips ;  Ignatia,  when  the  difficulty  has  been 
brought  on  by  grief.  Patients  of  this  description  should  not  drink  coffee 
or  strong  green  tea.  Blaok  tea,  cocoa,  and  m-lk  may  be  allowed,  with  a 
moderately  generous  diet. 

TnflaTnmation  of  the  OvarifiB 

This  difficulty  is  denoted  by  sharp  pains,  either  in  the  right  or  left  side, 
or  both,  just  front  of  tiie  upper  edge  of  the  hip-bone.  It  sometimes  is  very 
painful,  and  requires  rest  and  the  best  treatment  and  nursing  to  subdue  it, 
Conium,  in  daily  doses,  has  relieved  some ;  ao  has  PtihatiUa^  Belladonna, 
and  Ignatia.  Some  remedies  relieve  for  a  time,  such  as  Bryonia  and  Bha» 
tox.  Belladonna  will  cure  when  the  inflammation  is  attended  with  iiead- 
ache  and  considerable  neura'gic  pain  in  the  region  of  the  glands  ;  if 
much  fever  attends  the  affection,  give  Aconite  three  or  four  times  a  day. 
Now,  as  all  these  affections  disturb  the  nervous  system,  and  give  rise  to 
various  forms  of  nervous  complaints,  such  remedies  as  Pulsatilla,  Igna- 
tia, Hyoscyamus,  Nux  vomica,  Moschus,  and  Caulophyllin  will  be  con- 
stantly needed,  and  stimulants  need  to  be  taken  with  great  caution. 
Cold  compresses  in  acute  attacks. 


Ulceration  of  the  Wombi 

Any  thing  that  irritates  the  mouth  of  the  womb  may  occasion,  first,  iii- 
flammation  of  the  os  tincse,  and  then  ulceration.  Frequent  miscarriages 
will  so  weaken  the  organ,  and  especially  its  ligaments,  as  to  admit  of  its 
being  easily  misplaced,  or  turned  backwards  or  forwards.  These  mispiace- 
nents  are  oft;en  the  cause  of  ulcerations,  and  almost  always  the  source  of 
weakening  Leucorrhoea.  The  medical  treatment  of  this  diraculty  is  of 
the  first  importance.  Sulphur  every  night  may  commehce  the  treatment. 
If,  aflter  using  the  Sulphur  for  a  week,  the  purulent  discharge  becomes  less, 
and  there  is  less  pain  and  soreness  in  the  region,  and  still  considerable  pain 
remaiitidg  ill  the  back,  give  Nux  vomica  every  night  for  a  week.  If  these 
two  remedies  fail  of  bringing  about  a  cure,  then  drop  twenty  drops  of  the 
tincture  of  Calendula  (Marygold  flowers)  in  half  a  tumbler  of  water,  and 
inject  it  into  the  vagina  every  day,  and  at  the  same  time  take  a  dose  of 
S^ia  every  morning.  Continue  this  treatment  as  long  as  useful.  Calca- 
rea, taken  every  night,  sometimes  has  a  good  efiect.  Local  applications 
tc  the  ulcers  are  sometimea  made,  bot  this  is  the  business  of  the  anrfceon. 


DUKASIS  OF  THE  OBOANS  OP  OKNERATION. 


793 


d  condition  ot 
icated  by  pain 
bearing-down 
derangements, 
of  the  most 
well.  Sepia 
nausea,  and 
the  pain  is 
ilty  lias  been 
)t  drink  coffee 
lowed,  with  a 


lit  or  lell  side, 
letimes  is  very 
g  to  subdue  it, 
(,  Belladonna, 
mia  and  Rha» 
ed  with  head- 
e  glands  ;  if 
times  a  day. 
1  give  rise  to 
Isatilla,  Igna- 
'•  will  be  con- 


■rce&t  caution. 


ision,  first,  in- 
:  miscarriaffes 

• 

3  admit  of  its 
hese  mispiace- 
the  source  ol' 
irnculty  is  of 
he  treatment, 
becomes  less, 
siderable  pain 
eek.  If  these 
Y  drops  of  the 
of  water,  and 
ke  a  dose  of 
iseful.  Calc(b- 
[  applicationa 
tbe  suriiceon. 


J 


LeuoonrlioBa.  —  Whites. 

When  the  mucous  membrane  lining  the  womb  and  vagina  becomes  irri- 
tated or  inflamed,  it  undergoes  solution,  and  there  is  a  white  discharge. 
Tins  is  of  frequent  occurrence,  and  in  some  instances  is  sucli  a  drain  upon 
the  system  as  to  weaken  the  function  and  tone  of  the  nutritive  organs. 
Any  treatment  that  will  strengthen  the  whole  system  will  generally  cure 
the  derangement.  China,  Ferrum,  and  Aurum  are  remedies  that  may  be 
employed,  either  of  which,  in  daily  doses,  will  prove  sufficient.  In  the 
mean  time,  let  the  patient  refrain  from  over-exertion.  A  more  aggra- 
vated form  of  Leucorrhoea  attends  falling  of  the  womb,  and  this  perhaps  is 
the  cause  of  the  difficulty.  The  remedies  which  will  best  meet  this  diffi- 
culty are  Sepia  and  Calcarea  curb.  ;  the  former  may  be  given  every  morn- 
ing, and  the  latter  every  evening  ;  or  perhaps  Nu-x  vomica  may  be  ;^iven 
in  the  evening,  and  Calcarea  in  the  morning.  If  there  is  sick  headache 
attending  this  form  of  Leucorrhoea,  Sepia  is  still  the  remedy.  If  other 
biliary  derangements,  Nux  vomica  is  equally  applicable.  Ladies  afflicted 
with  any  of  these  uterine  difficulties  must  not  drink  strong  tea  or  c<JfFee  ; 
but  mild  black  tea,  cocoa,  and  milk  should  be  the  chief  beverages,  and,  if 
the  appetite  permit,  a  moderately  gfuierous,  but  non-medicinal  diet  may  b« 


•  «>■ 


loa. 


.  -  ^ 


•»  ».' 


f-1 


.  -i*»-^'.ctKiw,jai;  ,1.  -.g  .. 


j 

1 

1 

DISEASES  OF  THE  SKIN. 


Boila. — JFktruncuU, 


Thus  are  amall,  circumscribed,  and  painftil  tumora,  which  begin  in  the 
form  of  a  pimple,  and  then  grow  until  they  acquire  the  size  of  acorns. 
Thej  are  several  dajs  in  coming  to  maturity ;  and  sometimes  their  pain- 
fulness  excites  fever  and  chilliness,  loss  of  appetite,  and  other  derange- 
ments. When  suppurating,  the  pain  in  them  is  intense  and  pulsating  just 
before  the  crisis.  As  soon  as  they  break,  the  pain  diminishes,  and  very 
soon  the  injury  is  repaired.  Aconite  may  be  given  two  or  three  times  a 
day  to  subdue  any  fever  that  may  be  present.  Belladonna  also  will  re- 
move the  pain  of  congestion  ;  and  this  may  be  given  several  times  during 
the  day.  Amiea  tincture  may  be  applied  externally  to  remove  the  sore- 
ness, and  with  great  advantage  it  may  be  taken  internally ;  and  in  the 
same  way  Hamamelis  Virginica  may  be  employed.  Wet  a  compress,  and 
apply  directly  over  the  boils,  and  renew  several  times  a  day,  and  the  pair. 
will  be  very  ^^eatly  diminished.  Poultices,  in  case  of  very  large  boils, 
may  prove  of  service,  — bread  and  milk,  or  flaxseed ;  and,  when  employed, 
give  at  the  same  time  Hepar  sttlph.,  four  globules,  and  repeat  twice 
a  day.     Arsenicum  often  prevents  their  recurrence. 

OaxhTmole,  —  Anthrax, 

The  difference  between  a  boil  and  a  carbuncle  is  this :  a  boil  is  circum- 
scribed, but  a  carbuncle  travels,  or  moves  along  the  subcutaneous  tissue  ; 
and,  when  it  breaks,  it  seems  to  have  several  openings  instead  of  one  as  in 
the  case  of  the  boil.  Anthrax  is  a  troublesome  disorder :  sometimes  it  is 
attended  with  active  inflammatory  fever,  and  sometimes  with  low  fever. 
It  is  far  more  common  among  old  than  young  people,  and  sometimes 
very  diiflcult  of  cure.  A  carbuncle  upon  the  back  of  the  neck,  accom- 
panied by  fever,  requires  Aconite  during  the  time  of  its  development,  and 
afterwards  Hepar  sulphur.  The  effect  of  this  latter  remedy  is  to  hasten 
suppuration.  Phosphorus  is  also  employed  to  promote  the  same  end. 
Bread  and  milk  poultices  may  be  employed  ;  and  a  dressing  of  adhesive 
plaster,  with  apertures  for  the  pus  to  discharge,  mav  be  applied  after  the 
poultice.  The  sore  should  be  dressed  every  day  ;  and,  if  very  painful,  com- 
presses wet  with  HamamtUs  may  be  resorted  to.     To  remove  great  sore- 

794 


DISEASES  OF  THE  SKIN. 


795 


lich  b^n  in  the 
size  of  acorns, 
times  their  pain> 
other  derange- 
»d  pulsating  just 
lishes,  and  very 
•r  three  times  a 
na  also  will  re- 
ral  times  during 
?move  the  sore- 
lly ;  and  in  tlie 
a  compress,  and 
ly,  and  the  pain 
rery  large  boils, 
when  employed, 
d  repeat  twice 


boil  is  circum- 
aneous  tissue ; 
jadof  one  as  in 
sometimes  it  is 
I'ith  low  fever. 
»nd  sometimes 
!  neck,  accom- 
relopment,  and 
Iv  is  to  hasten 
he  same  end. 
>g  of  adhesive 
iplled  after  the 
r  painful,  com- 
•ve  great  sore- 


ness, Arnica  may  be  used  in  the  same  way.  Sometimes  in  aged  people  a 
carbuncle  becomes  gangrenous  ;  and  then  Ar$enieum  should  te  employed, 
a  dose  every  three  hours.  When  the  disease,  or  carbuncle,  comes  on  the 
back,  either  to  the  right  or  left  of  the  spine,  it  is  liable  to  make  its  way 
downwards ;  find,  in  order  to  prevent  its  doing  so  to  any  extent,  compresses 
bound  tightly  beneath  may  keep  tliem  where  they  begin.  In  all  cattes 
when  there  is  active  fever  accompanying  carbuncle,  Aconite  may  be 
necessary ;  for,  so  long  as  there  is  great  arterial  excitement,  it  will  tend  to- 
wards the  carbuncle  and  greatly  augment  its  severity.  If  low  fever,  or  a 
lassitude  and  stupor,  attends  the  discrasia,  give  Bryonia,  and  repeat  every 
three  hours  ;  or  perhaps  Jthus  tax. ;  Arsenicum^  it  the  pus  is  of  an  oifen- 
live  smell.  Carbuncles  are  supposed  to  originate  from  low  conditions  of 
the  circulation,  and  therefore  a  generous  diet  is  suggested.  Avoid 
medicinal  food  and  condiments,  except  salt.  Animal  food  is  most  com- 
mended for  a  diet. 

Absoessesi 

Abscesses  generally  form  in  the  subcutaneous  tissue,  but  manifest  them- 
selves  through  the  skin.  Generally  there  is  some  protuberance  or  swelling 
upon  th«  surface ;  sometimes  there  is  none.  Frequently  there  will  be 
some  redness,  to  indicate  that  an  inflammatory  process  is  going  on  ;  and, 
at  other  times,  there  will  be  no  indication  of  the  kind.  An  abscess,  then, 
is  simply  a  circumscribed  collection  of  pus,  formed  from  broken-down  tissues 
or  blood  corpuscles.  They  are  subject  to  medical  treatment.  Oalcarea^ 
for  abscesses  in  scrofulous  persons,  may  be  given  every  day,  and  espe- 
cially in  cases  of  scrofulous  children.  Abscesses  upon  the  arms  or  hands 
may  be  cured  by  the  use  of  Pulaatilla  or  Nux.  Abscesses  on  the  face 
require  Bryonia  and  Calcarea  ;  abscesses  from  the  bone  require  Silicea. 
Abscesses  should  be  relieved  of  their  pus  by  the  lancet  as  soon  as  suffi- 
ciently ripe.  They  may  be  washed  with  Calendula  tin^^ture.  Persons 
prone  to  suffer  from  abscesses  should  subsist  upon  a  spare  diet,  and  should 
avoid  rich  gravies  or  great  quantities  of  butter.  Bread,  potatoes,  beans 
and  peas,  beef  and  mutton,  may  constitute  about  the  range  of  diet ;  and 
coffee,  ale,  cider,  and  distilled  spirits  must  not  be  touched. 


'  Coma. 

The  feet  appear  to  be  the  only  locality  affected  by  corns ;  and  they 
occur  frequently  upon  the  toes.  A  corn  is  simply  hardened  cuticle  or 
skin,  rendered  so  by  some  pressure  or  irritation  upon  the  surface,  such  as 
a  tight  boot  or  shoe.  Those  who  subject  the  feet  to  such  treatment  must 
suffer  the  consequences.  The  best  treatment  for  a  sore  corn  is  to  shave 
off  the  hard  skin,  and  apply  the  tincture  of  Arnica,  or  perhaps  the 
tmcturo  of  Cauatiatm.  It  is  said,  however,  that  Graphites,  Silicea, 
Sulphur,  and  Aniimonium  ci'ud.  are  remedies  that  may  be  tflken 
internally  to  cure  corns.  Either  of  the  remedies  may  be  taken  in 
daily  doses.  A  corn-salve  is  sometimes  applied,  made  of  pine  pitch 
or  diachylon.  Any  plaster  that  will  protect  the  tender  and  irritated 
spot  from  the  pressure  of  the  boot  will  be  found  useful. 


pi'; 


^l-l 


79G 


■     DISEASES  OF  THE  SKIM. 


Uloers. 

Ulcers  are  included  among  skin-aifections,  because  they  break  the 
continuity  of  the  skin,  and  manifest  tliemselves  upon  the  surface.  An 
ulcer  is  formed  generally  by  the  disorganizing  influence  of  inHammation, 
which  affects  the  membranes  and  skin.  Ulceration  of  the  soft  parts,  and 
ulceration  of  the  stomach  and  intestines,  are  of  frequent  occurrence ; 
and  an  ulcer  is  slow  to  heal,  and  constantly  discharges  pus.  Ulcers  of 
the  legs,  toes,  feet,  hands,  and  arms,  are  met  with  extensively.  Uicera 
of  the  lower  extremities,  or  legs  and  feet,  can  be  cured  by  a  daily 
dose  of  Silicea  or  of  Sulphur.  Ulcers  of  the  upper  extremities,  or  tlie 
arms  and  hands,  can  be  cured  by  daily  doses  of  Calcarea  and  Qraphiltis. 
Ulcers  of  the  soft  parts  require  Phosphorus  or  China.  Ulceration  of  tlw 
stomach  requires  Conium  or  Phosphorus.  Ulceration  of  tiie  bowels 
requires  Arsenicum.  Each  of  these  remedies  may  be  given  in  daily  doses, 
and  continued  as  long  as  observation  teaches  their  utility.  Ulcerations 
are  supposed  to  result  from  low  states  of  the  blood  ;  and,  therefore, 
stimulants  must  be  employed  to  tone  up  the  system.  A  generous  diet  is 
generally  to  be  commended.  There  is  no  use  in  trying  to  heal  over  the 
surface  of  an  ulcer ;  for,  in  so  doing,  it  may  work  out  deeper  mischief  in 
the  economy.  The  only  safe  way  is  to  build  up  the  most  healthy  state 
of  the  system,  and  let  the  ulcer  discharge  itself,  and  heal  from  the  bottom. 
Persona  subject  to  ulcers  are  evidently  scrofulous,  or  the  victims  of 
some  other  taint.  If  scrofulous,  Arsenicum,  Silicea,  or  Calcarea 
may  benefit  the  condition.  Ulcers  arise  also  from  hereditary  syph- 
ilitic taint.  Mercurius  viv.,  Mercurius  iodatus,  and  Mercurius 
corr.  are  competent  to  eradicate  this  taint  from  the  constitution  ;  so 
is  Hepar  sulph.  or  Nitric  acid.  If  the  ulcers  arise  from  this  taint, 
alcoholic  stimulants  must  be  avoided,  and  the  most  generous  meat 
diet  must  take  their  place.  Whatever  be  the  predisposing  cause  of 
ulceration  known  in  a  family,  it  should  be  carefully  watched. 


OhilblainB.  :' 

Frosted  feet,  as  this  complaint  is  termed,  occurs  mostly  in  cold  weather, 
aJJd-most  frequently  in  persons  susceptible  from  some  constitutional  tairit. 
It  has  been  observed  that  chilblains  will  assume  the  character  of  panilul 
sores  in  those  known  to  be  of  a  scrofulous  habit.  The  feet  benig  very 
susceptible  to  cold,  become  chilled,  and  afterwards  the  heels,  and  some- 
times the  toes,  become  painfully  tender.  Croton  tig.  or  Arsenicum, 
in  the  usual  dose,  may  be  administered  twice  a  day,  when  there  is 
burning  heat  and  swelling ;  JVux  vomica,  in  the  same  way,  when 
attended  with  rheumalio  pains.  Pulsatilla  is  a  better  remedy  fur 
females  of  delicate  constitution,  and  subject  to  colds.  When  the 
chilblains  assume  a  bluish  appearance,  Phosphorus  and  Sulphur 
may  be  given ;  either  of  which,  in  the  usual  dose,  may  be  given 
twice  a  day.     Externally,  the  tiacture  of  Arnica  may  be  applied 


i^ 


It 


hey  break  the 
surface.     An 
I'nHainmation, 
soft  parts,  aiij 
occurreiico  ; 
'lis.      Ulcors  of 
sively.     Ulcers 
■d    by  a  duilyr 
emities,  or  tlie 
mil  Q-raphiUH. 
Iceratioii  of  tlw 
of  the   bowelH 
I  in  daily  doses, 
Ulcerations 
and,  therefore, 
enerous  diet  is 
heal   over  tiie 
)er  mischief  in 
t  liealtiiy  state 
>m  the  bottom, 
the  victims  of 
or  Calcarea 
•editary  syph- 
id  Mercurius 
ti8titution ;  so 
om  this  tuint, 
generous  meat 
mng  cause  of 
iehed. 


cold  weatlier, 
tutional  taint, 
ter  of  paiiil'iii 
'et  being  very 
jIs,  and  sonie- 
r  Arsenicum, 
k^hen  there  is 
0  way,  Avhen 

remedy  for 

When  the 

nd    Sulphur 

lay  be  given 

'  be  applied 


lo  rcniove  soreness.  Tincture  of  Cantharta,  if  there  is  an  incli- 
nation to  blister;  lihus  tax.,  if  they  are  red  and  inflamed.  A 
solution  of  glue,  in  wai*m  water,  has  been  found  a  good  palliativo 
as  a  foot-bath. 

'■■    '  Whitlow. 

This  is  an  inflammation  and  suppuration  around  the  nails  of  the  lingers ; 
sonietimes  slight,  and  at  other  times  exceedingly  painful,  ffepar  sulphur, 
taken  internally,  will  hasten  to  a  crisis  ;  Uraphitea  or  Mercuriua  is 
sometimes  used  for  the  same  purpose ;  8ilicea  will  hasten  sup- 
puration and  a  cure.  Rhua  or  Lacheaia,  if  the  system  is  in  a  low 
condition.  Either  remedy  may  be  administered  twice  in  twenty- 
four  hours. 


Itch.  —  Scabies. 

Thi3  cutaneous  eruption  consists  of  small  pimples,  or  pustules,  which 
make  their  appearance  in  clusters  upon  the  skin,  and  itch  and  burn  con- 
tinually. They  are  believed  to  result  vrom  the  acarus,  or  itch-mite,  era- 
beddea  in  the  cuticle.  These  pimples  usually  break  out  between  the 
fingers,  on  the  hands  and  wrists,  and  over  the  body.  Sulphur  has  ever 
boon  found  a  salutary  remedy,  taken  internally,  and  applied  as  an 
ointment  daily.  In  many  cases,  Calcarea,  Ileparsulph.,  Mercuriua, 
and  Rhus  have  been  found  useful.  For  what  is  termed  the  Prairie 
Itch,  which  is  very  stubborn,  Mercuriua  viv.,  taken  internally,  and 
an  ointment  of  the  red  oxide  of  mercury,  used  with  cure,  externally, 
has  proved  eflFectual.  Sulphur  ointment  has  been  in  general  use, 
and  is  of  great  service  if  used  sparingly  and  with  caution. 


Itohing  of  the  Skin.— 'PrMngro.    - 

Sometimes  there  will  be  intense  itching  of  the  skin,  without  any  appar- 
ent eruption.  Scratching  or  rubbing  does  not  relieve  ;  every  attempt  to 
lelieve  in  this  way  aggravates  the  difficulty.  There  is  no  disease  of  the 
skin  apparently  more  superficial,  nor  yet  more  annoying.  As  there  is 
1.0  prominent  symptom  but  itching,  we  would  naturally  suppose  tliat  some 
single  remedy  would  antidote  it.  But  not  so.  In  bilious  temperaments, 
Mercuriua  is  the  best  remedy.  In  sanguine  temperaments,  Nux  vomica, 
w  perhaps  Sulphur,  In  the  nervous,  Pulsatilla,  Ignatia,  Sepia,  Calca- 
rea, and  Conium.  The  remedy  selected  to  meet  the  case  may  be  given 
twice  a  day  until  relieved,  unless  there  is  found  a  necessity  for  change. 


Bingworm, — Herpes  Circinnatus.  ..  -, 

This  troublesome  disorder  usually  manifests  itself  upon  the  face,  and 
is  at  first  a  small  circular  eruption  that  enlarges  in  the  form  of  a  ring. 
The  cause  is  believed  to  be  a  minute  itch-mite,  which  lives  in  the  skin, 


798 


DUEASKS  07  THE  SKIM. 


and  commits  its  circuitons  mischief.  Sometimes  only  one  ring  appears ; 
at  other  times  there  are  several,  each  enlarging  its  area  •intil  tliu  face 
becomes  nearly  covered.  A  frequent  cause  of  their  appearing  is  by  being 
shaved  with  a  razor  that  communicates  the  infection.  A  strong  tincture 
of  Hyoacyamut^  applied  to  the  surface,  will  generally  extinguish  thoin ; 
but  there  must  be  some  constitutional  predisposition  that  favors  them  ;  ant' 
thertifore  internal  remedies  must  be  employed.  In  case  of  sypliilitic 
taint,  daily  doses  of  Mercuriut  viv.  will  be  required.  In  those  of  Htr.i- 
mous  constitutions,  Calcarea^  Arsenicum^  and  Sepia.  In  those  constitu- 
tionally inclined  to  erysipelas,  Bhu»  tox.,  Dulcamara,  Hepar  mlphur,  and 
Bryonia  will  be  found  of  use.  Two  or  three  doses  of  the  remc(fy  selected 
may  bs  administered  every  day  ;  and,  at  the  same  time,  the  Hyoscyamm 
linuture  may  ho  applied  oxtern».lly.  This  treatment  has  been  found 
cfficucious  in  most  cases.  A  Uilute  tincture  of  Ganlharia,  applied 
locally,  is  a  specific. 

Hives. 

Small  red  blotches  upon  the  skin,  that  burn,  itch,  and  sting,  are  usually 
called  hives.  They  are  believed  to  result  from  some  derangement  of 
nutrition,  caused  by  certain  articles  of  diet.  But  little  danger  attends  the 
difficulty,  unless,  by  exposure  to  cold,  ♦he  eruption  is  made  to  recede,  and 
It  falls  upon  the  bowels :  this  sometimes,  in  children,  results  in  diarrh(£a. 
Pulsatilla  may  be  given  in  the  usual  dose,  three  or  four  times  a  day.  In 
young  children,  who  may  be  teething,  Chamomilla  will  be  found  useful. 
If  there  is  any  nausea,  give  Bryonia  or  Ipecac,  and  tho  derangement 
will  be  corrected  very  soon.     Oroton  tig.  is  a  fine  general  specific. 


Varioose  Veins. 


congested 


The  external  veins  upon  the  lower  limbs  sometimes  become 
and  enlarged,  and  are  termed  *' varicose."  Inflammation  sometimes 
attends  this  difficulty,  and  terminates  in  varicose  ulcers.  The  best  remedy 
known  for  simple  varicose  veins  is  Hamamelii  Virg.  Pulsatilla  is  be- 
ieved  to  be  useful,  and  also  Lachesis.  Either  of  these  remedies  may  be 
administered  three  times  a  day.  The  Hamamdia  may  be  applied  externally 
when  administered  internally.  For  varicose  ulcers.  Arnica  may  be  giver* 
in  the  inflammatory  stage,  and  Hepar  iulph.  after :  when  ulceration  takes 
place,  Arsenicum  and  Varbo  vegetabilia  may  be  called  into  use.  A  dose 
every  day  will  hasten  a  cure. 

Felons. 

Felons  commence  at  the  bone,  beneath  the  periostenm,  or  membrane 
that  surrounds  it.  They  are  very  painful,  and  most  commonly  inake 
their  appearance  on  the  fingers  or  thumbs ;  at  first  a  prickling  sensation 
is  experienced,  as  from  a  splinter,  and  then  a  sensation  of  heat  attended 
with  intense  pain,  depriving  the  sufierer  of  rest  or  sleep.  The  skin 
comes  changed  in  color  at  the  surface,  and  there  is  painful  throbbing  and 
swelling.  The  most  speedy  cure  for  a  felon  is  to  thrust  in  the  lancet  to 
the  bone,  and  give  vent  to  the  matter  bene'i'ch  the  membrane ;  and,  afler- 
v«  ards,  an  application  of  warm  flaxseed  poulticus  will  keep  the  sore  dis- 


""g  "ppears; 
ea  'in til  the  face 
aring  is  by  being 
.  strong  tincture 
xtinguish  thoin; 
»vor8  them ;  nut' 
Pse  of  sypliilitic 
those  of  KtiM- 
those  constitii- 
'>ar  mlphur,  and 
•eine(fjr  selected 
the  Hyotcyarmm 
has  boon  found 
ilharia,  applied 


ing,  are  usually 
erangement  of 
iger  attends  the 
i  to  recede,  and 
Its  in  diarrlioea. 
imes  a  day.  In 
B  found  useful. 
0  derangement 
oral  specilic. 


ome  congested 
ion  sometimes 
he  best  remedy 
lUatilla  is  be- 
nedies  may  be 
ilied  externally 

may  be  given 
Iceration  takes 

use.     A  dose 


or  membrane 
imonlj  make 
ling  sensation 
leat  attended 
riie  skin 
irobbing  and 
he  lancet  to 
'i  and.after- 
tlie  sore  dis- 


smAsn  «iv  TBI  tux. 


799 


chai^Dg'  Prerloas  to  Unoing,  resort  has  sometimes  been  had  to  soak- 
ing the  part  in  hot  water  to  which  Ammonia  has  been  added,  to 
ripen,  and  prepare  the  way  for  the  matter  to  come  to  the  surface.  Hepar 
tulph.,  taken  internally,  exerts  a  beneficial  influence  in  hastening  suppura- 
tion. After  a  resort  to  the  lancet  is  had,  Silicea  is  a  valuable  remedy  to 
hasten  a  oure.  For  the  constitutional  disturbance  which  felons  excite, 
Aconite  may  be  given  to  reduce  arterial  excitement;  Arnica,  to  remove 
soreness ;  muo  vomiut^  to  allay  an  irritable  condition  of  the  stomach  ;  and 
Sulphur^  to  fortify  the  system  against  the  recurrence  of  the  diflSculty.  It 
Is  always  well  to  keep  tiie  hand  at  rest  until  the  pain  and  inflammation 
:ia8  subsided* 


Tetter.   Salt  Rheom.  —  Herpet. 

Tetter  is  an  inflammatory  disease  of  the  skin,  which,  fbr  t>  '^  most  part, 
appears  upon  exposed  surfaces,  —  the  hands  and  fiuie,  —  though  some- 
times it  comes  on  the  arms  and  legs.  It  is  a  red,  scaly,  or  burning  erup- 
tion, very  stubborn  in  its  character,  and  painful.  It  sometimes  Incomes 
complicated  with  constitutional  erysipelas,  and  causes  swelling  and  infiltra- 
tion of  the  cellular  tissues  around  the  eyes ;  affects  the  ears  and  nose : 
breaks  out  on  the  backs  of  the  hands  and  arms,  and  in  the  bend  of 
the  elbow-Joint,  causing  the  skin  to  crack  and  become  exceedingly 
sore.  Sometimes  the  Tetter  is  dry,  sometimes  humid ;  and  at  others 
scaly.  For  dry,  burning  Tetter,  Arsenicum  is  a  valuable  remedy.  1( 
there  is  feverish  heat  in  the  skin  generally.  Aconite  and  a  lotion  of 
tincture  of  Aconite  may  be  applied  externally.  When  the  skin  cracks 
and  is  dry,  it  may  be  anointed  with  the  glycerole  of  Aloes.  The  burn- 
ing may  be  somewhat  allayed  by  appi/ing,  with  a  down-brush,  a  little 
rye-flour.  Sepia,  Calcarea,  and  Duloamara  are  also  valuable  remedies 
for  dry  Tetter.  The  remedies,  when  selected,  must  be  used  persistently, 
two  or  three  doses  a  day.  For  humid  Tetter,  Rhus  tox.,  Conium,  and 
Sulphur  may  be  employed.  The  Rhus  tox.  may  be  given  first,  and  re- 
peated every  six  hours.  A  lotion  of  twenty  drops  of  the  tincture  in  half 
a  tumbler  of  water  may  be  applied  externally ;  and  a  similar  preparation 
of  Conium  may  be  used  externally  when  this  remedy  is  administered  inter- 
nally. When  humid  Tetter  smarts,  and  the  skin  is  broken,  cold  cream 
may  also  be  applied.  For  the  scaly  Tetter,  Galcarea  carb.  may  be  given 
persistently  three  times  a  day ;  if  this  fails.  Sepia,  especially  if  the  face 
is  implicated.  When  the  eyes  or  ears  are  affected  and  swollen  Rhus 
tox.  and  Belladonna  may  be  given  alternately  every  three  hours  until 
better.  In  all  cases  of  Tetter  of  the  Airfhraceous  type,  Natrum  muri- 
aticum  may  be  found  of  service  when  other  remedies  fail.  Cantharis 
is  accounted  a  general  specific.  All  persons  afflicted  with  the  disease 
should  refrain  fh)m  iho  use  of  salt  provisions,  pork,  rich  gravies,  and 
the  like;  for  these  articles  of  diet  heat  the  blood  and  augment  the 
suflering. 

''      Sorofiila.  , 

This  disease  shows  itself  in  swelling  of  the  glands,  and  sores  upon  the 
face,  nedi,  and  extremities.  To  rid  the  blood  of  this  discrasia,  Arsenicum 
may  be  given  when  there  are  sores  or  olcers  affecting  the  soft  parts. 


ij-, 


■po" 


DI8IA8ES   or  lUI  HUX. 


Sorw  around  the  mouth  and  upon  the  faces  of  scrofuloua  children  may 
be  cured  with  PtUsatUla  or  Bryonia.  For  swelling  of  the  glunda,  give  Mer- 
curiu$  three  times  a  day  ;  and,  if  there  is  a  tendency  to  supnuration,  give 
Hepartulph.  In  some  children  of  scrofulous  taint,  vaccination  will  bring 
out  sores  on  the  face,  hands,  and  arms.  This  has  been  ascribed  to  impure 
vaccine  matter ;  but  this  is  not  usually  the  case,  as  the  best  virus  ever 
used  will  often  be  followed  with  this  result ;  and,  when  it  is,  Qalcarea 
carb.  or  Silicea  may  ho  given  in  daily  doses,  till  the  humor  di-siip- 
ponrs.  Ointments  that  Biinply  drive  those  huniora  from  the  aurfiice 
uro  pernicious,  und  often  result  in  producing  worse  forms  of  the  dis- 
oase.  Groat  caro  in  reference  to  diet  is  necessary  when  these  sores 
break  out  upon  children.  They  should  bo  fed  mostly  upon  farinu- 
roous  food. 

•■•^  ■"  ..;  ,  .*■■  i* 

Eozema. 

This  is  a  disease  of  the  skin,  that  may  be  brought  on  by  working  in 
smelting-furnaces,  where  the  victims  are  all  the  time  exposed  to  much 
heat,  and  are  obliged  to  work  among  cinders  and  steam.  The  appearance 
of  this  skin-disease  is  that  of  red  and  inllamed  spots  covering  the  entire 
body.  The  biliary  system  seems  to  be  much  deranged,  and  nutritive 
system  impaired.  Persons  thus  affected  become  very  much  prostrated, 
and  suffer  intensely  from  the  burning  and  smarting  of  the  eruption.  Al- 
most any  severe  exercise  that  heats  the  blood  of  those  usually  forced  to 
live  upon  an  indifferent  diet  of  unwholesome  food  will  become  subject 
to  Eczema.  To  treat  this  difficulty  successfully  is,  first  to  regulate  the 
biliary  system  by  three  or  four  doses  of  Nux  vomica  or  Mercurius  viv.,  for 
cioveral  days;  and  then  follow  with  Arsenirum,  Tartar  em  eth'.  Petro- 
leum, or  Antimonium  crudum,  three  or  four  doses  every  day;  and, 
H9  soon  as  the  appetite  and  stomach  will  permit,  furnish  the  patient 
with  a  generous  diet,  and  let  him  change  his  employment  for  one  of 
less  exposure. 

Liver  Spots.  —  Maculce,  Moaa. 

riiis  affection  consists  of  discolored  spots  upon  the  skin  of  the  face, 
sometimes  covering  the  surface  of  the  forehead  with  dark  discolorations 
of  the  skin.  Derangements  of  the  liver  are  believed  to  be  the  cause  ;  and, 
nl though  these  discolorations  are  not  painful  (except  to  the  mind),  they 
often  mar  the  countenance,  aud  annoy  those  smitten  with  tiiese  marks. 
Tiiey  can  be  removed  with  appropriate  remedies.  Sepia  is  one  of  the 
most  proniiinent.  Ohelidomum,  given  the  same.,  is  useful.  A  dose 
shoiihl  1)0  given  morning  and  evening  persistently,,  until  the  color 
fades  iind  the  spots  disappear.  To  facilitate  this,  let  the  patient 
avoid  coffee,  milk,  eggs,  and  all  oily  food.  An  animal  diet,  of  the 
lean  of  well-fed  beef  and  mutton,  is  preferable,  with  bread.  Pota- 
toes, and  esculents  of  every  kind,  may  be  allowed ;  but  gravy  and 
much  butter  are  pernicious  j  as  are  stimulants,  such  as  malt  liquors 
and  highly  seasoned  soups. 

tjourvy.  "^ 

Persons  so  situated  as  to  be  obliged  to  subsist  upon  salt  provisions  are 
liable  to  become  affected  by  a  disease  termed  "  Scurvy."     It  manifests 


•  children  in«j 

?Jand8,^iveJ/tT. 
uppuration,  give 
lation  will  bring 
*rib«>d  to  irnpuru 
Ijest  virus  ever 
It  is,  Qalcarea 
litiinor  dimip- 
'"i  tho  aurfuce 
ms  of  tho  dis- 
len  these  sores 
y  upon  furiiiu- 


by  working  in 
posed  to  much 
riie  appearance 
ring  the  entire 
I,  and  nutritive 
^uch  prostrated, 
eruption.     Al- 
iiiaily  forced  to 
become  subject 
to  regulate  the 
rcurius  viv.,  for 
emefii',  Petro- 
cry  day ;  and, 
ih  the  patient 
leut  for  one  of 


n  of  the  face, 
:  discolorations 
le  cause ;  and, 
0  mind),  they 
tiiese  marks, 
is  one  of  the 
fill.     A  dose 
itil  the  color 
''  the  patient 
i  diet,  of  the 
read.     Pota- 
it  gravy  and 
malt  liquors 


rovisions  are 
It  manifests 


DISKASE8  OK  THE  SKIN. 


801 


itself  in  scorbutic  eruption;)  upon  tho  skin,  and  by  an  influmed  and  sore 
condition  of  tlie  gums,  whicii  sometimes  become  so  much  afffctod  as  to 
cause  the  tooth  to  become  loose.  TIjo  want  of  fresh  vegetables,  or  lemons, 
oranges,  and  other  fruits,  is  believed  to  bosurticiont  to  cause  tint  dilHculM' 
To  cure  the  disorder,  a  wholesome  diet  mu>t  be  provided,  witli  plenty  ol 
fiuil,  fresh  provisions,  and  vegetables.  Tlio  only  remed^v  necessary  u; 
carry  olF  tho  difficulty,  after  providing  the  proper  diet,  is  Natruni  iiuri- 
alicumt  three  doses  a  day,  —  morning,  noon,  and  night.  Mercur'mt 
viv.,  Nitric  acid,  and  Muriatic  acid  are  also  remedies  that  have  l>een 
employed. 

Barber's  Itch.  —  aycosia  Mentagra. 

Tlus  is  exclusively  a  disease  of  the  male  sex,  and  occurs  about  the 
tune  the  beard  begins  to  grow  thick  and  hard.  The  disease  is  supposed 
to  1x3  contracted  by  using  bad  soap  upon  the  face,  when  siiaving  or  washing 
the  beard.  A  dull  razor,  that  pulls  and  irritates  the  skin,  may  form  the 
nucleus  of  tho  difficulty..  In  laboring  people,  exposed  to  dust,  especially 
of  tobacco,  and  where  there  is  not  particular  pains  in  washing  out  the 
dust  frecjuently,  the  disease  is  likely  to  be  generated.  The  disease 
resembles,  in  some  degree,  the  herpes  of  the  lips,  makes  its  first  appear- 
ance on  the  chin  in  small  clusters  of  red  pimples,  or  tubercles,  each  of 
which  is  perforated  with  a  hair.  These  pimples  increase  in  size  and  dis- 
gusting appearance,  though  not  painful,  until  arrested  by  some  remedial 
means.  Q-raphitei,  in  daily  doses,  has  often  cured.  Nitric  add,  also, 
twice  a  day,  has  proved  eracicnt.  Aurum  muriaticum,  alone,  will  cure 
cases  in  those  having  psoric  or  syphilitic  taint.  Silicea,  Carbo  animaiis. 
IIyo»oyamu9  tincture  (externally),  are  also  good  remedies.  Nitric  acid 
may  be  applied  m  a  diluted  form,  externally,  and  also  /Sufp/iur 
ointment.  A  solution  of  Iodide  of  Potass.,  two  grains  to  an 
ounce  of  water,  applied  several  times  daily,  cures  stubborn  cases. 

101 


,1 


'^ 


f 

p.' 


DISEASES  OF  THE  HEAD, 


Eeadaohoi  —  Cephalagia. 

This  affection  is  usually  attendant  on  other  difHculties,  and  must  be 
treated  with  reference  to  the  cause-  J*"  from  cold,  affecting  the  entire  sys- 
tem, and  accompanied  by  pains  in  the  back,  gi  /e  Nux  vomica.  If  from 
heat,  or  determination  of  blood  to  the  head,  Belladonna.  If  from  chilli- 
ness, Arsenicum.  For  rheumatic  Headache  in  cold,  damp  weather,  Bry- 
onia. For  that  produced  by  constipation,  Nux  vomica.  Bilious,  Merc. 
viv.  Sick-headache,  Iris  versicolor.  Sepia,  Pulsatilla,  or  Sulphur. 
Nervous  headache,  Goffea.  For  headache  caused  by  suppressed 
eruption,  Oalcarea  or  Sulphur.  From  suppression  of  the  menses, 
Pulsatilla.  From  a  fall,  or  fatigue.  Arnica.  From  simple  cold  in 
the  bead,  Aconite.  A  dose  of  four  globules,  of  any  remedy  se- 
lected, may  be  repeated  every  four  hours  until  relieved. 

Vertigo,  Swimnung  of  the  Head. 

This  uncomfortable  feeling  consists  in  a  sensation  of  the  head  whirling 
around,  causing  one  to  stagger,  and  sometimes  to  fall.  If  from  a  de- 
ranged stomach,  Nux  vomica.  If  from  a  cold,  G-elseminum  or  Arsenicum. 
From  derangement  of  ihe  biliary  system,  Aconite,  Pulsatilla,  or  Bryonia, 
Vertigo  produced  by  rush  of  blood  to  the  head,  Aconite  or  Belladonna, 
The  remedy  indicated  may  be  repeated  in  the  usual  dose  every  two  hours. 
For  vertigo  from  riding  in  a  carriage,  Cocculu^.  From  a  snock  or  fall. 
Arnica.    Dose  and  administration  as  above. 


Bin^orm  of  tbe  Soalp. 

This  is  a  pustular  eniption,  that  begins  at  one  or  more  points  upon  the 
hairy  scalp,  and  spreads  sometimes  so  as  to  in\r»lve  much  of  the  surface. 
Wlvcn  there  i.:e  a  number,  they  spread  until  they  coalesce  and  form  a 
conti.mous  eruption,  from  which  exudes  a  greenish  or  sanious  mattor,  that 
mats  the  hair,  and  renders  the  whole  appearance  of  the  hnad  disgusting. 
Great  '•are  is  required  to  keep  the  surface  clean ;  and,  for  this  purpose,  no 
soap  should  be  used  Water,  eoicened  by  the  white  of  a  raw  egg, 
is  a  better  wash.     Oulcarea  may  be  administered  in  the  usual  dose 


ointa  upon  the 
of  the  surdace. 
6  and  form  a 
us  matter,  that 
ad  disgasting. 
lis  purpose,  no 
at  a  raw  egg, 
he  usual  dose 


3,  and  must  be 
tl'.s  entire  sys- 
nica.  If  from 
If  from  chilli- 
weather,  Bry- 
Bilious,  Merc. 
,  or  Sulphur, 
y  suppressed 
•  the  menses, 
iraple  cold  in 
\y  remedy  se- 

Am 


head  whirling 
If  from  a  de- 
er Arsenicum, 
la,  or  Bryonia. 
jr  Belladonna. 
ery  two  hours. 
.  shock  or  fall. 


every  morning  and  evening.  If  this  remedy  does  not  prove  effi- 
cient, give  Sulphur  in  the  same  way,  and  also  Hepar  eulph.,  or 
Lycopodium.  The  head  may  be,  at  the  same  time,  washed  once 
or  twice  a  day  with  a  lotion  made  of  twenty  drops  of  the  tincture 
of  Sulphur  in  a  half-tumbler  of  water. 

;t     •  Soald-lieadi  —  Tinea  Capitis,  i 

This  is  also  an  eruption  upon  the  scalp,  that  may  be  dry  or  humid. 
For  the  dry  Scald-head,  Natrum  muriaticum  or  Sulphur  may  be 
administered  twice  or  three  times  a  day.  For  the  humid  Scald- 
head,  Lycopodium,  Arsenicum,  Conium,  or  Graphites  may  be 
given  twice  a  day.  The  same  restriction  as  to  the  use  of  soap 
must  be  observed,  and  the  same  measures  for  cleansing  may  bo 
recommended,  as  in  the  case  of  pustular  liingworm  of  the  scalp. 

Uloers  of  the  Soalp. 

In  scrofulous  children,  these  ulcers  sometimes  occur  in  the  forr . 
of  small  furunculi,  or  boils,  exceedingly  sore  and  painful.  The 
best  remedies  are  Arsenicum,  Hepar  sulphur,  Nitric  acid,  and 
Silicea.  They  may  be  given  as  required  in  daily  doses  of  four 
globules.  The  ulcers  may  be  wet  with  Hamamelis  Virginica,  after 
having  been  pricked  with  the  laocet. 

Baldness. 

Vhen  the  hair  falls  from  the  head  by  reason  of  debility,  the 
remedies  to  be  given  are  Ghina  and  Ferrum;  when  in  consequence 
of  perspiration,  Mercurius;  from  the  use  of  quinine.  Belladonna, 
or  Pulsatilla;  if  from  the  abuse  of  mercury,  Garbo  vegeta. ;  if 
from  gnef  or  trouble,  Phos,  acid.  If  Baldness  occurs  after  pro- 
tracted inflammatory  diseases,  and  nervous  and  typhoid  fevers,  give 
Calcarea  in  daily  doses  or  Hepar  sulph,  a,ndSUicea,  For  Dandruff, 
give  Lycopodium, 


-,-! 


t%::.- 


?■ 

■  ™ 

t,  ; 

DISEASES  OF  THE  BRAIN  AND  NERVES. 


Brain  Fever. 

This  disease  comes  on  with  more  or  less  pain  in  the  head,  attended 
with  he  it  and  dehrium ;  the  eyes  also  exhibit  a  red  or  tlery  appear- 
ance: and  tills  pain,  heat,  and  delirium  are  sometimes  followed  by  drowsi- 
ness, and  inclination  to  vomit.  The  pulse  is  usually  rapid  and  feeble. 
In  Brain  Fuvcr,  ther§  is  loss  of  appetite,  great  restlessness,  short,  comatose 
naps,  and  frequent  inclination  to  cry  out  with  pain.  Aconite  is  useful 
to  commence  with,  and  this  may  be  followed  with  Belladonna.  If  respi- 
ration i»  hurried  and  labored,  give  Arsenicum.  If  Brain  Fever  is  brought 
on  by  a  full,  or  a  blow  upon  the  head,  give  Arnica;  and  if  no  n^lief 
follows  in  twenty-four  hours,  Glonoine.  If  from  trouble  or  gi-Jef, 
Ignatia.  If  from  intoxicating  drinks,  Nux  vom.  If  at  the  men- 
strual period,  Pulsatilla.  If  from  intense  study,  or  close  application 
to  business.  Sulphur  and  iVwa;  vomica. 


Bush  of  Blood  to  the  Head. 

The  signs  of  this  occurrence  are  intense  headache  or  vertigo  at  first, 
which  is  followed  by  fainting,  and  often  with  loss  of  consciousness ;  at 
times  there  will  be  twitching  and  spasms.    The  difficulty  may  occur  from 
various  causes,  and  is  common  with  females  and  those  of  nervous  temper- 
ament.   Aconite,  in  solution,  may  be  put  in  tue  mouth  of  the  patient,  and 
also  the  head  rany  be  wet  with  cold  water.     The  head  should  be  laid  a 
little  lower  than  the  body  ;  the  lower  extremities  should  be  rubbed,  and 
friction  should  be  applied  to  the  arms  and  hands.     Belladonna  may  be 
given  alior  Aconite,  or,  in  grave  cases,  Glonoine.     If  the  ruah  of 
blood  has  been  caused  by  running  and  getting  heated,  give  Arnica, 
and  bathe  the  temples  with  a  solution  of  twenty  or  thirty  drops  in 
half  a  tumbler  of  water.     If  at  the  menstrual  period,  give  Pulsatilla. 
In  plethoric  persons,  expc^ed  to  the  heat  of  the  sun,  give  Niix  vom- 
ica, and  apply  friction  to  the  extremities.    If  "n  consequence  of  hav- 
ing drunk  stimulating  beverages,  Arsenicum  and  Iftix  vomica.     If 
from  indigewtion,  PulaatUla.     If  from  fright, -4contte.     If  from  ex- 
posure to  winter  cold,  Camphora.     The  dose  of  any  of  the  remedies 
selected  may  be  repeated  every  fifteen  minutes  until  the  patient  is 
better. 


E8. 


head,  attended 
'  tlery  appear- 
ved  by  drowsi- 
)id  and  feeble, 
ihort,  comatose 
^onite  is  useful 
ina.  If  respi- 
jver  is  brought 
id  if  no  relief 
uble  or  gi-ief, 
r  at  the  men- 
se  application 


vertigo  at  first, 
isciousness ;  at 
lay  occur  from 
Bvvous  temper- 
le  patient,  and 
ould  be  laid  a 
>e  rubbed,  and 
•ionna  may  be 
[f  the  ruah  of 
give  Amtca, 
lirty  drops  in 
ye  Pulsatilla. 
ive  Niix  vom- 
[uenoe  of  bav- 
X  vomica.  If 
If  from  ex- 
'  the  remedies 
:ho  patient  is 


8lUl8troke>  —  Coup  de  Soleil, 


Protracted  exposure  to  theAeat  of  the  sun  will  sometimes  produce  ft  sud- 
den prostration  of  the  nerves,  and  an  intense  headache,  causing  blindness, 
vertigo,  and  extreme  sensitiveness  to  the  glare  of  light,  and  sometimes  a 
sudden  chilUness  and  shuddering,  extremely  alarming.  This  is  tenned  Sun- 
stroke, and  frequently  is  so  intense  as  to  prove  fatal  in  a  few  hours.  The 
remedies  that  have  been  found  the  most  useful  are  Olonoive,  Belladonna, 
Phosphorus.  These  ma}'  be  given  singly,  and  repeated,  until  reUef  is  ob- 
tained, every  thirty  minutes.  As  soon  as  the  patient  recovers  consciousness, 
give  Cliina,  in  the  usual  dose,  several  times  a  day ;  or,  if  there  be  disturb- 
ance of  digestion  and  feeble  voice,  or  entire  loss  of  voice,  Antimonium,  cru- 
dum.  The  patient,  when  convalescent,  should  be  kept  out  of  the  sun,  and 
away  from  strong  light.  After  one  has  suffered  from  Sunstroke,  it  may  be 
several  weeks  before  he  ftiUy  recovers.  When  it  occurs  in  summer,  his  sys- 
tem will  be  exceedingly  impressible  to  the  sun's  rays  until  cold  weather,  or 
until  his  nerves  regain  their  normal  vigor.  Gieat  care  should  be  exercised 
in  reference  to  tbe  diet.  For  alter  treatment,  Lwli^ia  or  Niim  acid  often 
indicated. 

■'         i 

Apoplezyi  —  Apoplexia. 

This  alarming  disorder  is  the  result  of  a  sudden  determination  of  the  blood 
to  the  head,  which  produces  a  rupture  of  some  one  or  more  of  the  blood- 
vessels of  the  brain,  and  a  hemorrhage  in  the  nervous  centre.  When  only 
the  left  side  of  the  brain  sustains  this  injury,  the  right,  upper,  and  lower 
extremities  are  liable  to  paralysis.  When  the  right  is  similarly'  affected,  the 
left  side  usually  becomes  paralyzed.  When  both  hemispheres  of  the  brain 
become  implicated  in  the  hemoiThage,  there  usually  occurs  general  paralysis, 
and  the  patient  falls  entirely  senseless.  There  are  premonitory  sjTnptoms 
of  this  disorder,  which,  if  carefully  heeded,  may  suggest  a  treatment  that 
"^ill  ward  off  the  difficulty.  These  symptoms  aie  vertigo,  fulness,  and  dull 
neadache,  and  sometimes  nose-bleed.  When  one  feels  an  uncomfortable 
fiilucss  of  the  head,  under  which  he  walks  with  an  unsteady  gait,  he  may 
find  relief  by  one  or  two  doses  of  Aconite ;  or  if  he  finds  this  uncomfortable 
fulness  takes  the  form  of  a  dull,  stupefying  headache.  Belladonna  may  be 
preferable,  and  is  the  leading  remedy.  If  there  is  vertigo  and  fulness, 
v/ith  prostration,  Nux  vomica  is  indicated.  In  case  of  nose-bleed,  give 
Aconite,  Bryonia,  or  Pulsatilla.  These  preliminary  symptoms  may  be  made 
to  disappear  with  these  remedies,  when  otherwise  they  might  augment  until 
an  apoplectic  attack  set.m.  Then  is  the  period  of  danger.  But  few 
cases  of  sanguinary  Apoplexy  are  cured ;  rfnd  yet  some  do  recover. 
When  the  clot  pressing  upor  the  brain  is  of  small  size,  and  the  hemor- 
rhage comparatively  light,  an  absorption  of  the  clot  may  take  place,  and 
tlie  patient  recover ;  but,  when  the  clot  is  too  luige  to  be  disposed  of  by 
the  process  of  absorption,  it  becomes  an  obstacle  in  the  way  of  recovery : 
and  yet  active  measures  should  in  all  cases  be  called  into  requisition. 
Aconite  should  be  placed  in  the  mouth,  and  the  face  should  be  bathed 
with  it.  The  bowels  should  be  moved  by  an  enema,  and  cold  applica- 
tions, or  rather  applications  of  tepid  water,  should  b^  made  to  the  head. 


i 


*3 


■i 


« 


\ 


■.i 


806 


DISEASES  OF  THE  bBAIN  AND  NERVES. 


Friction  should  be  applied  to  the  surface  of  the  entire  body  and  the  ex- 
tremities. Belladonna  is  also  a  remedy  that  may  be  administered  if 
)ossible,  and  repeated  every  half-hour  or  hour.  Ignatia,  in  persons  of 
ymphatic  temperament,  may  be  given  in  the  same  way.  Arnica  may 
)e  administered  internally  and  externally.  The  skin  may  be  rubbed  with 
it ;  the  usual  doses  may  be  given  every  hour,  by  placing  the  globules  in 
the  mouth.  If  the  attack  follows  the  nose-bleed,  and  tliere  is  heavy  or 
labored  breathing,  Araenicum  or  Pulsatilla  may  be  used.  It  is  impor- 
tant to  get  an  action  on  the  bowels  as  soon  as  possible. 


Epilepsy,  Fits, 

This  disease  is  termed  the  Falling  Sickness,  as,  without  warning,  the 
patient  loses  consciousness,  and  falls  insensible  to  the  ground  or  floor,  with 
convulsive  motion  of  the  limbs,  distortion  of  the  muscles  of  the  face,  froth- 
ing at  the  mouth  ;  and  sometimes  the  mouth,  lips,  and  jaws  are  spasmod- 
ically closed,  the  hands  clinched,  and  a  general  rigidity  of  the  muscles 
of  the  entire  body.  After  a  time,  the  rigidity  passes  off,  and  all  the  mus- 
cles become  relaxed  ;  the  patient  then  appears  to  be  in  a  deep  slumber, 
and  remains  so  for  a  longer  or  shorter  period,  and  then  awakes  to  con- 
sciousness, feeling  wearied,  but  totally  unaware  of  any  thing  unusual  hav- 
ing occurred.  Confirmed  Epilepsy  is  rarely,  if  ever,  cured.  When  the 
disease  is  not  congenital,  the  incipient  stage  may  be  overcome. 
Sulphur,  or  Calcarea  curb.,  may  bo  given  when  the  first  signs  of  the 
difficulty  occur ;  and  this  may  bo  followed  with  Belladonna,  Hyos- 
cyamus,  or  Ignatia.  When  Epilopsy  ia  brought  on  by  intemperance, 
its  first  signs  may  be  attacked  with  Nux  vomica,  and  the  sooner 
the  patient  can  be  brought  into  a  state  of  total  abstinence  the 
better.  Cuprum  wet.  may  be  given  to  this  class  of  patients  when 
there  is  pain  in  the  head,  and  nausea,  attending  the  incipient 
stage.  Opium,  when  there  is  inclination  to  sopor,  may  be  given 
every  two  hours.  Stramonium,  also,  when  there  is  deep  sleep  and 
loss  of  consciousness.  When  there  is  loss  of  memory  following 
one  of  these  falling  or  unconscious  fits,  give  Sulphur,  China,  Fer- 
rum,  and  Nux  vomica,  if  all  are  required  to  effect  a  cure ;  the  only 
hope  for  which  is  in  preserving  the  patient  in  a  condition  for  the 
curative  action  of  the  remedies.  In  all  cases,  between  the  attacks, 
no  fat  food  should  be  eaten;  but  a  simple,  nutritious,  and  spare 
diet  should  be  adhered  to. 

Acute  Inflammation  of  the  Spinal  OoTA.—Myeletis. 

This  is  denoted  by  pain  in  the -back,  along  the  course  of  the  spine, 
which  also  affects  the  spinal  nerves,  and  results  in  general  suffering  ot  the 
trunk.  When  the  cervical  or  neck  portion  of  the  core  is  implicated, 
there  isi  pain  and  stiflfhess  of  the  neck,  and  pain  in  the  back  part  of  the 
head;  and  sometimes  the  accessory  nerves  become  so  afiacted  as  to  pro- 
duce derangement  of  the  organs  of  speech  and  deglutition.  Aconite  is 
one  of  the  remedies  that  must  be  employed  to  remove  the  inflammation 
when  in  this  location.  Ryperioum  is  another;  and  this  may  bo  used 
mtemally  and  externally  three  times  a  day.  Verat.  viride  is  con- 
sidered by  some  a  specific  remedy.     When  the  doisal  portion 


DISEASES  OK  THE  BBAIN  AND  NERVES. 


-j:   8C7 


y  and  the  ex- 
ministered  if 
in  persons  of 

Arnica  may 

>e  rubbed  with 

le  globules  in 

re  is  heavy  or 

It  is  impor- 


t  warning,  the 
or  floor,  with 

the  face,  froth- 

fs  are  spasmod- 
of  tlie  muscles 
nd  all  the  mua- 

deep  slumber, 
awakes  to  con- 
if  unusual  liav- 
d.  When  the 
be  overcome. 
•8t  signs  of  the 
idonna,  Hyos- 

intemperance, 
nd  the  sooner 
ibstinence  the 
patients  when 

the  incipient 
may  be  given 
deep  sleep  and 
lory  following 
r,  China,  Fer- 
cure ;  the  only 
ndition  for  the 
sn  the  attacks, 
)us,  and  spare 

'/eletis. 

0  of  the  spine, 
suffering  of  the 
:  is  implicated, 
ick  part  of  the 
idcted  as  to  pro* 
nn.  Aconite  in 
le  inflammation 
is  may.  be  used 
.  viride  is  con- 
dotsal  portion 


of  the  spinal  cord  is  beset  with  inflammation,  there  is  shortness  of  breath, 
dyspnoea,  or  fainting,  and  a  sense  of  suflbcation.  There  is,  at  the  same 
time,  pain  in  the  back  and  chest,  a  rapid  action  of  the  heart.  The  spinal 
accessory  nerves,  that  supply  the  intercostal  muscles,  partaking  of  the 
difficulty,  renders  ^le  function  of  lungs,  diaphragm,  and  heart,  severally, 
impaired.  Aconite,  for  the  inflammation  in  this  locality,  may  be  given  at 
first,  and  repeated  every  hour;  and  a  lotion  of  twenty  drops  of  the  tincture 
in  half  a  tumbler  of  water  may  be  applied  to  the  spine.  Belladonna  may 
be  given  when  there  is  intense  pain  between  the  slioulder-blades.  Bryo- 
nia is  quite  essential  when  every  motion  of  the  patient  aggravates  the 
suffering ;  Coniumy  when  the  pain  is  not  so  marked,  but  the  respiration 
is  difficult ;  Cocculus,  also,  when  the  pain  in  the  back  affects  th>.»  Hfomach, 
producing  nausea  and  prostration ;  Pulsatilla,  when  this  occuis.  m  young 
women  or  children,  or  in  those  of  lymphatic  temperaments.  The  patient 
should  take  but  little  exercise,  if  any.  If  only  the  lower  portion  of  the 
spinal  cord  is  affected,  there  will  be  pain  in  the  small  of  the  back.  The 
secretion  of  the  kidneys  may  be  diminished  or  increased ;  the  bladder, 
also,  may  be  implicated.  The  womb  may  be  subject  to  neuralgic  pains ; 
the  nerves  accessory  may  implicate  the  abdomen,  and  cause  severe  pains. 
Nux  vomica,  when  I  he  pain  is  the  most  prominent  in  the  small  of  the  back, 
and  when  there  is  pain  in  the  bowels,  and  constipation.  When  the  bladder 
is  implicated,  or  spasmodically  closed,  Myoacyamus  is  the  remedy.  When 
there  is  too  great  secretion  of  the  urine,  Nux  vom.  and  Sulphur  will  ob- 
viate the  difficulty.  When  this  portion  of  the  spinal  cord  is  affected,  the 
womb  may  become  subject  to  neuralgic  pains.  Belladonna,  Cicuta,  Ig- 
natia,  and  iVkc  vom.  are  all  valuable  remedies.  Conium,  to  remove  the 
inflammation  of  the  cord,  may  be  given  every  three  hours,  until  the  pain 
ceases.  If  spasms  attend  the  difficulty,  give  Syoseyamus  every  two 
hours,  as  long  as  they  last,  or  else  Ignatia  or  Belladonna.  If  the  inflam- 
mation is  brought  on  by  a  fall,  or  shock  upon  the  nerves,  give  Hyperi- 
cum every  two  hours,  and  bathe  the  back  with  a  lotion  of  the  tincture, 
-forty  drops  in  half  a  tumbler  of  water.  Bryonia  is  also  good  for  inflam- 
mation of  the  cord  in  the  lumbar  region,  and  especially  when  motion 
augments  the  suffering.  The  diet  for  all  persons  having  the  nervous 
eentres  implicated  must  be  simple  and  nutritious. 


Paralysis,  Palsy. 

When  the  whole  muscular  system  becomes  so  feeble  and  trembling  as  to  be 
no  longer  controlled  by  the  will,  it  is  a  case  of  Palsy ;  and  this  is  brought  on 
by  some  trouble  in  the  nervous  centres.  It  attends  Apoplexy,  Epilepsy,  and 
other  aflfectiona  incident  to  the  nervous  centres.  Inflammation  of  the  Spinal 
Cord  will  often  produce  the  affection.  The  palsy  may  affect  only  one  baud  or 
one  cheek  ;  or  it  may  be  more  general,  and  all  the  muscles  may  be  smitten 
with  paralytic  weakness.  Belladonna  is  often  indicated  for  right-sided  paral- 
ysis, and  is,  perhaps,  the  best,  remedy,  in  the  majority  of  cases.  Pulsatilla  is 
one  of  the  best  remedies  for  this  disorder  :  give  a  dose  of  it  three  times  a 
day.  If  this  does  not  cure,  give  Cocevius,  in  the  same  waj',  or  Nua 
vomica,  China,  or  Ignatia.  For  palsy  of  the  tongue,  give  Calcarea;  for 
palsy  of  the  face,  Pulsatilla;  for  palf>y  of  the  arms  and  legs,  give  Merourixn 


1 


■\ 


m 


'•■.r-V  i 

;-      -i  ■•  ■•■.' 


i;ti>.,  Nux  vomiea,  Pulsatilla,  and  Bryonia.  If  the  palsy  is  the  result  of 
a  shock  or  fall,  give  Arnica.  If  great  weakness  and  slow  fever,  give 
Rhus  tox.  Strong  tea  and  coffee  are  not  advisable  beverages  for  those 
threatened  with  Palsy  Water,  milk,  and  black  tea  of  moderate  strength, 
may  be  allowed. 

Lockjaw,  Trismus. 

One  of  the  most  painful  affections  that  can  assail  human  nature  is  the 
shock  upon  the  nervous  system  produced  by  a  wound.  Lockjaw  is  a 
rigid  stiffness  of  the  muscles  of  the  jaws,  by  some  irritation  from  a 
wound  being  first  sent  to  the  brain,  and  thence,  by  some  nervous  channel, 
to  the  muscles  that  control  the  jaws ;  causing  thorn  to  assume  a  pain- 
fully rigid  hardness,  closing  them  beyond  the  possibility  of  opening  them. 
Pain  oftentimes  is  felt  in  other  muscles,  at  th-^  same  time  causing  them  to 
be  rigid.  One  of  the  common  resorts  to  control  Traumatic  Fever,  or  the 
fever  produced  by  a  wound,  is  brandy  or  Vkhiskey.  It  is  said  that  large 
drafts  of  either  will  have  no  intoxicating  effect  when  this  fevei  is  pres- 
ent. Tincture  of  Opium,  Black  Drop,  and  Opium  itself,  have  been  given 
to  antidote  it,  and  sometimes  with  success.  One  of  the  best  remedies  for 
Traumatic  Fever,  or  that  produced  by  a  wound,  is  Amicr,.  It  may  hd 
given  every  hour  or  two  hours,  internally  ;  or  applied,  in  the  full  strength 
of  the  tincture,  to  the  wound.  There  can  be  no  other  remedy  more 
likely  to  produce  pleasant  results,  unless  from  actual  injury  of  some  nerve, 
Hypericum  is  made  to  take  the  place  of  Arnica.  If  the  patient  is  nour- 
ished through  a  quill,  and  the  circulation  is  made  vigorous  by  stimulants, 
»nd  the  intensitv  of  the  i^ain  is  kept  under  by  anodynes,  tlie  remedial 
eflecta  of  Arnica  and  Hypericum  may  cure.  Lac/iesis  has  benefited 
sumo  cases. 


Tetanus. 

This  is  the  general  disease  of  which  the  foregoing  is  a  part.  A  woun  J 
either  in  the  nail  of  the  foot  or  palm  of  the  hand  may  so  forcibly  trans- 
fer its  irritability  to  the  brain,  *hat  the  brain  distributes  the  effect  to  the 
whole  system,  producing  that  laost  painful  of  all  mortal  suffL-rings,  —  tlie 
Lockjaw,  or  general  Tetanus.  Bdladonni,  Nux  vo  iiica,  Ignatia, 
Mercurius  viv.,  and  Sulphur  may  be  employed  in  the  general  form 
of  the  disease,  in  addition  to  the  treatment  for  Lockjaw. 

Delirium  Tremens. 

This  disease  is  the  sequel  of  persistent  inebriation.     When  a  man  for- 


gets the  extremity  to  which  his  appetite  may  lead,  and  keeps  his  nervous 
system  excited  even  to  intoxication,  after  a  while  iiis  stomach  will  lose 
its  tone,  and  become  extremely  irritable  ;  his  system,  consequently,  gains 
but  little  support  from  food :  and,  what  is  still  worse,  his  strength  leaves 
him  ;  his  mind,  operated  upon  by  his  weakened  nerves,  is  filled  with  fan- 
cies, and  he  is  unable  to  sleep.  Even  before  he  becomes  delirious,  he  has 
what  in  common  parlance  is  termed  "  the  horrors,"  which  seem  to  be  a 
wretched  nervous  agitation,  and  fearful  foreboding  of  trouble.    Finally, 


.4 


the  result  of 
■  fever,  give 
ges  for  those 
rate  strength, 


nature  is  the 
Lockjaw  is  a 
ition  from  a 
'^ous  channel, 
same  a  pain- 
>ening  them. 
ismg  them  to 
Fever,  or  the 
i  that  large 
evei  is  pres- 

been  given 
rencedies  for 
It  may  hd 
full  strength 
emedy  more 
some  nerve, 
lent  is  nour- 
r  stimulants, 
lie  remedial 
IS  benefited 


.  A  wounJ 
•rcibly  trans- 
iffect  to  the 
ririiis,  —  the 
3a,  Ignatia, 
:eneral  form 


1  a  man  for- 
liis  nervous 
ch  will  lose 
lently,  gains 
ength  leaves 
ed  with  fan- 
•ious,  he  haa 
leem  to  be  a 
e.    Finally, 


the  mind  becomes  so  unsettled  as  to  bo  totally  dcran<»ed.  Illusory  pictures 
present  themsilves  continually;  such  as  serpents  and  other  reptiles,  with  other 
hideous  si<j;hts  too  numerous  to  particularize.  Unless  some  remedial  measures 
are  made  available  ia  procuring  sleep,  his  life  in  this  world  will  soon  terminate. 
Bn^onia  once  cured  a  case  of  Delirium  Tremens  in  an  army  oHicer,  who,  in 
delirium,  had  passed  eight  successive  nights  without  sleep.  Nnx  vomica  will 
often  quiet  the  nerves,  and  bring  about  a  cure.  Opium  is  a  valuable  remedy, 
and,  in  massive  doses,  has  been  emidoyed  for  many  years.  Arsenicum  is  a 
valuable  remedy  to  allay  the  irritability  of  the  stoniach;  Jynatia,  also,  when 
there  ia  much  inclination  to  weep.  The  dose  of  any  of  the  remedies  maybe 
four  globules,  or  from  one  to  five  drops  of  the  dilution  in  a  spoonful  of  water; 
repeated  at  intervals  of  one  or  two  hours.  As  soon  as  the  patient  can  eat,  give 
liini  the  lightest  kind  of  food,  gradually  increasing  its  strength  until  he  is  able 
to  take  full  meals. 

Neuralgia. 

Tliis  disease  is  a  simple  pain  in  the  nerves,  and  manifests  itself  in  various 
parts  of  the  body,  —  most  frequently  in  the  face;  and  may  be  caused  by  de- 
cayed teeth,  or  any  weakening  influence,  such  as  loss  of  olood,  diarrhoea,  or 
dysentery.  A  torpid  liver  or  feeble  digestion  may  be  the  source  of  the  pain. 
It  is  usually  a  stubborn  disease,  and  proves  in  some  cases  an  agony  of  suffering 
for  years.  It  accompanies  spinal  irrittition.  It  often  follows  miscarriages  in 
females,  and  is  too  frequently  an  accompaniment  of  other  female  diseases. 
When  diseased  teeth  are  evidently  the  cause,  Arsenicum  or  Belladonna  may 
afford  relief;  or  else  let  the  tooth  or  teeth  be  extracted.  If  from  extreme  de- 
bility, China  and  Arsenicum.  Chamomilla,  when  there  is  a  flushed  face,  and 
raucn  restlessness  and  extreme  inquietude.  Conium.,  when  it  accompanies 
spinal  irritation.  Sepia  and  Valcarea,  when  dependent  upon  uterine  derange- 
ment. For  Neuralgia  of  the  stomach  and  bowels,  give  Cocculus,  Ignatia,  or 
VulHutilla.  That  which  occurs  after  miscarriage,  dysentery,  or  diarrhoea,  re- 
quires China,  Ferrum,  Ifitric  Add,  or  Sulphur. 

St.  Vitus's  Dance,  Chorea. 

A  debilitated  condition  of  the  nervous  system  may  show  itself  in  involun- 
tary twitchings  of  the  muscles  of  the  face,  extreme  restlessness  of  the  limbs, 
involuntary  movements  of  the  hands,  arms,  and  the  entire  body.  Nux  vomica, 
Ignatia,  and  Cocculus  are  remedies  that  will  cure  a  m.ijority  of  cases.  Vhin't 
is  best  for  debilitated  persons;  Belladonna,  for  those  of  nervous  temi)erament; 
Sulphur,  when  there  has  been  suppressed  eruption.  One  remedy  should  be 
selected  and  tried  first,  and  repeated  every  three  hours  until  the  patient  is  bet- 
ter; or,  in  case  of  no  change,  select  another,  and  so  on.  Children  afflicted 
with  Chorea  should  not  be  couiined  in  school,  or  be  tasked  with  studies. 

Stammering. 

This  is  but  another  form  of  Chorea,  affecting  the  organs  of  speech.  Bella- 
donna Htdfihur,  Ilyosci/umus,  and  Causticum  have  been  employed  against  thi? 
difflcuUy,  aud  with  success.  The  training  of  young  boys  or  girls  addicted  to 
stammering,  to  be  deliberate  in  their  efforts  to  express  themselves,  will  often 
accomp.ish  more  than  remedies  It  is  remarked  that  stammerers  can  sing,  oi 
utter  any  sentence  in  song.  This  would  indicate  the  propriety  of  enjoining 
upon  alTlhus  affected  to  practise  slow  and  deliberate  speech.  Cuprnm  m-t.  is 
a  remedy  that  has  cured  many  cases;  and  so  has  Ferrum,  Ignatia,  and  Btllu- 
donna.    Employ  each  remedy  singly,  and  repeat  every  throe  hours. 


Loss  of  Memory. 


Forgetfulness  may  be  the  result  of  nervous  disease,  as  well  as  of  heedless- 
ness. Great  aud  debilitating  losses  of^«n  impair  the  memory ;  so  does  a  resort 
to  Opium  to  destroy  pain.  Excesses  of  any  kind  may  result  in  this  difflculty. 
The  remedies  that  nave  been  employed  are  Phosphoric  acid,  Sulphur,  Nnx 
vom'ca,  and  Ignatia.  Of  the  remedy  selected,  prepare  twenty  drops  in  half  a 
tumbler  of  water,  and  give  a  tablespooof ul  twice  a  day. 


^;^ 


DIPHTHERIA. 


3<. 


AN  exudative  inflanamation  of  the  throat,  during  the  progress  of  which  a 
dirty,  grayish  mcmbrauo  is  exuded  upon  the  tonsils,  and  often  upon  the  phar- 
ynx and  posterior  nares,  The  disease  is  commonly  ushered  in  by  the  follow- 
ing byraptoms:  chilliness,  headache,  pains  in  the  back  and  limbs,  excessive 
prostration,  fever,  some  difficulty  in  swallowing,  though  not  always,  and  offen- 
sive breath.  Later  appear  acrid  running  from  the  nostrils,  or  bleeding,  as 
rather  an  unfavorable  indication;  swelling  of  the  external  throat;  and  some- 
times, in  very  severe  cases,  vomiting  or  hoarseness,  and  other  indications  that 
the  disease  is  invading  the  larynx  or  trachea. 

This  disease  is  now  almost  universally  considered  in  some  degree  contagious, 
and  for  this  reason  the  patient  should  be,  so  far  as  possible,  isolated  from  those 
who  are  not  in  ch.irge  of  the  case.  All  his  excreta  should  be  disinfected  willi 
a  strong  solution  of  Sulphate  of  Iron  at  once.  The  room  should  be  well  aired 
constantly.  The  throat  should  be  gargled,  to  prevent  decomposition,  nith 
glycerine  and  water  mixed,  one  part  of  glycerine  to  seven  of  water,  to  be  used 
every  two  hours,  or  oftener  in  severe  cases.  Small  pieces  of  ice  allowed  to 
dissolve  in  the  mouth  have  a  favorable  influence.  The  patient's  strength 
should  be  sustained  by  nourishing  liquid  food,  such  as  broth  of  beef,  lamb, 
mutton,  or  fowl;  milk,  or  milk  and  raw  egg;  oatmeal  gruel;  oysters,  in  cold 
weather,  are  allowable.  Stimulants  are  not  recommended,  except  as  a  gargle, 
as  much  as  formerly;  though  in  severe  cases,  with  alarming  sinking  of  vital- 
ity, brandy  in  small  doses  may  do  good,  when  repeated  often. 

Dangerous  symptoms  have  resulted  from  the  patient  being  allowed  to  sit  up 
too  soon.  The  membrane  should  begin  to  disappear  on  or  before  the  fifth  day, 
else  grave  symptoms  may  be  apprehended,  such  as  delirium,  epistaxis,  vomit- 
ing, croup,  or  paralysis  of  the  heart.  The  urine  should  be  watched  carefully, 
as  albuminuria  is  generally  present  in  a  mild  form,  and  sometimes  complicates 
convalescence,  inducing  dropsical  swellings,  etc. 

In  severe  cases  the  patient  should  exercise  care  against  a  relapse  for  at  least 
three  months. 

Be  sure  that  your  house  is  properly  drained.  Local  filthis  the  most  common 
exciting  cause  of  this  dreaded  and  fatal  disease. 

For  the  benefit  of  those  who  cannot  secure  the  advice  of  a  competent  physi* 
cian  in  this  grave  disease,  the  following  brief  but  trustworthy  indications  for 
its  treatment  are  given :  — 

For  the  premonitory  symptoms,  such  as  chilliness,  flushed  face,  headache, 
backache,  and  fever,  Oelaemium,  ten  drops  in  half  a  tumblerful  of  water,  a 
teaspoonful  every  half-hour  until  the  fever  subsides.  Should  there  be  no  im- 
provement in  twelve  hours,  give  Cimtcifuga  in  the  same  way.  This  remedy 
has  proved  of  great  service  in  the  hands  of  physicians  of  both  schools.  For 
the  throat  symptoms,  the  most  frequently  indicated  remedies  are  the  several 
preparations  of  Mercurius,  the  Mcrcuriua  biniod.  taking  preference,  in  water, 
and  repeated  hourly.  This,  or  the  Mercurius  cyanuretum,  may  be  alternated 
with  Cimicifuja,  or  Oelscmium,  or,  later,  in  obstinate  continuance  of  the  mem- 
branous exudate,  with-  Phytnlicca  decandrn.  When  'he  liieath  is  very  putrid 
early  in  the  attack,  and  the  membrane  offensive,  with  fever,  darkly  flushed 
face,  delirium,  Baptisiu  is  better  than  Oelaemium,  or  any  other  remedy .  Should 
the  tonsils  swell  rapidly,  aftd  the  throat  and  external  face  have  a  puffy  appear- 
ance, Apta  mel.  is  indicated,  in  pl.oce  of  the  mercurial  preparations.  It  should 
Ve  given  in  water,  hourly.    Should  croupous  symptoms  begin,  indicated  by 


688  of  which  a 
|upon  tho  phar- 

i  by  the  follow- 
Imbs,  oxcesHive 
pys,  and  oft'en- 
or  bleeding,  as 
bat;  and  some- 
Indications  that 

[ree  contagious, 

ted  from  tiioso 

[isinfectod  with 

Id  be  well  aired 

position,  nith 

vter.  to  be  used 

ice  allowed  to 

ient's  strength 

of  beef,  lamb, 

oysters,  in  cold 

ept  as  a  gargle, 

nking  of  vital- 

Uowed  to  sit  up 
re  the  fifth  day, 
pistaxis,  vomit- 
tched  carefully, 
nes  complicates 

ipse  for  at  least   ! 

e  moat  common 

mpetent  physl' 
indications  for 


'ace,  headache, 

:ul  of  water,  a 

lere  be  no  im- 

This  remedy 

schools.  For 
ire  the  sereral 
snce,  in  water, 

be  alternated 
e  of  the  mem- 
is  very  putrid 
Jarkly  flushed 
ned)i.  Should 
puffy  appear- 
18.  It  should 
,  indicated  by 


hoarseness,  whistling  breathing,  dusky  complexion,  or  doughy  pallor,  croupy 
cough,  Spongia  or  lodium  will  be  tho  main  reliance,  together  with  the  inhala- 
tions of  the  vapor  of  boiling  water.  Lachenia  has  saved  cases  of  a  grave  typo, 
which  have  resisted  tho  before-mentioned  remedies.  When  bleeding  from  the 
nose  becomes  troublesome  and  alarming,  the  best  remedy  is  Carlo  Veg.,  to- 
gether with  a  free  local  use  of  ice.  The  remedies  should  not  bo  changed 
oftencr  than  once  in  twelve  hours,  as  it  is  a  disease  slow  to  show  improvementt 


Homoeopathio  Treatment  of  Diphtheria.  ^ 

Two  views  have  been  taken  with  regard  to  the  intimate  nature  and  cause  of 
diphtheria.  Most  physicians  regard  it  as  an  essential  fever,  and  arc  of  the  opin- 
ion that  the  local  affections  of  the  throat  and  air  passages  are  secondary,  and 
are  but  local  manifestations  of  the  special  condition  of  the  system,  and  thtit 
they  have  the  same  relation  that  the  local  affection  of  the  skin  and  niiicoiis 
membranes  have  to  the  eruptive  fevers.  Tiiey,  liowever,  admit  that  the  general 
disorder  is  increased  and  intensified  by  the  absorption  of  the  septic  matters 
of  tho  local  disorder,  thereby  producing  tho  I>lood  poisoning  of  septieainiia. 

The  other  view  is  what  is  called  the  germ  theory.  According  to  this  view, 
the  disease  is  caused  by  a  vegetable  organization,  which  naturalists  call  sphero- 
bacteria  or  micrococci,  which,  finding  access  to  the  throat  through  tho  nostrils 
and  the  mouth,  fasten  upon  the  raucous  membranes  of  the  tonsils  and  f.ances, 
and  produce  an  inflammation  which  is  characterized  Ijy  tho  effusion  of  a  fibri- 
nous exudation  called  diphtherite.  This  is  not  all:  under  the  conditions  favor- 
able for  their  life  and  growth  they  possess  an  enormous  power  of  reproduction. 
From  this  centre  of  infection  these  germs  find  their  way  into  the  different  tis- 
sues of  the  body,  and  acting  as  ferments,  give  rise  to  deleterious  chemical  prod- 
ucts which  destroy  life.  These  vegetable  parasites,  according  to  this  theory, 
are  as  inseparable  from  the  diphtheritic  process  as  the  bacteria  of  decompo- 
sition are  from  putrefaction  and  decay.  Without  bacteria  there  can  be  no  diph- 
theria. In  grave  cases,  these  parasites  are  found  everywhere,  in  the  smallest 
patches  of  membrane,  and  in  immense  numbers  in  the  different  tissues  of  the 
body.  They  are  the  cause  of  embolism,  of  metastatic  abscess,  and  the  inten- 
sity of  the  disease  increases  with  their  number.  These  are  the  theories  of 
diphtheria. 

The  duration  of  the  disease  depends  upon  its  severity.  The  period  of  incu- 
bation occupies  from  two  to  eight  days.  In  mild  cases  the  membrane  com- 
mences to  be  shed  on  the  fourth  day  ;  in  severe  cases  not  before  the  tenth  or 
twelth  day,  and  it  may  take  four  or  more  days  to  finish  it. 

The  membrane  is  detached  in  the  same  way  as  any  slough  or  necrotic 
tissue,  by  the  process  of  suppuration.  Whatever  theory  is  adopted,  the  local 
treatment  is  of  primary  .and  equal  importance  ;  for  the  mucous  membrane  of 
the  throat,  if  it  is  the  avenue  through  which  germs  find  entrance  to  the  body, 
is  also  the  generator  of  those  irritant  poisons,  the  absorption  of  which  con- 
taminates the  system  and  destroys  life.  No  specific  has  as  yet  been  discovered 
for  this  disease  The  object  of  the  treatment  is  first,  to  put  a  stop  to  the 
■Spread  of  the  disease,  and  to  bring  about  a  retrogression  of  the  inflainmatoiy 
process,  with  the  removal  of  the  membrane  ;  secondly,  by  the  most  perfect  dis- 
infection and  antiseptic  cleansing  of  the  mouth  and  throat,  to  prevent  the 
absorption  of  injurious  products  of  decomposition  from  the  surfaces  of  the 
diseased  tissues. 

In  order  to  accomplish  Ihe  above  results,  the  local  treatment  by  the  applica< 
tion  of  disinfectant  and  antiseptic  remedies  is  now  in  vogue. 


.,'*. ..  "<*- 


'<-^^,  !Tl^^N 


in 


f ,       ri  1 


Cauterizing  Rubstanccs  are  coiiHidercd  hurtful,  and  but  suldom  used.  Tlio 
mcfit  t'oinmou  remodies  how  resortod  to  iiro  carbolic  acid,  salicylic  acid,  per- 
raaugiiuate  of  poUvsh,  choral  hydrate,  sulphite  of  soda,  boazoato  of  soda,  and 
chlorate  of  potash.  Tiiose  various  substances  hive  bboa  app  led  in  solu- 
tion by  means  of  a  sponge  or  a  brush,  in  the  form  of  spray,  and  In  the  form 
of  a  pnwder,  taiion  d.y  into  llio  m  )ulh  combined  with  sui^ar. 

1  think  that  tlio  best  way  to  treat  the  throat  is  by  the  frequent  inhalation  of 
a  hot  steam,  applied  in  hourly  sittingi  of  about  fifteen  minutes'  duration.  These 
may  be  medicated  with  chloride  of  sodium,  or  the  chlorate  of  potash,  id)out 
twenty  grains  to  tlie  ounce.  Such  fluids,  steadily  flowiug  over  the  surfaces  of 
the  mucous  membranes,  wash  away  masses  of  mucus,  remnanls  of  food,  and 
other  products  of  decomposition.  They  assist  nature's  work  of  promoting  sup- 
puration, which  is  the  legitimate  way  in  which  these  pseudo-membranes  are 
shed;  and  by  combining  this  treatment  with  the  use  of  strong  gargles,  com- 
posed of  the  solution  of  any  of  the  above  disinfecting  substances,  we  more  com- 
pletely prevent  septic  absorption  than  by  any  other  treatment  ever  used.  The 
steam  may  be  generated  in  any  ordinary  kettle,  and  conducted  to  the  patient's 
mouth  through  any  suitable  tube.  The  general  treatment  of  the  patient 
is,  as  in  every  other  infectious  disease,  to  be  sustaining. 

Tonics,  such  as  sulphate  of  quinine  and  the  tipcture  of  the  muriate  of  iron, 
are  also  always  indicated. 

It  has  been  claimed  that  alcohol  conjoined  with  quinine,  given  freely  from 
the  first,  is  an  effective  curative  agent.  Alimentation  is  an  essential  part  of 
the  treatment.  The  diet  should  be  highly  nutritious;  milk  and  animal  broths 
are  of  this  class. 

Patients  affected  with  this  disease  should  be  at  once  isolated.  Thorough 
disinfection  of  the  dejections,  and  of  all  articles  which  have  been  in  contact 
with  patients,  and  of  the  apartments  which  they  have  occupied,  is  to  be  recom- 
mended, and  all  defects  of  drainage  must  be  remedied. 

Belapsing  Fever. 

A  fever  has  lately  made  its  appearance  in  some  of  our  large  cities,  having 
all  the  characteristics  of  a  common  typhoid,  that  apparently  passes  through  all 
its  stages,  and  then  reproduces  itself,  and  the  same  round  occurs  again.  Each 
siege  lasts  about  seven  days.  Several  of  these  in  succession  make  the  condi- 
tion of  the  patient  precarious,  and  the  prognosis  unfavorable.  The  treatment 
is  with  stimulants,  and  the  uiual  remedies  for  low  fevers,  such  as  Ars.,  Carbo 
vegeiahilin,  Bryonia,  and  Rhus  tox.  Doses  as  usual,  and  repetition  of  the  rem- 
edy selected  every  three  hours.    A  stimulating  diet  always  required. 

Black  Tongue. 

In  warm  climates  and  in  a  low  country,  there  are  biliary  derangements,  ac- 
companied with  low  fever,  and  a  black  coating  upon  the  tongue.  This  is  what 
is  termed  the  Black  Tongue.  Carbo  veg.  has  been  given  freely,  even  the  crude 
powder,  a  teaspoonful  at  a  dose. 

Black  Vomit. 

This  is  another  bilious  disease,  that  results  from  superabundance  of  carbon 
in  the  blood,  and  a  wretched  derangement  of  the  liver  and  stomach,  which 


o^sS^^asi^griaai.. 


oin  used.  Tlio 
cylic  acid,  per- 
to  of  soda,  and 
iod  ill  Bolu- 
iiii  in  tlio  form 

t  inhalation  of 
iinition.  Tliese 
if  potasli,  iit)out 
tlie  Hurfac'os  of 
In  of  food,  and 
pioniDting  sup- 
nionibrancs  are 
;  gargles,  com- 
i,  we  more  coin- 
vcr  used.  The 
to  the  patient's 
of  the  patient 

nuriate  of  iron, 

en  freely  from 

isential  part  of 

animal  broths 

ted.  Thorough 
been  in  contact 
,  is  to  be  recom- 


fe  cities,  having 
usses  through  all 
'3  .again.  Each 
lake  the  condi- 
The  treatment 
as  Are.,  Carbo 
tlon  of  the  rem  ■ 
[lired. 


rangements,  ac- 

:.    This  is  what 

even  the  crude 


lance  of  carbon 
stomach,  which 


MIBOKLLANEOUS   DISEASKS. 


813 


causes  copious  vomitings  of  black  bile.  Ameiiirinn,  given  every  hour,  has 
remedied  this  difHculty.  After  the  vomiting  is  lu rested  by  the  »!*(•  of  AiHcni' 
cum,  give  Carbo  vey.,  (Jhina,  lihua,  or  Br;ioniu  VVhichover  remedy  is  selected 
by  the  indications  should  be  repeated  every  hour  or  two  hours,  until  ( oinplota 
recovery  takes  place  As  soon  as  the  patient  can  take  nourishmcnl,  give  beef- 
tea  and  other  nourishing  soups,  and  then  nior'-      lid  aliments. 

Nightmare.  —  Tncuhua. 

The  characteristic  symptoms  of  this  distressing  condition  are  semi-con- 
sciousness, and  a  sense  of  inability  to  extricate  one's  self  from  some  iuiiigiuury 
weight  or  seizure.  It  may  be  caused  by  some  defect  in  the  circulation,  or 
indigestion.  The  sufferer  is  generally  supposed  to  be  asleep;  but  in  some 
cases,  he  knows  when  persons  are  about  him,  and  yet,  unless  he  is  spoken 
to  or  moved,  or  by  effort  himself  can  voluntarily  move  his  foot  or  h  uid,  lie  is 
liable  to  remain  spell-bound,  under  a  souse  of  weight  or  opjjn'Hsi  m.  To 
relieve  one  when  thus  affected,  turn  or  shake  him.  The  remedies  tli;il  ui  ly  bo 
employed  to  prevent  Nightmare  are  ^4cjn»<e,  when  there  is  a  feverish  condi- 
tion of  the  system;  Nux  vomica,  when  there  is  indigestion;  and  also  Pulsatilla 
and  Hulphur. 

Hysteria.  '  . 

This  is  a  name  applied  to  a  great  variety  of  nervous  derangements,  tha.  for 
the  most  part  are  dependent  upon  nervous  debility.  It  may  manifest  itself  in 
an  irresistible  inclination  to  weep  or  laugh;  sometimes  in  fainting  and  spasmi, 
shortness  of  breath,  screeching,  and  a  sensation  of  chokiu;^.  Amiiite  will 
sometimes  quiet  the  nerves;  Tgnatia,  if  there  is  an  inclination  to  weep;  Ifijos- 
eyumiis,  if  inclined  to  laugh;  l*ul)iaUlla,  if  connected  with  the  menstrual 
period.  For  hysteric  mania,  Hyoscyamns,  Stramonium,  or  BelL.donna. 
Either  of  the  remedies  may  be  given  in  the  usual  dose,  and  repeated  every  two 
dr  three  hours  until  relief  is  obtained;  and  it  is  also  recommended  that  such 
persons  ride  out  in  the  open  air,  and  seek  change  of  scene. 

Hydrophobia.  —  Babies. 

The  bite  of  rabid  dogs  is  productive  of  this  disease.  The  poison  communi- 
cated by  the  bite  may  remain  in  the  system  for  an  indefinite  period  ;  and  then 
all  at  once,  the  sight  of  water  or  some  polished  metal  will  throw  the  vic- 
tim into  indescribable  distress  and  raadne-ss,  which  are  apt  to  increase  and  ter- 
minate in  death.  A  dread  of  water  is  an  unmistakable  sign  of  the  disease. 
When  one  is  bitten  by  a  rabid  animal,  the  effect  may  be  extinguished  by  an 
immediate  resort  to  cauterization.  A  heated  poker  brought  as  near  to  the 
wound  as  possible  without  contact  is  believed  to  be  effectual  in  destroying  the 
poison  ;  or  the  application  of  Nitrate  of  Silver  immediately  may  also  have  the 
same  effect.  Hydrophobia  has  been  cured  by  th.;  persistent  use  of  Belladonna 
in  the  usual  dose,  repeated  every  hour  or  two  hours  for  several  days  ;  Ilyoscya- 
mus  may  also  be  employed  in  the  same  way;  Cantharis  has  been  recommended 
as  an  antidote  to  Habies.  LachesiSj  and  even  copious  draughts  of  whiskey, 
have  been  found  useful.  Nothing,  however,  has  been  found  more  salutary  as 
an  immediate  resort  than  dry  or  radiating  heat. 


.,4': 


DISEASES  OF  THE  EYE  AND  LIDS. 


Stye.  s    ,  . 

This  is  a  small  tumor  on  the  lid,  al)out  the  size  of  a  pea,  which 
is  quite  painful.  Aconite  will  often  cure  in  a  day  ;  Pulmlilla,  also, 
affords  speedy  relief;  Belladonna,  when  the  inflammation  of  the 
stye  causes  redness  of  the  eyeballs ;  Staph,  prevents  their  recur- 
rence, taken  once  daily  awhile. 

Inflammation  of  the  Eyelids. 

When  the  entire  lids  become  involved  in  acute  inflammation, 
Aconite,  in  the  usual  dose,  may  be  given  every  two  hours  until 
relieved  ;  Puis.,  the  same  way,  when  there  is  burning,  with  flow  of 
tears.  If  the  lids  become  congested,  red,  and  swollen,  give  Bella- 
donvto.'  If  the  inflammation  is  chronic,  give  Calcarea  onco  a  day, 
or  olfje  Sulphur  or  Hepar  sulphur.  If  dependent  upon  gastric  or 
bilious  derangement,  give  Nux  vomica  or  Mercuriua  every  two 
hours  until  relieved,  the  latter  especially  when  there  are  cutting 
pains,  worse  nights. 

Iritis,  Inflammation  of  the  Iris. 

The  little  circle  in  the  front  of  the  eyeball,  which  we  call  the  Iris, 
is  subject  to  inflammation.  It  may  result  from  a  cold,  or  from  injury, 
or  from  some  impurity  of  the  blood.  When  from  a  cold,  Aconite 
speedily  aflbrds  relief.  If  very  painful.  Belladonna.  If  from 
injury,  Arnica  or  Aconite.  The  patient  must  be  kept  in  a  dark 
room  until  the  inflammation  passes  off.  To  relieve  acute  pain, 
resort  has  been  had  to  Morphine,  in  one  eighth  of  grain  doses, 
repeated  every  four  hours  if  necessary.  It  is  doubtful  if  any 
external  applications  in  Iritis  ever  prove  beneficial.  If  any  are 
used,  none  are  better  than  water  in  which  six  grains  of  Opium  to  a 
scill  has  been  boiled. 

Sorofnlons  Sore  Eyes. 

In  persons  of  a  strumous  constitution,  a  cold,  or  any  undue  exposure 
of  the  eyes,  may  cause  them  to  be  the  seat  of  scrofulous  inflammation  ; 
in  which  event,  there  will  be  a  redness  of  the  eyeballs,  and  swelling  and 
ulceration  of  the  lids,  and  a  greater  or  less  accnmulation  of  matter  be- 
neath the  lids.  This  disease  is  often  very  painful,  and  destructive  to  the 
soats  of  the  eye ;  and,  whrt  is  worse,  it  becomes  the  fruitfril  source  of 

AU 


^y.,-^,   .^  i»-'^  ■.-•■»^li»i..wy.-.. 


I 

Mi 


E 


^s 


■f. 


IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


Photographic 

Sciences 

Corporation 


CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


"10^ 


DISEASES  OF  THE  EYE  AND  LIDS. 


816 


cataract  and  blindness.     When  the  eyes  first  become  inflamed  and  burn- 
ing, Arsenicum  may  be  given  ;  when  the  lids  are  implicated,  give  Calca 
rea;  when  the  inflammation  passes  off,  leaving  white  spots  on  the  cornea, 
give  Sulphur,  Hepar  sulphur,  or  Conium.    Daily  doses  of  the  remedy 
selected  will  be  sufficient. 

Sjrphilitio  Sore  EyeSi 

Sometimes  syphilis  %f  ill  affect  the  eyes,  and  threaten  the  destruction  of 
sight.  The  lids  will  iiiHame ;  the  cornea  will  bo  congested,  and  of  a 
bluish  red  ;  the  conjunctiva  will  become  the  seat  of  inflammation,  and 
sometimes  of  ulceration.  Merourius  iod.  may  be  given  first,  while  the 
patient  is  kept  in  a  quiet  and  darkly  illuminated  room,  two  doses  daily. 
If  the  patient  has  already  been  treated  with  Mercurius,  give  Nitric 
add  or  Hepar  sulph.  If  considerable  matter  exudes  from  under  the 
lids,  give  Aurum  once  a  day ;  and  if  the  eyes  itch  contiuually,  give 
Sulj)hur. 


^         Oataraot. 

This  film,  that  obstructs  the  sight  of  the  eye,  is  undoubtedly  the  sequel 
of  scrofulous  inflammation,  or  injury  of  the  crystalline  lens.  It  is  simply 
an  abnormal  growth  of  a  film  over  the  pupil  of  tne  oye,  partially  if  noi 
wholly  obstructing  the  sight.  Conium  mac,  given  twice  a  day.  Merc, 
iod.  is  also  a  good  remedy;  Phosphorus,  Cousiicnm,  or  /Sulphur 
may  be  indicated.  Either  may  be  repeated  twice  a  day  when 
selected.  ,    >  ' 


'  Rheumatio  Sore  Eyes. 

Rheumatism  of  an  inflammator}'  character  may  fall  with  great  force 
upon  the  eyes,  and  produce  severe  pain  and  temporary  bliiidnc  "s.  Nux 
vom..  Belladonna,  Bryonia,  and  Aconite,  are  remedies  that  may  be  con- 
sulted, Bryonia  may  be  given  three  times  a  da}',  when  every  effort  to 
open  the  eyes  is  attended  with  pain  ;  Belladonna,  when  the  pain  is  such 
as  to  give  the  sensation  of  the  eyeball  being  too  large  for  the  socket ;  and 
also  when  there  is  a  feeling  as  if  the  eyeball  wouUl  burst.  Sidphur,  for 
dull  pain  in  the  eyeballs,  and  the  Hij'ht  impaired.  Rhus  when  the 
eyes  are  pink,  and  lame  on  moving  them. 

Gonorrhoeal  Sore  Eyes.  '  -       ' 

When  the  eyes  become  inoculated  with  gonorrhoeal  matter,  there  will 
be  smarting,  and  then  ''  '  immation  and  swelling  of  the  lids,  and  such 
serious  infiltration  as  to  ^.^^3  the  eyes ;  and,  in  a  very  brief  period,  a  per- 
fect disorganization  of  the  texture  of  the  eye  will  take  place.  As  soon  as 
the  character  of  the  inflammation  becomes  known,  it  is  well  to  make  some 
compresses  of  linen  a  half-inch  thick,  and  bind  them  tightly  over  the 
eyes,  and  then  give  Cannabia  every  three  hours  for  two  or  three  days ; 
afterwards,  give  Cantharia  in  the  same  way ;  and,  after  the  smarting  pain 
begins  to  cease,  carefully  remove  the  compress,  keep  the  patient  in  a  dark 
rooui,  and  Sulphur,  in  daily  doses,  may  complete  the  cure. 


■Mm 


816 


DISEASES  OF  THE  ETE  AMD  LID8. 


U 


Specks  on  the  Oornea. 

Little  opaque  spots  on  the  cornea  may  be  left  after  scrofulous  inflam- 
mation has  passed  away.  These  may  be  removed  by  daily  doses  of  Sul- 
phur or  Euphrasia. 

Watery  Eyes. 

When  the  eyes  are  watery,  or  prone  to  become  so,  from  slight  exposure 
to  ^Yind  or  cold,  the  diificulty  may  be  obviated  with  daily  doses  of  JPulsa- 
tilla,  Mercnrtus  vivus,  or  Lachesia.  Blood-shot  eyes  will  be  re 
lioved  by  daily  doses  of  Euphrasia. 

Squinting,  Strabismus.  . 

What  is  termed  croa-eyed.  in  persons  is  usually  the  sequel  of  some 
cerebral  disturbances,  that  have  deranged  the  normal  action  of  the  little 
muscles  that  regulate  the  position  of  the  eyeballs,  and  give  tliem  an  ab- 
normal or  squinting  appearance.  Sometimes  daily  doses  of  Ilijoscyamut 
or  Belladonna  will  entirely  remedy  the  diflficulty.  SnoRT-siouTEDNijaf 
may  be  remedied  by  daily  doses  of  Sulphur,  Lj/copodium,  or  Pul 
satilla. 


/ . 


/ 


^"v:^ 


'"  ,     V 


>fulous  inflam- 
loses  of  Sul 


slight  expossre 
loses  of  Puha- 
will  be   re 


equel  of  some 
Jii  of  the  little 
e  tliom  an  ab- 
f  Ilyoscyamtn 

T-SIOUTEDNlJSf 

dium,  or  Pul 


DISEASES    OF   THE   EAR. 


Inflammation  of  the  Ean 

When  the""^  is  inflammation  and  swellinir  of  the  external  ear,  and  it 
has  a  red  anu  fiery  appearance,  Pulsatilla  may  be  administered  twice  a 
day.  Jf  the  swelling  and  inflammation  extend  within,  so  as  to  close  the 
external  orifice,  give  Bdladonna  twice  a  day  until  the  difficulty  passes 
away.     If  suppuration  threaten,  Hepar  sulph. 

Earache. 

This  may  result  from  cold,  or  from  gathering8  within  the  ear;  or 
it  may  possibly  be  neuralgia,  or  proceed  from  decayed  teeth  ;  or,  in 
children,  from  teething.  When  from  cold,  give  Chamomilla  or 
Dulcamara  three  times  a  day ;  if  from  injury,  Hypericum  or  Ar- 
nica; if  from  gatherings,  Hepar  sulph.  or  Calcarea;  if  from 
decayed  teeth,  Mercurius  viv. ;  if  in  teething  children,  Pulsatilla, 
two  doses  a  day ;  if  the  pain  is  neuralgic,  give  j^ux  vomica  or 
Pelladon7ia. 

Running  of  the  'Eo.ra,— Ottorrhcea. 

Ottorrlioea  may  be  occasioned  by  a  cold,  when  there  are  no  sores.  For 
tills,  pive  Pulsatilla;  when  from  sores  in  tlie  ears.  Culaarea.  If  this 
should  fail  of  cure,  try,  in  succession,  Sulphur,  Mercurius  viv.,  and 

Silicea. 


Deafness,  Hardness  of  Hearing. 

To  remedy  this  difficulty  when  produced  by  a  cold,  give  Nux  vomica 
ijvery  night  until  relieved.  For  tiiat  which  occurs  after  scarlet  lever, 
Calcarea,  and  for  tiiat  after  measles,  pive  Pulsatilla ;  from  hardened 
wax.  Sulphur ;  if  from  rush  of  blood  to  the  head,  or  congestion,  Aoonite 
or  Belladonna;  Gausticum,  if  these  fail.  The  remedies  may  be 
repeated  every  four  hours  until  relieved. 

Nervous  Dea&ess. 

Wlien  the  nerves  of  the  ear  lose  their  vitality,  and  Deafness  results  as 
..he  consi-queiice,  Phosphoric  acid  may  be  given,  in  drop  doses,  twice  a 
day ;  or  Sulphur  may  be  given  every  night,  or  Nux  vomica,  or  Causti- 
cum,  in  like  manner.  Wlien  Deafness  occurs  from  Rheumatism,  Pulsa- 
tilla may  he  given  three  times  a  day.  Arsenicum,  Nitric  acid,  Calcarea, 
and  Mercurius  viv.  may  likewise  be  consulted.  If  Deafness  occurs  from 
suppressed  eruption,  the  remedies  are  Sulphtir,  Calcarea,  Graphites,  or 
Gausticum,  in  daily  doses.  If  Deafness  is  tiie  sequel  of  malarious  fevers. 
Phosphorus  or  Phosphoric  acid,  in  daily  doses ;  if  from  sudden  check  of 
nose-bleed,  or  discharges  from  the  nose  or  ears,  Hepar  sulphur,  or  Lache- 
«'«;  if  from  enlargement  of  the  tonsils,  Nitric  acid,  Mercurius,  or 
Aurum.  g]7 

lai        


J 


1 1 


n 


'.  'I 


DISORDERS  OF  THE  NOSE. 


Nose-bleed. — ^a»toxi«. 

This  troubl-^  arises  from  various  causes,  and  must  be  treated  accord- 
ingly. Wlien  it  arises  from  arterial  excitement,  Acunite;  from  an  injury, 
Arnica  ;  from  rush  of  blood  to  the  head,  Belladonna  ;  if  from  inflamma- 
tion of  the  lungs,  Bryonia;  in  typhoid  fever,  Rhus  tox.;  if  caused  by 
worms,  Gina  or  Spigelia;  if  from  weakness  or  debility,  China,  or 
Carbo  veg. ;  if  from  cold,  or  coryza,  Nux  vomica.  Dose,  three 
times  a  day.  ". 


Obstraotion  of  the  Nose.— Ozomo. 

Ozoena  is  an  entire  obstruction  of  the  nasal  ducts,  from  thickening  of 
the  mucous  membrane,  or  other  causes.  If  from  accumulation  of  the  mu- 
cus, Pulsatilla;  if  from  suppressed  eruption,  Sulphur,  Lycopodium,  and 
Calcarea;  if  from  scorbutic  tendency,  Bryonia;  if  with  dry  crusts, 
Aurum.     The  usual  dose,  three  times  a  day. 

Polypus  of  the  Nose.  \ 

Not  unfreqnently,  a  morbid  growth  attached  to  the  mucous  membrane 
of  the  nose  will  fill  the  entire  nostril.  This  is  termed  a  Polypus,  and  is 
pe'fectly  curable.  Calcarea,  when  the  disease  appears  in  scrofulous  sub- 
jects ;  Sanguinaria,  when  a  cold  has  been  the  exciting  cause ;  Sej)ia, 
when  there  is  pain  in  the  head  and  nausea ;  and  Staphysagria,  when  u  is 
the  sequel  of  other  disorders.  The  medicines  may  be  given  in  the  usual 
dosOt  and  repeated  every  four  hours. 

Ml 


DROPSIES,  HYDROPS. 


A  GENERAL  swelling  of  the  whole  exterior  surface  of  the  body,  and  a  sen- 
sation of  weakness,  is  termed  General  Dropsy,  because  the  water  infiltrates 
into  the  cellular  or  subcutaneous  tissue  all  over  the  body.  Local  dropsies 
may  affect  the  chest,  abdomen,  head,  womb,  and  testes. 


,■ 


treated  accord- 
from  an  injury, 
from  inflamma- 
;  if  caused  by 
ity,  China,  or 
Dose,  three 


m  thickening  of 
ation  of  the  mu- 
jycopodium,  and 
vith  dry  crusts, 


General  Dropsy,  Anasarca. 

This  is  caused  by  Cellulitis  and  infiltration  of  water  into  the  areolar 
tissue,  causing  one  to  swell  all  over  the  body.  There  is  generally  some 
thirst  and  fever  that  ushers  in  General  Dropsy.  Arsenicum  in  the  usual 
dose  may  cure  the  disease  when  it  seems  to  arise  from  a  low  state  of  tlie 
system.  When  it  is  the  sequel  of  Scarlatina  or  Erysipelas,  give  Helleborm 
nig.  three  times  a  day.  If  after  a  Bilious  Fever,  give  Mercurius 
viv.     Following  Scarlet  Fever,  Apis,  or  Terebinth. 

Dropsy  of  the  "BeWj,  — Ascites. 

When  inflammation  of  the  peritoneum  terminates  in  Dropsy  of  the 
Abdomen,  Apia  melifica  may  be  given,  every  three  or  four  hours,  for  sev- 
eral days.  If  it  fails  of  effecting  a  cure,  Apocymim  may  be  given,  in  t)ie 
same  way,  and  in  like  manner,  Bryonia,  Hellehorus  nig.,  and  Ar- 
senicum. Tapping  is  somGtimes  necessar}',  when  the  peritoneal  sack 
is  filled  with  water,  and  dees  not  yield  to  remedies. 


icons  membrane 
,  Polypus,  and  is 
1  scrofulous  sub- 
y  cause;  Sepia, 
agria,  when  ii  is 
iven  in  the  usual 


Dropsy  of  the  Chest,  or  Hydrothorax. 

The  cause  of  this  affection  is  inflammation  of  the  pleura,  causing  an 
•iccumulation  of  serum  in  the  pleural  cavity.  Apis  melifica  in  the  usual 
doses,  repeated  at  intervals  of  three  or  four  hours,  will  often  effect  a  rad- 
ical cure,  and  so  will  Ajpocynum,     If  these  fail,  use  Sulphur, 

Dropsy  of  the  Heart. 

This  is  an  accumulation  of  water  around  the  heart,  in  the  cavity 
of  the  pericardium.  Spigelia  ov  Apis  mellifica  will  generally  cure. 
Sulphur  is  eflicicnt  in  many  cases.  Bryonia,  if  from  pericarditis 
or  rheumatism. 


820 


DBOPSIES,  HTDBOPS 


Dropsy  of  the  Btdim,  —  Hydroc^halua. 

Inflammation  of  the  brain  may  terminate  in  an  eft'usion  of  serum  in  the 
arachnoid  cavity,  and  is  oflen  fatal,  ffj/oieuamiu  in  the  usual  dose,  re- 
peated four  or  five  times  a  day,  may  prove  beneficial.  Apis  melifica  has 
been  employed  in  the  siinic  way,  also  Hellehorus. 

Dropsy  of  the  Womb.  —  Hydro  metra. 

Inflammation  of  the  womb  often  terminates  in  this  affection.     Bella 
donna,  Apis  melifica,  Arsenicum,  aqd  Helleborua  nig.  have  been  employe.' 
against  it.  .  ^ 

Dropsy  of  the  Borotam,— Hydrocele. 

This  consists  in  the  scrotum  becoming  filled  with  serwm  or  water,  after 
inflammation  and  swelling  of  the  testes.  It  may  be  caused  by  Gonorrhoea, 
or  it  may  be  the  sequel  of  Scarlet  Fever.  The  same  remedies  employed 
in  other  local  dropsies  may  bo  employed ;  or,  these  failing,  the  water 
may  be  drawn  off,  and  a  weak  solution  of  iodine  may  be  injected 
into  the  sack  by  a  surgeon. 

Ovarian  Dropsyi 

Inflammation  of  the  ovaries  is  the  cause  of  this  difficulty.  Arsenitmm 
will  generally  have  a  good  effect,  and  so  will  Oonium,  and  also  Apii 
melifica  and  Pulsatilla ;  either  remedy  in  the  usual  dose  may  be  admm- 
Istered  every  three  hours,  with  the  prospect  of  relief. 


\ 


)f  serum  in  the 
asual  dose,  r«- 
m  melifica  has 


ection.     Bella 
been  employe.' 


or  water,  after 
by  Gonorrhcea, 
edies  employed 
ling,  the  water 
ay  be  injected 


ty.  Arsenicum 
and  also  Api$ 
may  be  admm- 


\ 


SURGICAL   DISEASES. 


Oonoussion  of  the  Braiiii 

Tins  is  the  result  of  a  fall  or  blow,  and  may  be  relieved  by  Arnica, 
usual  dose,  and  repeated  if  necessary.  Should  stupor  and  inability 
to  retain  food  persist,  try  Glonoine, 


Oonoussion  of  the  Ohest. 

This  may  be  produced  by  some  sudden  mechanical  injury.  If  there  is 
fever,  give  Aconite  every  three  hours.  If  from  having  been  compressed 
mechanically,  Arsenicum  may  prove  serviceable ;  and  so  may  Arnica,  Pul- 
satilla, and  Nvjc  vomica,  Bryonia,  and  China.  Any  of  the  remedies 
selected  may  be  given  in  the  usual  dose  every  three  hours.  In  all  cases 
let  the  diet  be  simple,  and  use  friction  externally ;  and  when  there  has 
been  a  blow  upon  the  head,  causing  the  concussion,  pour  a  stream  of  cold 
water  from  a  small  pitcher  or  coffee-pot  for  thirty  or  forty  seconds. 


■   Sprains.  " 

A  sprain  may  be  more  or  less  severe.  Sometimes  it  may  implicate 
only  the  muscles,  and  at  others  the  ligaments,  involving  the  apparatus  of 
the  joints.  A  sprain  of  the  wrist  requires  Arnica,  internally  and  exter- 
nally at  first,  and  then  a  compress  of  tepid  water,  covered  with  a  dry 
bandage.  A  sprain  of  the  hip-joint  or  shoulder-joint  requires  Ledum, 
with  a  lotion  of  the  same  of  twenty  drops  to  half  a  tumbler  of  water, 
applied  by  means  of  wetting  with  it  a  compress,  covered  with  a  dry  ban- 
dage. A  sprain  of  the  knee-joint  should  be  treated  with  Arnica,  exter- 
nally and  internally,  as  above,  and  also  with  Pulsatilla  after.  Sprains  of 
the  ankles  arc  soonest  cured  by  applying  compresses  of  cold  water, 
and  dry  bandages  over  them,  and  by  the  administration  of  Ledum 
internally.     Should  this  fail,  use  Bryonia. 

'  '  li\jury  of  a  Nerve. 

The  place  which  Arnica  has  in  surgery  m  the  treatment  ot  ordinary 
bruises  and  sprains  is  of  no  greater  importance  thai>  that  of  Hypericum 

fl3I 


1 


m 


fl- 


f 


I 


i  I 


S22 


SURGICAL  DISEASES. 


perforatum  applied  directly  to  injuries  involving  the  nerves.  Shocks 
upon  the  nervous  system,  injuries  to  the  spine,  or  from  extracting  teeth, 
all  require  Hypericum  internally  and  externally,  in  the  usual  dose,  and 
lotion. 

Wounds. 

Wounds  are  of  various  kinds  ;  such  as  incised,  lacerated,  puncturod. 
oun-sliot  wounds,  &c.  A  simple  incised  wound  needs  only  tlio  "iik's- 
|)i*essed  together,  and  compressed  with  a  strip  of  adhesive  plaster.  'I'lic 
application  of  Calendula  externally  will  facilitate  the  healing.  Laco- 
r.itcd  wounds  require  careful  adjustment  and  dressing,  and  then 
lot  the  dressing  bo  wet  frequently  with  a  dilute  tincture  of  Calen- 
dula; and  where  it  is  supposed  tho  trunks  of  nerves  are  implicated, 
use  Hypericum.  Any  of  these  remedies  may  be  used  internally,  in 
the  usual  dose,  three  times  a  day.  Contused  wounds  require  com- 
presses of  cold  water  and  Arnica;  while  Arnica,  Ruta,  and  Hy- 
pericum may  bo  administered  in  the  usual  form  iuternally. 

Hemorrhage  from  Wounds. 

To  remedy  protracted  hemorrhage  from  wounds,  give  Arnica  or 
Calendula  internally,  and,  with  a  lotion  of  forty  drops  of  either  in 
half  a  tumbler  of  water,  -vet  compresses,  and  apply  externally. 

Hernia,  or  Eupture. 

There  are  two  kinds  of  rupture  met  with  among  persons.  One  is 
termed  the  femoral,  and  is  near  the  groin ;  and  another  is  termed  umbilical, 
and  is  near  the  navel.  There  is  a  third  kind,  where  the  sack  descends 
into  the  scrotum  ;  and  it  is  termed  scrotal  or  inguinal  hernia.  When 
either  has  been  of  long  standing,  well-adjusted  trusses  must  be  worn,  or 
else,  lor  scrotal  hernia,  a  suspensory  bandage.  For  recent  inclination  to 
rupture.  Aconite  will  subdue  any  inflammatory  symptoms.  Arnica,  if 
caused  by  a  strain ;  Nux  vomica,  in  case  of  constipation  of  the  bowels. 
The  remedies  ab  indicated  may  be  given  in  the  usual  dose,  three  or  four 
times  a  day.  For  strangulated  hernia,  Nux  vom.  every  half-hour : 
and  if  this  affords  nc  relief.  Opium  the  same.  Lycopodimn  and 
Sulphur  follow  these  well,  given  three  times  daily.  The  patient 
should  bo  in  a  recumbent  posture  upon  the  back. 

-   ■         Luxations,  or  Dislocations.  .  " 

These  consist  in  the  removal  of  the  head  of  the  bone  from  its  corro 
eoonding  cavity,  where  it  forms  the  joint.  After  dislocation  is  i educed, 
the  joint  may  be  bathed  with  a  lotion  of  forty  drops  of  tho  tincture  of 
Aconite  in  half  a  tumbler  of  water,  while  four  globules  may  be  used 
iuternally  to  allay  any  febrile  excitement.  Arnica  lotion  prepared  and 
used  in  the  same  way  will  relieve  the  soreness.  The  usual  dose  of  this 
remedy  may  be  administered  internally,  and  repeated  two  or  three  times 


[•ves.  Shocks 
Iracting  teeth, 
sual  dose,  and 


ed,  puncturi'd. 
only  tlio  xiilos 
I)laster.     Thi 

biling.  Laco- 
li:;,  and  then 
nro  of  Calen- 
re  implicated, 
internally,  in 

A  require  com- 

iuta,  and  Hy- 

lally. 


jivo  Arnica  or 
ps  of  either  in 
xternally. 


Tsons.  One  is 
ornied  umbilical, 
le  sack  descends 
hernia.  When 
mst  be  worn,  or 
it  inclination  to 
ims.  Arnica,  if 
1  of  the  bowels, 
se,  three  or  four 
I  very  half- hour : 
lycopodium  and 
^     The  patient 


e  from  its  corro 
ition  is  I  educed, 
the  tincture  of 
33  may  be  used 
an  prepared  and 
3ual  dose  of  this 
JO  or  three  times 


8UB0I0AL  DISEASES. 


823 


R  day.     To  remove  the  pain  and  sufForing  of  luxations  in  general,  Arnica^ 
Aconite,  and  Rhiui  tox.  may  be  given  as  required. 

« 

Fractures. 

When  there  is  a  separation  of  bony  fibres,  either  simple  or  compli- 
cated, and  the  fracture  has  been  properly  reduced  and  bandaged,  and 
splints  have  been  called  into  requisition  to  aid  the  system  in  recovery 
t'roin  the  shock,  give  two  or  three  doses  a  day  of  Arnica  internally,  and 
wet  the  bandages  with  a  lotion  of  the  same.  If  there  is  fever,  give 
Aeonite  or  Bryonia. 

Bums  and  Scalds. 

By  a  burn  is  understood  a  sore  or  blister  caused  by  dry  heat.  By 
scald  is  understood  that  produced  by  some  heated  fluid,  as  water,  spirits, 
or  oil.  The  former  is  soonest  relieved  by  the  application  of  cotton,  pro- 
vided the  skin  is  not  broken.  The  latter  by  cotton  dipped  in  lime-water. 
If  the  skin  is  broken,  it  will  be  necessary  to  use,  in  each  instance,  a  sah"^ 
made  of  lard  and  finely  prepared  caroonatc  of  linio.  In  all  cases  of 
burns  or  scalds,  internal  remedies  are  required ;  Aconiie,  in  ca-se 
of  much  fever;  Arsenicum,  or  Gantharis,  if  there  is  much  l)iiniinj^, 
smarting,  and  thirst;  Apis  met.,  if  there  is  swelling,  and  infl.uu- 
mation  following  as  a  sequel. 

Snake  Bites. 

These  are  to  be  treated  somewhat  afler  the  manner  of  the  bites  of  rabid 
animals :  that  is,  by  dry  or  radiating  heat  at  first,  and  then  by  cauteriza- 
tion ;  internally,  LacJiesis,  Apis  melificn,  and  Hyoacyamus.  Either  may 
be  given  every  two  hours ;  at  the  same  time,  there  is  good  authority  foi 
drinking  copiously  of  whiskey  or  other  alcoholic  spirits.  Several 
drops  of  tincture  of  Iodine,  repeated  every  fifteen  minutes,  have 
saved  some  cases. 

Stings  of  Insects. 

Aconite,  Belladonna,  Merc,  viv.,  are  remedies  for  internal  administra- 
tion, either  of  which  may  be  given  three  times  a  day  ;  Arnica  lotion,  weak 
solution  of  Nitric  acid,  or  Lemon  juice,  may  be  applied  externally. 
Dilute  Aqua  ammonia  is  a  good  antidote  as  a  lotion. 

The  Removal  of  Tumors. 

Nearly  all  tumors  require  removal  with  the  knife.  It  is  not  our  pur- 
pose to  specify  the  nature  of  the  operation,  but  rather  to  point  out  a 
treatment  to  be  pursued  after  their  removal.  When  cancerous  tumors 
are  removed,  Arsenicum  should  be  persistently  given,  every  three  or  four 
hours,  with  the  view  of  preventing  the  cancerous  diathesis,  or  condition 
from  reproducing  the  same.  Where  fibrous  tumors  are  cut  out,  give  CaZen- 
dula  three  or  four  times  a  day,  and  apply  it  to  the  wound.  Adipose 
tumors  require,  aftjr  their  removal,  Pulsatilla,  three  or  four  times  a  day. 
Fungous   tumors   require,  afler  removal,  Calcarea.     The  fungoid   oi 


J 


m 


i  -i  n 


^::-.'ii 


824 


BURQIOAL  DISEASES. 


medullary  tumors  are  mainly  subject  to  medical  treatment,  and  various 
r  jmedies  may  aid  in  curing  them.  Conium,  Arsenicum,  Sulphur,  Cvr 
prum  met,  and  Oalcarea  may  bo  consulted.  Encysted  tumors  are  em- 
bedded in  the  skin,  and  require  dermic  treatment.  Nitrum,  Natrum 
muriaticum,  and  Natrum  carb.  may  be  employed,  internally  and  extor- 
nnlly.  Scrof'idous  tumors  require  Arsenicum,  Qraphiles,  Juglatu  regia, 
and  Calendula.  The  two  last  named  may  be  used  internally  and  exte^ 
nally.  ScrofulouH  tumors  require  Arsenicum,  Graphites,  and  Ca- 
lendula.  The  two  last  named  may  bo  used  intonially  and  oxtcrnuUy, 
sovoral  times  ii  day. 

Lumbar  Abscess.  .  - 

A  very  malignant  sore,  that  discharges  a  cheesy  matter,  and  from  wliirh 
very  few  recover.  Calendula,  Hepar  eitlphur,  and  H^ercurius  may  be 
given  internally,  and  Calendula,  Saptisia,  and  Arnica  may  be  used  \t\ 
the  form  of  lotions,  to  apply  externally. 

Uloeration  of  the  Bone. 

For  bone  ulcers,  Aurum  met.,  Silicea,  and  Calcarea  may  be  given  in 
daily  doses,  —  one  remedy  only  at  a  time:  Aurv/m  met.,  for  bone  ulcers 
caused  by  syphilis ;  Silicea,  'f  from  injury ;  Calcarea,  if  from  scrofula. 
For  ulceration  of  the  hip-joint,  Arsenicum,  three  times  a  day  ;  of  the  knee- 
joint,  Sulphur,  or  perhaps  Pulsatilla,  twice  a  day. 

"Bidketa.—Bachitis. 

Disorder  of  the  nntridve  functions  may  end  in  distortion  of  various 
parts  of  the  system,  and  give  rise  to  various  deformities  of  the  I'.ead,  trunk, 
and  extremities.  Remedies  directed  to  the  digestive  system  must  first  be 
employed,  in  order  that  a  healthy  nutrition  may  be  established.  Nux 
vomica,  Pulsatilla,  Ferrum,  and  China,  either  of  which  may  be  given  in 
the  usual  dose  three  times  a  day ;  after  which,  Calcarea  carb.  may  be 
given  in  diiil3^  doses  persistently,  followed  by  Silicea.  Good  animal 
food  niiiy  be  allowed  as  a  diet.  Frequent  bathing  with  salt,  water, 
and  friction,  are  also  to  bo  commended. 

White  Swelling.       ~       1     - 

This  is  a  form  of  scrofula,  and  requires  the  same  remedies  used  in  other 
scrofulous  complaints.  Arsenicum,  J'>divm,  Calcarea,  and  Sulphur  may 
be  employed  ;  and  whichever  remedy  is  (.elected  may  be  given  twice  in 
twenty-four  hours.  Pulsatilla,  Bryonia,  and  Nux  vom.,  in  like  manner, 
ma^  be  given,  one  at  a  time,  and  repeated  every  four  hours,  when  there 
is  any  pain  in  the  affected  joints. 

Dropsy  of  the  Joints. 

Friction  externally,  and  some  kind  of  soap  liniment,  and  then  the  ap- 
plication of  compresses.  Apia  melijiea  may  be  given  internally,  every 
four  hours,  or  else  Puhatilla,  Arsenicum,  Bryonia,  or  Conium. 


*\..., 


t,  and  various 
Sulphur,  Cur 
mors  are  em- 
ram,  Natrum 
Ely  and  extcr- 
higlaru  regia, 
\y  and  exter 
lies,  niul  Ca- 
nd  cxternully, 


nd  from  wliioh 

urins  may  be 

lay  be  used  in 


lay  be  given  in 

for  bone  ulcers 

from  scrofula. 

y  ;  of  the  knee- 


•tion  of  various 
the  head,  trunk, 
;m  must  first  be 
tablished.  Ifias 
may  be  given  in 
ta  carb.  may  be 
Good  animal 
ith  salt  water, 


ies  used  in  other 

id  Sulphur  may 

given  twice  in 

in  like  manner, 

ars,  when  there 


nd  then  the  ap- 
ntemally,  every 
)r  Gonium. 


BUBQIOAL  DISEA8E& 


825 


Stiff  Joints.— -4ncAy?oai«. 

This  difficulty  involves  the  tendons,  ligaments,  and  bones,  which  in 
some  instances  become  united  at  'heir  extremities.  These  joints  may  be 
showared  with  cold  water,  rubbed  with  a  stiff  brush,  bathed  with  soap 
liniment ;  while  Sulphur,  in  daily  doses,  may  be  given  intemallj,  or  else 
Aurum  mur..  Nitric  add,  or  Jodivm. 


Anonrism. 

Aneurisms  are  pulsating  tumors  formed  of  arterial  blood.  Aconite  is  a 
good  remedy  to  administer,  three  or  four  times  a  day  ;  Digitalis,  also,  in 
the  same  way ;  Valerian,  in  the  usual  dose,  when  the  tumor  appears  to 
be  in  the  abdomen.  For  Varico8E  Aneurism,  bandaging  is  required, 
while  Samamelis  Virg.  may  be  administered  internally. 


Varicose  Veins. 

When  the  entire  lower  extremities  are  involved,  bandaging  with  a 
roller,  or  lace  stocking,  must  be  employed,  while  Hamamelis  Virg.  is 
administered  several  times  a  day,  internally.  Pulsatilla,  for  preg- 
nant women  thus  aftected,  and  follow  with  Lycopodium,  after  three 
weeks. 

,  Goitre. — Bronchocde. 

This  is  an  enlargement  of  the  thyroid  gland,  and  causes  a  swelling  of 
the  neck.  Jodium,  ex  ^rnally  and  internally,  is  said  to  be  a  sure  remedy. 
Kali  hydriodicum,  the  usual  dose  three  or  four  times  a  day,  may  also  be 
used.  Spongia  is  also  a  valuable  remedy,  and  so  also  are  Merc,  iod., 
Merc,  biniod.  The  remedies  must  be  used  persistently  until  the  goitre 
disappears. 

Wry  "SQck,— TorticoUia. 

This  is  owing  to  the  contraction  of  some  of  the  cervical  muscles*) 
Stimulating  liniments  may  be  employed  externally,  while  Nuxvom., 
Uhvs,  Sulphur,  Bryonia,  or  Pulsatilla  may  bo  administered  in-> 
ternally. 

Fistula  in  Ano.      ,  - 

This  difficulty  requires  Silicea,  Calcarea,  or  SvXphur,  in  daily  doses, 
if  an  oppi^tion  has  been  performed,  and  the  Sphincter  ani  has  been 
divided,  -nica  may  be  given  three  or  four  times  a  day,  or  perhaps 
Valendu  J ;  after  which,  consult  PvhatiUa  and  Nvx  torn. 

104  '':  ,    :■.■■■  ■     '         ■ 


'\    : 


-mi 


iki 


iiJBA<SMjikSi££i^ 


'm 


DISEASES  OF  WOMEN.    ' 


Derangement  of  the  Fanotion  of  Menstiaatlon. 

From  the  age  of  puberty  until  the  change  of  life,  the  health  of  the 
female  system  depends  upon  regular  menstruation,  varying  in  intervals 
from  twenty-six  to  twenty-nine  days.  With  this  standard  in  view,  the 
irregularities  as  to  time  are  easily  noted.  By  the  period  of  puberty  is 
understood  the  age  capable  of  bearing  children,  which  is  denoted  by 
menstruation  taking  place. 

''        Ailments  at  the  Age  of  Puberty. 

Immediately  preceding  the  first  menstrual  period,  the  breasts  increase 
in  size,  the  voice  is  changed,  the  system  becomes  rapidly  developed,  and 
the  mind  matured.  There  may  be  headache,  dulncss  of  the  eyes, 
pains  in  the  lower  abdomen,  lassitude,  capricious  appetite,  and,  not 
unfrequently,  a  premonitory  leucorrhcea.  To  relievo  these  ailments, 
Aconite;  four  globules  may  be  given  first ;  Pulsatilla  may  be  given 
after  Aconite,  to  remove  the  pains  in  the  abdomen,  and  to  promote 
menstruation.  If  there  is  much  pain,  and  the  function  is  tardy  in 
making  its  appearance,  give  Galcarea  or  Sulphur,  and  then  follow 
"with  Pulsatilla  every  four  or  six  hours  until  the  period  commences. 
In  case  of  considerable  leucorrhcea,  give  Sepia,  or  perhaps  Gra- 
phites. When  the  periods  become  established,  they  should  last 
from  three  to  five  days.  If  scanty  at  first,  give  Ferrum,  and  follow 
with  Pulsatilla;  if  there  is  intense  headache,  give  Belladonna',  if 
there  is  hysteria,  and  much  agitation  and  suffering,  give  Hyoscyamus ; 
and,  during  the  interim,  let  the  young  iady  take  strengthening  food 
until  signs  of  the  recurrence  of  another  period.  If  it  comes  on 
normally,  it  is  well ;  but  if  ;ardy  or  painful,  resort  again  to  Pul- 
satilla, Hyoscyamus,  Belladonna,  and  Graphites,  as  they  may  be 
indicated ;  and  continue  this  treatment  from  time  to  time  until 
regularity  is  established.  If  tardy,  with  pains  in  the  back,  Kali 
carb. 

Interrapted  Menstmation. 

Tliis  may  be  caused  by  cold,  fright,  fevers,  diarrhoea,  and  dysentery, 
and  by  pregnancy.  When  by  cold,  or  getting  the  feet  wet.  Aconite,  at 
first,  to  remove  any  febrile  excitement  or  headache,  and  then  Pulsatilla, 


DISEASES   OF   WOMEN. 


827 


tioa. 

e  health  of  tha 
ring  in  intervals 
ird  in  view,  the 
I  of  puberty  is 
is  denoted   by 


breasts  increase 
developed,  and 
53  of  the  eyes, 
petite,  and,  not 
these  ailments, 
a  may  be  given 
md  to  promote 
ition  is  tardy  in 
ind  then  follow 
iod  commences. 
r  perhaps  G^n- 
ey  should  last 
'um,  and  follow 
Belladonna',  if 
6  Hyoscyamus ; 
mgthening  food 
If  it  comes  on 
again  to  Pul- 
8  they  may  be 
3  to  time  until 
the  back,  Kali 


,  and  dysentery, 
wet.  Aconite^  at 
then  PuUatilla. 


If  this  fail  to  remove  the  obstmction,  give  Calcarea,  and  follow  with 
IJ'ux  mosv.hata ;  should  this  ii\\\,\vy  tiulphur.  When  menstruation 
is  interrupted  by  fright,  and  there  is  intense  headache,  give  Aconite, 
and  follow  with  Belladonna  or  Ignatia,  and  finally  with  PuUatiVa. 
When  fevers  weaken  and  depress  the  system,  so  as  to  interrupt  the 
function,  first  reduce  the  fover,  and  then,  by  properly  nourishing  the 
patient,  the  period  may  return.  The  same  rule  may  be  observed  in 
treating  the  interruption  caused  by  Diarrhoea  or  Dysentery.  These 
diseases  should  be  treated  and  cured  by  appropriate  remedies,  and 
the  period  will  be  likely  to  return  spontaneously.  If  otherwise, 
resort  may  be  had  to  Pulsatilla,  Belladonna,  iSej)ia,  Calcarea,  and 
other  remedies,  according  to  indications. 

Excessive  Menstraation. 

When  the  flow  is  excessive  or  weakening,  Ipeaac.  and  China  may  be 
employed,  —  the  first  to  regulate,  the  last  to  strengthen  the  system  ;  and 
this  treatment  will  be  found  necessary  at  each  pt  riod,  until  duly  vogu 
lated.     Calcarea  should  be  given  once  daily  between  the  periods. 

Menorrhagia,  or  Profuse  Bleeding  from  the  Womb. 

This  indicates  a  want  of  tone  in  the  uterus,  if  noi  a  state  of  disease, 
and  is  usually  attended  with  fainting,  pain  in  the  back,  nausea,  and  liys- 
teiia.  When  from  a  want  of  tone,  or  debility,  CJuna  or  Ferrum  may 
arrest  the  difficulty  ;  if  from  disease  or  inflammation,  Belladonna  or  Ar- 
unlearn. ;  when  there  is  fainting  and  nausea,  Ipecac.  ;  pain  in  the  back, 
Nnx  vomica,  Nux  moschata,  ov  Ljnatia,  especially  if  the  flow  is  dark 
or  almost  black,  with  fainting  and  drowsiness ;  for  hysteria,  give 
ili/o.sci/amns.  The  patient  should  lie  iu  bed  until  relieved,  and 
should  begin  sitting  up  with  great  caution.  A  generous  diet,  easy 
of  digestion,  should  be  supplied  patients  of  this  description.  When 
the  strength  will  permit,  this  class  of  patients  should  seek  fresh  air, 
and  should  avoid  warm  baths.    Bathing  with  tepid  water  is  far  better. 

Painful  Menstruation.  —  Dysmenorrhceu. 

Some  ladies  suffer  intensely  at  every  menstrual  period.     They  have 
chills,  headache,  fever,  colic,  and  most  excruciating  pains  in  the  womb. 
Acanite  must  be  given  for  the  fever,  Belladontta  for  the  chills  and  head 
ache,  Colocynth  for  the  colic,  and,  for  the  pains  in  the  uterus,  Hyos- 
cyamus, Pulsatilla,  Oimicifuga,  or  Ilhus. 

Ailments  attending  Change  of  Life.  •, 

This  occurs  about  the  forty-fifth  year  of  life,  and  is  denoted  by  irregu 
larities,—  profuse  menstrual  periods,  great  irregularities,  pam  in  tlie  litnul, 
melancholy,  mania,  loss  of  memory,  and  great  nervous  depression,  box 
profuse  m'enstruation  at  this  jwriod,  give  Arnica  or  Lachem ;  tor  head- 
aclie,  Belladonna  or  Sepia;  lor  intens.-  pains  in  the  womb,  ArmncHm 
and  Conium;  lor  Melancholy,  Larh-ais,  or  perlmps  Petroleum;  lui 
mania  Stramcninm  :  for  loss  orui.-m-.rv,  SiJphur,  China,  or  Calcarea. 


\  ■« 


. 


828 


mScu^lUI  OF  WOMKM. 


Ailments  daring  Pregnancy. 

Some  ladies  are  ♦-oubled  much  with  morning  sickness  in  the  early 
stage  of  pregnancy,  and  this  is  often  cured  with  Cocculua  or  Nux  vomica ; 
if  with  heartburn,  Cimicifuga  or  Mercurius  viv. ;  if  with  water-brash 
of  a  hot  or  acrid  nature,  Arsenicum.  Sometimes  these  derangements 
are  so  stubborn  that  no  remedies  seem  to  relievo.  /Simple  sirup,  by 
the  wineglassful,  has  been  taken  by  some,  Champagne  wine  by 
others,  hard  Cider  by  others.  The  simple  resort  will  sometimes 
relieve ;  and,  at  others,  nothing  seems  to  afford  relief.  Discharge 
t)f  blood  from  the  uterus  may  be  cured  with  China.  Leucorrh(Ea, 
Tery  profuse  and  debilitating,  requires  Sepia  twice  a  day ;  corroding 
discharges,  Calcarea  twice  a  day ;  for  rheumatic  pains,  Caulophyl- 
lum ;  for  painful  breasts,  bathe  with  Phytolacca ;  for  threatened  mis- 
carriage, Ipecac,  8ahina,  China,  Arsenicum,  and  Belladonna;  for 
sleeplessness,  iVwas  vomica  or  Ars.,  and  a  light  diet  at  night;  for 
nose-bleed,  Carbo  veg..  Aconite,  Belladonna,  Lachesis,  and  Jfer- 
curius,  a  dose  of  any  one  of  them  twice  a  day. 


J     . 


A . 


V  .      .' 


in  the  earlj 

Niix  vomica ; 

I  wiiter-brash 
iorangements 
nple  sirup,  by 
ffne  wine  by 

II  sometimes 
Discharge 

lEUCORRHCEA, 

ay ;  corroding 
3,  Gauliyphyl- 
ireatened  mis- 
'lladonna;  for 
at  night;  for 
sis,  and  Jfer- 


lABOR,  PARTURITION. 


False  Fains. 


There  is  a  kind  of  pain  that  afflicts  parturient  women,  that  simply 
aggravates  and  imsettl(3S  the  nerves.  Gimicifuga  or  Gaulophyllum 
will  usually  control  this.  When  true  labor  pains  commence,  they 
may  be  regarded  as  normal  if  they  come  at  regular  intervals,  and 
increase  in  force  and  frequency  as  the  labor  progresses.  No  medi- 
cine is  needed  ;  and  waiting,  with  patient  labor,  will  accomplish  the 
object.  After  the  child  is  born,  a  dose  of  Pulsatilla  will  aid  in  ex- 
pelling the  placenta.  If  thei'e  is  hemorrhage,  elevate  the  hips  and 
depress  the  head,  and  give  a  dose  of  jSecale  cornutum;  if  anything 
more  complicated  occurs,  call  on  an  experienced  midwife. 


'     '  .  •  Milk  Fever.    ^ 

About  the  third  day  after  labor,  there  is  a  struggle  in  the  system  to  fill 
the  breasts  with  milk,  attended  with  fever.  Give  Bryonia  or  Pul- 
satilla; if  the  milk  is  tardy  in  coming,  give  Galcarea. 

Difficult  Urination. 

After  labor,  there  may  be  difficulty  in  passing  urine,  which  Ar- 
senicum or  Hyoscyamus  will  usually  relieve,  if  aided  with  cloths 
wrung  out  of  warm  water  applied  to  the  region  of  the  bladder ;  or 
else  Aconite  may  be  used  instead  of  Hyoscyamus^  and  sometimes 
Pulsatilla,  or  Gantharis. 


t-    V 


1    ■!  '    1. 


■»  Soreness  after  Deliv.:iy. 

A  painful  soreness  of  the  muscles  after  delivery  may  be  relieved  liy 
the  internal  administration  of  drop  doses  of  Arnica  in  a  spoonful  of  water, 
while  at  the  same  time  a  towel  wet  with  Arnica  tincture  may  bo  ppplied 
to  the  abdomen.  If  there  is  soreness  of  the  vagina,  forty  Hrops  of  the 
tincture  of  Calendula,  in  half  a  pint  of  tepid  water,  may  used  as  an 
injection. 


■^'  -yj 


m 


■   -r- 


<30 


LABOR,  PARTUBITIOJl. 


t:- 


OoDStipation  of  the  Bowels. 

This  condition  after  labor  may  be  removed  by  one  or  two  doses  of  Nva 
t'oinica^  or  perhaps  by  the  same  of  Lycopodium  ;  if  they  fail,  the  bowels 
siiould  1)0  moved  by  an  enema  of  warm  salt  water. 

V  r 

■^       Excoriated  Nipples. 

Soon  after  the  breasts  fill  with  milk,  and  the  child  begins  to  nurse,  the 
nippies  are  apt  to  become  sensitive,  and  sometimen  exceedingly  sore.  For 
I  little  sensitiveness,  or  slight  irritation,  bathing  the  breasts  with  a  solu- 
tion of  Arnica  will  help  them ;  or  perhaps  a  solution  of  powdered  Boraa. 
will  do  as  well.  If  the  soreness  amounts  to  a  decided  inflammation,  and 
tho  'Xterior  of  the  nipples  crack  and  bifod,  a  more  careful  and  efficient 
treatment  is  needed.  When  putting  the  child  to  ihe  breast  excites  great 
pain  in  the  gland,  and  seveYe  after-pains  at  tho  stime  time,  the  internal 
administration  of  Belladonna  is  necessifr}', —  two  or  three  doses  during 
twenty-four  hours  ;  and,  at  the  same  time,  wet  a  compress  with  Arnica 
cincture,  and  apply  to  the  nipple.  Arnica  also  msiy  be  given  internally. 
When  Belladonna  fails,  Bryonia^  when  the  ])ains  are  worse  in  damp,  cold 
weather.  As  an  external  ap[)lication,  a  decoction  of  Oak  hark  has  been 
found  isetwl,  and  also  the  same  of  the  Apple-tree  root.  A  solution  of 
Alwii  Tannin^  or  Sulphate  of  zinc,  has  been  employed  ;  but  if  the  -ikin 
is  crat  d,  and  blood  oozes  out  every  time  tho  child  nurses,  it  is  of  little 
service  A  weak  solution  of  Ititric  acid  is  better,  two  drops  to 
an  ounce  of  water.  The  best  external  application  for  healing  tho 
cnu-ks  is  the  Glycerole  of  aloes,  which  is  made  by  dissolving  one 
oiinco  Aloes  in  four  ounces  of  Glycerine.  This  is  the  best  prepara- 
tion known  to  heal  an  inflamed  and  cracked  surface  on  any  part  of 
the  body.  At  the  same  time,  Sulphur,  Hepar  sulphur,  Calcarea, 
and  Nitric  acid  may  be  administered  internally.  It  is  hardly  neces- 
sary h)  add,  that  whatever  lotion  is  used  externally  must  be  carefully 
washed  ofl"  with  warm  milk  and  water  before  the  child  is  allowed  to 
nurse. 


Suppression  of  the  Milk. 

Aftflr  tlic  breasts  have  once  filled  with  milk,  and  it  disappears,  a  return 
iniiv  1 1"  promoted  by  the  internal  use  of  Ccdcarea  carbonica,  followed 
with  Pulsatilla,  or  Phytolacca,  while  the  patient  is  required  to  drink 
chocolate,  or  table  beers. 

Induration  of  the  Breasts. 

When  the  breasts  cake,  or  portions  of  them  seem  hard,  like  a  potato, 
rub  them  well  with  lard,  and  give  internally  Oarho  animalis.  In  a  ma- 
jority of  inst'.nces,  these  I'ard  cakes  will  disappear  if  carefully  attended 
to.  When  lard  fails  tn  soften,  try  dry  rubbing  with  the  hand.  If  the 
breasts  ache,  give  Belladonna;  if  there  Is  fever,  Aconite,  or  Phytola,cca.  If 
iuflanimation  sets  in,  and  cannot  be  scattered,  give  Hepar  s\ilphur  U)  hasten 
it  Ui  a  crisis.    Poultices  of  flaxseed  meal  may  also  be  applied  to  hasten  suppu 


.  I  1 1,11,1  II!  I.U!1I,W« 


■- 1 


wo  doses  of  iVke 
fail,  the  boweU 


LABOR,  PARTUBITION. 


831 


ration.  If  it  is  found  necessary  to  lance  the  abscess,  lut  it  be  done  with 
an  opening  in  the  direction  of  the  milk-ducts,  and  not  across  them  ;  for, 
when  once  severed,  the  parts  never  nnite  perfectly  again.  After  the 
matter  lias  discharged,  some  emollient  sulve  spread  on  chamois  skin  may 
be  applied,  for  the  double  purpose  of  protecting  the  breasts  and  healing 
the  sore. 


;ins  to  nurse,  the 
ingly  sore.    For 
ist3  with  a  solu- 
jowdered  Boras. 
iflamraation,  and 
;f'ul  and  efficient 
east  excites  great 
ime,  the  internal 
iree  doses  during 
)res3  with  Arnica 
given  internally, 
rse  in  damp,  cold 
ik  hark  has  been 
A  solution  of 
but  if  the  .?kin 
•ses,  it  is  of  little 
T,  two  drops  to 
ff)r  healing  the 
Y  dissolving  one 
the  best  prepara- 
i;e  on  any  part  of 
iphur,  Calcarea, 
;  is  hardly  neces- 
mist  be  carefully 
ild  is  allowed  to 


isappears,  a  return 
arbonica.  followed 
required  to  drink 


ard,  like  a  potato, 
imalu.  In  a  wia- 
carefully  attended 
the  hand.  If  the 
,  or  Phytolacca.  If 
tr  sndphur  to  hasten 
ed  to  hasten  suppu 


Suppression  of  the  Lochia. 

Tlie  flowing  after  delivery  is  termed  "  Lochia,"  and  should  continue  foi 
ten  days  or  two  weeks.  If,  through  any  unfavorable  induences,  the  flow 
is  suppressed,  the  whole  system  will  be  more  or  less  disturbed.  If  simply 
arrested,  Pulsatilla  may  be  given  every  two  hours,  for  at  least  a  day  ;  and, 
if  there  is  no  return,  give  Secaie  comtUum.  If  still  the  8ui)pressiou 
seems  stubborn,  and  the  head  begins  to  feel  light,  and  the  nerves  become 
unstrung,  give  Hyoscyamus,  and  reoeat  every  three  hours  until  better, 
or  there  is  indication  tor  a  change.  Sulphur  will  sometimes  remove  the 
difHculty.  If  the  light-headedness  be  very  marked  and  maniacal,  and 
there  is  no  inclination  to  sleep,  a  decided  advantage  may  be  found  in  the 
use  of  Belladonna.  If  the  lochia  should  finally  return,  and  be  of  offen- 
sive odor,  give  Iihu8  tox.;  if  much  thirst  and  dryness  of  the  throat,  Arsen- 
icum; in  case  of  diarrhoea,  Arsenicu7n  and  Mercuriua  viv..,  repeated 
every  two  hours.  The  application  of  tepid  cloths  to  the  abdomen  is  rec- 
oininended,  until  the  lochia  returns.  Should  the  lochia  continue  too 
long,  —  that  is,  beyond  the  seventeenth  day,  —  Rhus. 

,'  Child-bed  Fever. 

A  low  form  of  fever  frequently  sets  in  about  the  fourth  or  fifth  day 
after  confinement,  sometimes  severe  enough  to  prostrate  the  patient  for 
weeks.  Every  day,  she  will  suffer  from  pain  in  the  head  and  copious 
perspiration ;  the  hair  falls  out.  This  fever  sometimes  continues  until 
a  diarrhoea  sets  in,  and  the  patient  sinks  into  a  typhus  and  expires. 
Therefore,  at  the  first  manifestation  of  this  fever,  Bryonia  should  be 
given  every  three  hours  ;  and  this  may  be  followed  with  Rhtis  tox.,  in  the 
same  manner.     In  case  of  diai'rhoea  and  prostration,  give  Arsenicum  or 

Veratrum  album.  If  there  is  sallowness  of  the  complexion,  give  Mer- 
curial viv.  A  very  light  mutton-broth  may  be  given  for  nourishment. 
Should  there  be  a  general  pain,  and  aching  of  the  whole  body,  give 
Phosphorus  two  or  three  times,  and  especially  if  the  diarrhoea  should  be 

lark  and  watery.  If  the  fever  should  be  subdued,  and  convalescence 
established,  allow  the  patient  a  little  wine  and  water,  beef-tea,  and  a  grad- 
ual approach  to  more  substantial  aliments.  Should  the  above  reme- 
dies fail,  any  typhoid  symptoms  present  themselves,  Baptisia,  hourly. 

Leaoorrhoea  afker  Oonfinement. 

A  flux  of  this  kind  may  result  from  general  debility,  and  r  'quires  for 
its  removal  a  good  nourishing  diet.  (Mina  may  be  given  three  or  four 
limes  a  day  at  first,  and  aflerwards  Sqna  or  Calcarea. 


n 


^1 


.-•ieiii!-'-- 


832 


LABOR,  PAFTUBITIOlf. 


Falling  of  the  Womb. 

In  some  cases,  after  child-birth,  there  will  be  falling  of  the  womb. 
This  may  be  the  result  of  a  weakened  condition  of  the  muscles  that  retain 
the  womb  in  its  place.  When  this  trouble  is  of  an  agp;ravated  form,  and 
is  attended  with  copious  Leucorrh<jea,  Nux  vomica  may  be  given  every 
evening.  The  patient  should  allow  herself  to  be  as  little  upon  the  fen', 
as  possible,  —  rest  being  one  of  the  essential  conditions  for  gaining 
strength  and  for  obviating  the  difficulty.  '  . " 


"  i'  Hemorrhoids,  or  Piles.  ^ 

For  the  piles  consequent  upon  a  tedious  labor,  Arnica  may  be  given 
every  morning  and  evening,  or  perhaps  Mamamelis,  if  they  are  inchned 
to  bleed ;  also  Ntix  vomica  and  Sulphur^  when  there  is  severe  constipa- 
tion and  hemorrhage  at  every  stool.  Sulphur  in  the  mornuig,  and  Nux 
vomica  in  the  evening.  Stewed  prunes,  Graham  toast,  and  chickeo 
loup,  may  enter  into  the  diet. 


i! 


f  .      ' 


'N    ,  • .  ■• 


of  the  womb, 
scles  that  retain 
vated  form,  and 
be  given  every 

upon  the  feo'. 
>ns   for  gaining 


I  may  be  given 
ley  are  inchned 
severe  constipa- 
•rning,  and  Nux 
it,  and  ckickeD 


>  '     < 


DISEASES  OF  INFANTS. 


Crying. 

When  a  young  infant  is  inclined  to  cry  continuully,  and  sleeps 
hut  little,  give  it  one  or  two  globules  of  Cojea,  and  repeat  every 
four  hours. 

Oolio. 

For  infantile  colic,  which  may  be  caused  by  flatulence,  give  Cham< 
omiUa ;  put  one  or  two  globules  upon  its  tongue.  If  this  does  not 
relieve,  give  a  globule  of  Nux;  if  restless,  and  throws  up  its  food, 
after  the  Nux,  give  a  globule  of  Ooffea.  Verat.  album  is  an 
excellent  remedy  for  infantile  colic,  and  Dioscorea  has  a  great 
reputation. 

Infantile  Diarrhoea. 

There  will  generally  be  a  diarrhoea  after  an  infant  has  nursed  the 
first-fruits  of  the  breast.  If  excessive,  give  one  or  two  globules  ol 
Puhalina ;  if  attended  Avith  colic,  give  the  same  of  Ghamomilla ; 
if  the  diarrhoea  is  acrid  or  scalding,  give  Arsetticum,  one  or  two 
globules  ;  if  with  excessive  vomiting,  give  Ipecac. 


'       Infantile  Dysentery. 

When  young  infants  are  observed  to  strain,  and  have  frequent  stool; 
and  sometimes  pass  mucus  and  blood,  give  Ipecac.^  one   globule,  or  eke 
Mereuriusi     If  they  cry  out  after  each  stool,  and  the  intestine  protrudes, 
give  one  or  two  globules  of  Ignatia.     If  they  refuse  the  breast,  give 
Aconite.     In  case  of  heat  in  the  head,  give  Belladonna. 


Inability  to  take  the  Breast. 

Some  infants  are  congenitally  opposed  to  nursing  the  breast ;  and  all 
the  coaxing  and  trying  which  a  patient  perseverance  can  8ui>ply  avails 
but  little.  Such  infants  require  to  be  fed ;  and  to  devise  for  them  a  good 
and  wholesome  nouiishment  is  sometimes  difficult.  The  nursing-bottle 
must  take  the  place  of  the  breast,  and  the  child  t  >t  be  nourished  by  it. 
One  of  the  best  preparations  of  food  for  young  infants  is  a  thin  grue) 

105 


i|'i 


mado  of  a  tnble-spoonfiil  ot  unbolted  flour  to  a  quart  of  water,  to  be 
boiled  balf  an  bour,  and  then  strained  throuf;h  a  fine  strainer,  sweetened, 
and  put  into  a  nursing-bottle  sufficiently  tliin  to  flow  through  tiie  tube. 
This  food  may  be  enriched  with  a  little  good  milk,  as  the  child  requires 
it.    Nothing  has  so  unifortnlj  answered  as  a  substitute  for  the  breast. 


I 


. ''.       Infantile  Jaundice.  . 

Young  infants  sometimes  become  yellow,  and  their  skin  affords  evident 
si^ins  of  jaundice.  One  or  two  globules  of  Merouriua  viv.,  followed  by 
oiii.'  or  two  of  Pulsatilla,  will  change  tiiis  condition.  If  frequent  dis- 
c'huigi's  from  tiie  bowels  (ccur  after  these    remedies,  give  one  or  two 

(ili)liulos  of  Amenicum. 

■  '  I 

Snuffles. 

In  cold  weather,  young  infants  are  prone  to  take  cold  easily,  from  the 
bliglitcst  change  :  and  they  will  show  it  by  sneezing  and  snuffling:  occasion- 
ally tiiero  will  he  indications  of  fever,  and  heat  in  the  head.  One  or  two 
kIo1)uIl's  of  Acotiite  may  be  given  first  and  then  one  or  two  of  Nhx  vomica. 
If  there  \s  thin  discharge  from  the  nose,  give  a  globule  or  two  of 
Arsenicum.     Sambucus,  twice  daily,  is  a  good  remedy. 

Sore  Mouth,  Aphth89. 

Considerable  uneasiness  is  manifest  in  young  children  from  a  percepti- 
ble inflammation  of  the  mucous  membrane  of  the  mouth.  It  will  look  red 
and  inflamed,  and  there  will  be  perceptible  some  little  points  or  pimples 
of  a  whitish  character.  Give  one  or  two  globules  of  Mercurius  or  Bn/' 
onia,  and  wash  the  mouth  with  warm  tea,  or  milk  and  water.  Some  have 
introduced  into  their  mouths  a  little  powdered  Borax.  This  difHculty  is 
generally  of  brief  duration,  and  is  but  a  trifling  malady. 


■'% 


Throsli. 


This  is  also  a  sore  i  iOntb  to  which  infants  are  subject,  and  a  .it tie  more 
serious  in  its  charactei.  The  child  first  has  fever,  and  then  refuses  to  take 
its  food.  On  examining  the  mouth,  it  is  found  to  contain  a  number  of 
wlii*:e  blisters  that  have  a  sore  and  inflamed  appearance.  One  or  two 
globules  of  Phosphorus  will  often  cure  the  trouble.  Bryonia  has  also  been 
used.  Mercurius  viv,  may  also  be  used.  A  decoction  of  black  tea  may 
constitute  a  wash  ;  also  a  weak  solution  of  Borax.  Good  nursing,  and 
care  to  prevent  taking  cold,  are  essential.  If  with  thid  kind  of  sore  mouth 
there  is  diarrhoea,  give  one  or  two  globules  of  Arsenicum.  If  the  child 
cries  much  from  colic,  one  or  two  globules  of  Colocynth  may  afford  relief. 


Bed  Gum. 
When  an  infant  is  one  or  two  days,  or  a  week  old,  there  occurs  an 
eniption  all  over  the  body,  of  a  bright  red  appearance,  that  probably 
itclios,  and  causes  the  child  some  suffering.     A  globule  of  Pulsatilla  night 
«nd  morning  will  suffice  to  cure  the  difficulty. 


DISEASES  OF  INFANTS. 


835 


of  water,  to  be 

ner,  sweetened, 

ough  tl>e  tube. 

child  requires 

the  breast. 


affords  evident 

v.,  followed  by 

If  frequent  dis- 

'ive  one  or  two 


easily,  from  the 

tHing:  occasion- 

ul.     One  or  two 

o  of  JVux  vomica. 

obule  or  two  of 


from  a  percppti- 
It  will  look  red 
points  or  pimples 
ercurius  or  Bn/' 
iter.     Some  liave 

This  difficulty  is 


and  a  .it tie  more 
len  refuses  to  take 
lin  a  number  of 
ce.  One  or  two 
onia  has  also  been 
)f  black  tea  nmy 
3od  nursing,  and 
ind  of  sore  mouth 
m.  If  the  child 
may  afford  relief. 


there  occurs  an 
36,  that  probably 
fPuUcUillanig,\\t 


Betention  of  Urine  in  Toung  Infants. 

This  difficulty  occasionally  is  observed,  ano  s  attended  with  much  rest- 
lessness and  inquietude.  An  infant  should  urinate  eight  or  ten  times  in 
twenty-four  hours  ;  and,  when  here  is  a  failure  in  this  respect,  give  one  or 
two  globules  of  Hyoicyamua^  and  repeat  every  three  or  four  hours  until 
the  derangement  is  ol)viutod.  When  Ifyoscyamua  fails,  give  a 
globule  or  two  of  Pulsatilla  or  Aconite, 

Teething,  Dentition. 

When  an  infant  has  attained  the  age  of  four  or  six  months,  the  period 
of  teething  commences.  The  child  begins  to  drool,  and  is  restless  and 
uneasy,  and  frequently  cries  out  with  pain.  At  times  the  cheeks  will  bo 
red,  and  the  head  will  be  hot ;  or  else  there  will  be  diarrhoea,  and  the  food 
will  pass  the  bowels  undiMsted.  The  child  is  generally  fretfal  and  un- 
easy. The  most  effectual  remedy  for  the  restlessness  ""''  irritative  fever 
is  Chamomilla.  Two  or  three  globules  may  be  given  Imee  times  a  day. 
When  the  head  is  hot,  and  the  child  thrusts  its  fingers  into  its  mouth,  give 
two  globules  of  Belladonna  ;  when  the  food  passes  undigested,  give  two 
globules  of  Pulsatilla.  When  there  is  a  general  heat  of  the  body,  and 
deranged  condition  of  the  stomach,  give  two  globuloa  of  Aconite;  if 
this  fails  to  relieve  in  twenty-four  hours,  give  Cimicifuga  every  hour. 

Summer  Oomplaint,  Cholera  Infantum. 

During  the  heat  of  summer,  teething  children  are  prone  to  be 
affected  with  a  prostrating  diarrhoDU,  sometimes  watery,  at  others 
dyserteric,  when  the  stools  are  tinged  with  blood.  In  the  first  stage, 
when  there  is  considerable  fever  and  watery  dischiirges  from  the 
bowels,  two  or  three  globules  or'  Aconite  may  arrest  the  difficulty, 
followed  by  Tartar  emetic;  if  the  discharges  are  profuse  and  fre- 
quent, Veratrum  album;  if  there  is  much  thirst,  Arspnicum.  For 
discharge  of  mucus,  give  Mercuriun ;  when  tinged  with  blood,  give 
Ipecac.  The  dose  of  either  is  two  globules.  When  there  is  cold- 
ness of  the  face  and  extremities,  give  Oarbo  vea.  If,  in  spite  of 
thes)  remedial  measures,  the  disease  continues,  let  the  child  be 
taken  into  the  open  air,  or  into  the  country.  A  trip  upon  the  water 
in  a  steamboat  has  frequently  resulted  in  a  favorable  change  in  the 
condition  of  the  child.  The  diet,  aside  from  nursing,  should  be 
mutton-broth  and  beef-tea,  or  perhaps  aiTowroot  cr  farina  gruel. 

Marasmns,  Extreme  Emaciation. 

From  the  combined  effects  of  teething  and  interrupted  nutrition  and 
also  from  diarrhoea,  the  child  will  lose  its  flesh  in  a  remarkable  degree, 
and  nearly  all  the  adipose  or  fatty  tissues  will  seem  to  disappear.  The 
bones  of  the  face  will  become  prominent ;  the  eyes  will  sink  back  into  their 
sockets  ;  the  skin  will  be  shrivelled  and  loose  over  the  entire  body,  end 
very  markad  upon  the  upper  and  lower  extremities.  The  most  prominent 
feature  of  the  disease  is  interrr.pted  nutrition ;  and  often  the  child's  stom- 
ach r^ects  the  simplest  lund  of^  food.     When  there  is  continual  retching. 


:^ 


836 


DISEASES  OF  INFANTS. 


pive  Ipecac,  to  allay  the  irritablu  condition  of  the  stomach  ;  and  then  give 
Caharea  ;  or  if,  at  first,  thero  is  no  nuusca,  but  tliirst,  givo  Arsenicum. 
Sulphur  is  a  valuablo  remedy,  and  also  Ferrnm.  When  cither  b<!of- 
tea,  or  barley-griicl,  or  any  other  kind  of  hght  Houp  or  giiiei,  fans  of 
being  retain<!(l  upon  the  stomach,  a  gruel  made  of  the  th)ur  of  the 
yelit  of  a  hard-boiled  egg  has  supplied  the  want  of  nourisliiucnt,  and 
|)r()moted  the  recovery  of  marasmus  patients.  When  ihe  child  is  old 
enough  to  feed  himself,  the  yelk,  boiled  hard,  may  l)e  broken  in  a 
saucer,  and  seasoned  with  a  little  salt ;  and  the  child  will  nick  it 
up  a  little  at  a  time  and  eat  it.  But  if  otherwise,  to  a  pint  of  ooiling 
water  add  a,  half-pint  of  fresh  milk  and  tiio  flour  of  one  ydk,  seasoned 
with  sah,  and  sweetened.  This  makes  a  gruel  that  will  flow  throuiih  a 
nursinj^-tubo.  This  food  contains  the  I)e3t  preparation  of  iron  l()r  tiio 
intiuitile  system,  and  in  many  instances  has  been  effectual  in  curing 
marasmus. 

Hiccough.  —  Singultus. 

This  annoying  difficulty  results  from  the  irritation  of  the  diaphragm 
and  the  CBSophagus,  or  passage  from  the  moutli  to  the  stomach.  Nux 
vomica.  Ipecac,  Pulsatilla,  and  Sambucus,  iiave  been  employed  as  reme- 
dies. A  single  dose  of  two  globules  of  either  may  be  administered  when 
infants  are  so  affected. 

Convulsions,  Fits. 

There  may  be  various  causes  of  these  convulsions  in  infants.  A  fever, 
an  irritable  stomach,  teething,  or  cold,  may  produce  them  ;  when  from 
fever,  give  two  globules  of  Aconite,  and  in  two  hours  follow  with  a  dose 
of  two  globules  of  Belladonna.  When  from  an  ill-conditioned  stomach, 
give  (Jhamomilla,  Ipecac,  or  Ignatia;  when  from  cold,  A^mx  vomica 
or  Sulphur.  When  the  convulsion  comes  on  with  vomiting,  Ipecac. ; 
when  from  colic,  Pulsatilla  or  Oolocynth ;  when  with  inclination  to 
Bleep,  Opium,  or  perhaps  Stramonium ;  when  from  the  sudden 
disappearance  of  any  rash  or  eruption.  Cuprum. 

Excoriations. 

The  tender  and  delicate  skin  of  infants  is  liable  to  become  excoriated 

from  the  slightest  causes.     To  relieve  the  pain' and  suffering  attendant 

ipon  it,  give  two  globules  of  Chamomilla,  Mercurius  viv.,  or  Pulsatilla 

ihtemally,  and  wash  them  with  a  weak  solution  of  Arnica  or  Hama- 

melis  externally.     Should  this  condition  persist,  give  Sulph.  daily. 

Soreness  behind  the  Ears. 

When  a  child  is  teething,  and  there  is  considerable  of  the  fever  of 
dentition,  an  eruption  is  liable  to  show  itself  behind  the  ears  ;  and,  although 
this  eruption  is  beheved  to  be  effectual  in  preventing  more  serious  disease 
of  the  head,  it  is,  ne\'ertheless,  an  unnecessary  disease.  Qraphitea  may  be 
given  to  remedy  tl»e  iifficulty,  a  single  dose  in  twenty-four  hours ;  and,  in 
like  manner,  Arsenicwm,  Calcareay  and  Baryta  Oarb-t  may  be  employed. 


%.:': 


and  then  give 

ivo  Arsenieum. 

!n  oithor  boof- 

<j;iiicl,  liiiis  of 

lo  flour  of  Ihc 

insl\in«'nt,  luui 

lO  chiUlis  old 

)(i  broken  in  n 

d  will  nick  it 

)int  of  Doiling 

yi'lk,  sonsoned 

now  tlu'ou;ili  u 

of   iron  Ibr  tiio 

tual  in  curing 


the  dinphra(];m 

stomach.    Nux 

ployed  as  reme- 

ninistered  when 


fants.  A  fever, 
em  ;  when  from 
low  with  a  dose 
itioncd  stomach, 
Id,  Ifux  vomica 
iiiting,  Ipecac. ; 
h  inclination  to 
jm  tbo  sudden 


come  excoriated 
fering  attendant 
tVi,  or  Pulsatilla 
mica  or  ffama- 
)  Sulph.  daily. 


of  the  fever  of 
■8 ;  and,  although 
re  serious  disease 
Iraphitea  may  be 
ir  hours ;  and,  in 
lay  be  employed. 


DISEASES  OP  INFANTS. 


837 


Friokly  Heat. 

During  intensely  lot  woather,  children  are  liable  to  break  out  with 
prickly  heat.  The  stomach  at  first  seems  slightly  deranged,  and  the 
eruption  upon  the  si.rface  appears  to  bo  un  elimination  of  some  internal 
disorder,  '"^hcre  is  Kometimes  mucli  fever  and  headache :  for  this,  give 
two  globules  of  Aionite.  If  the  child  is  teething,  give  Chamomllla.  If 
the  surface  becomes  red  and  inflamed,  give  Ithiia  tox.  If  burning  and 
smarting,  give  Arsenicum.  In  case  of  severe  itching,  give  iSulj>hur. 
When  children  are  taken  out  by  their  nurses  on  a  hot  day,  they  must  not 
be  exposed  to  the  heat  of  the  sun  :  shade  should  bo  sought  for  them, 
where,  if  any  air  is  stirring,  they  can  get  the  benefit  of  it. 


Milk-Onist. — Pomgro. 

This  is  a  scabious  eruption  upon  the  scalp  of  nursing  infants,  which  at 
first  appears  to  be  a  humid  scurf.  It  collects  as  a  slight  humor,  and 
begins  to  enlarge,  involving  more  and  more  of  the  surface,  until  that 
of  the  scalp  is  entirely  covered.  It  is  a  source  of  annoyance  to  mothers 
and  nurses.  There  appears  to  be  great  difficulty  in  keeping  the  affected 
surface  clean,  and  consequently  a  hasty  resort  to  some  drying  wash  has 
wrought  disasfcrous  effects.  When  Milk-Crust  is  suppressed,  the  irritation 
is  apt  to  fall  upon  internal  organs,  and  produce  worse  affections.  The 
tar  and  sulphur  ointments,  which  have  been  too  frequent  a  resort,  have 
had  the  effect,  in  some  measure,  to  dissipate  the  eruption  ;  but  the  usual 
sequel  to  this  are  convulsions,  or  fatal  brain  diseases.  It  is,  therefore, 
recommended  as  the  most  prudent  course,  to  depend  upon  the  internal 
administration  of  remedies  such  as  eliminate  the  humor,  and  keep  it 
upon  the  surface.  The  purer  the  blood  can  be  kept,  the  sooner  will  the 
disease  disappear.  If  no  attention  is  paid  to  the  use  of  external  agents, 
the  entire  difficuliy  will  bo  eliminated  and  dissipated  in  the  course  of  a 
few  months.  Two  globules  o{'  Aconite  may  be  given  when  there  is  fever, 
and  this  may  be  followed  for  a  while  with  daily  dose.!  of  Jthus  tox.  and 
Bryonia.  In  scrofulous  children,  give  Calcarea,  Arsenieum,  or  iSulphur. 
In  debilitated  constitutions,  give  Qraphitea,  Ferrum,  Ifepar  sulphur,  and 
Chhia.  Lycnpodium,  three  times  daily,  has  cured  most  obstinate 
cases.  All  oily  food  should  be  withheld.  Butter  is  not  allowable. 
After  children  have  been  weaned,  and  still  the  Milk -Crust  remains, 
a  farinaceous  food  is  best. 

Scurf  of  the  Head. 

This  is  an  accumulation  upon  the  scalp,  of  an  oily  and  dirty  appearance, 
which,  in  many  cases,  is  the  result  of  not  being  particular  in  washing 
and  wiping  the  head  dry.  Soap  should  never  be  used  upon  the  scalp, 
and  strong  alkaline  solutions  are  injurious.  Water  softened  with  c()rn  or 
rye  meal  will  answer  all  the  purposes  for  cleanliness.  As  the  diiliculty 
does  not  penetrate  below  tb«  external  skin,  Rhus  tox.,  Pulsatilla,  Calca- 
rea, and  Silicea  are  remed  es,  either  of  which,  in  daily  doses,  will  be  all 
that  is  required. 


11 


888 


DISEASES  OP  INKAMT8. 


Sorofhlous  Swelling  of  the  Salivary  Olands. 

This  is  a  disousu  Homowlmt  common  to  cliildruii  tf  scrofulous  parents; 
Bnd  it  in  of  the  utmost  imuortunce  to  understand  well  its  character  iind 
treatment.  When  these  children  take  cold,  the  glands  are  apt  to  bec-ouio 
excited,  nnl  there  is  a  pei'petuul  flow  of  saliva  from  the  mouth  ;  at  the 
samu  time  there  will  be  soreness  of  the  throat,  stillness  of  the  neck,  and 
swelling  of  the  j^iands  externally.  Sometimes  children  will  carry  their 
hea(h  to  the  rij^lit  or  left  shoulder,  when  laboring  under  the  ditticulty ; 
HI-  1,  in  suite  of  the  l)ost  efforts  to  relieve  them  of  suffering,  they  will  con- 
tinue indisposed  a  long  time.  Two  or  three  globules  of  Aconite  will 
subdue  the  initial  f('V?r.  Merourius  viv.  may  then  be  given  two  or 
three  times  a  day.  If  this  fail  to  arrest  the  salivation,  give  Nitric  acid 
for  a  day,  at  intervals  of  six  hours.  Belladonna  also  may  be  given  to 
remove  any  congestion  of  the  throat.  Silicea  may  bo  given  afterwards 
to  aid  in  softening  the  glands.  Also,  Nux  vomica  nnd  Sulphur  may 
prove  to  be  useful  remedies.  The  children  should  be  kept  in  a  room  of 
moderate  temperature,  and  not  be  allowed  at  any  time  to  bo  exposed  to 
extremes  of  heat  and  cold  until  they  have  fully  recovered. 


Sleeplessness  of  Infants. 

Infants  arc  sometimes  smitten  with  inability  to  sleep,  as  well  as  adults. 
The  cause  is  not  always  known.  It  is  believed,  however,  to  be  the  result 
of  some  disorder  acting  upon  their  delicate  nerves  ;  such  as  indigestion, 
excoriation,  or  overloading  their  stomachs.  If  from  an  irritable  stomach, 
give  them  Chamomilla  or  Coffea  every  night.  If  from  any  excoriated 
surface,  that  burns  and  smarts,  give  two  globules  of  Arsenicum^  and  then 
apply  to  the  excoriated  surface  a  little  rye  flour,  or  Lycopodium  pow* 
der,  and  soothe  them  to  sleep  in  a  qu:3t  and  noiseless  room.  If  the 
sleeplessness  is  produced  by  retention  of  urine,  give  Hyoscyamus  ;  if  by 
worms,  Cina.  If  the  head  is  hot,  give  Belladonna.  If  the  sleepless- 
ness is  from  feeding  the  child  too  much,  give  two  globules  of  Pulsatilla. 
If  from  constipation  of  the  bowels,  give  Nux  vomica  or  Lycopodium  at 
light.  If  these  remedies  fail,  a  tepid  bath  will  often  consummate  the 
i(^<.sired  result. 


■ 


■I 


■  V  ;• 





m 


ous  parontR ; 

cimractur  and 

apt  to  bec-oiuo 

noiitli ;  at  tliu 

the  neck,  and 

carry  their 

ho  diflicuUy ; 

they  will  con- 

Aconite  will 

^iven  two  or 

vo  Nitrio  acid 

ly  be  given  to 

ven  afterwards 

/Sulphur  may 

)t  in  u  room  of 

bo  exposed  to 


well  as  adults. 
to  be  the  result 

as  indigestion, 
•itable  stomach, 

any  excoriated 
ileum,  and  then 
icopodium  pow- 

room.  If  tho 
iCT/amus;  if  by 
if  the  sleepless- 
}  of  Pulsatilla. 
Lycopodium  at 
lonsummate  the 


DISEASES  OP  VARIOUS  ORGANS  AND  REGIONS. 


Passage  of  Qall-^^tones. 

The  passage  of  gall-stones  is  attended  by  severe  pain  in  the  region 
of  the  Btomacli,  obliging  one  to  writhe  in  agony,  and  roll  from  side  to 
side.  Tho  strongest  men  become  subdued  when  suflering  from  the  pas- 
sage of  these  concretions.  The  pain  resembles  an  intense  colic ;  and 
sometimes  the  agony  produced  by  biliary  calculi  goes  under  the  name 
of  Bilious  Colic.  In  addition  to  the  pain  occasioned  by  the  concretions, 
u,^ro  maj  be  vomiting,  headache,  cold  extremities,  and  sallow  com- 
plexion. To  relieve  the  suffering,  resort  has  been  had  to  Morphine  and 
Opium;  but  those  sedatives  only  prolong  the  difficulty.  They  afford 
only  temporary  relief  from  pain,  and  the  use  of  them  must  be  discour- 
aged. Cathartics,  on  the  whole,  have  failed  of  accomplishing  tho  pur- 
pose, and  only  weaken  the  patient.  Homceopathic  remedies  have  some- 
times afforded  prompt  relief;  but,  as  a  general  thing,  the  success  attend- 
ing the  most  perfect  affiliations  of  indicated  remedies  has  not  been  great. 
The  most  modern  treatment  for  biliary  calculi  is  to  administer  to  the 
patient  from  two  to  four  ounces  of  pure  Olive  oil,  tho  laxative  effect  of 
which  has  gently  moved  tho  bowels,  and  brought  from  the  gall-duct 
large  numbers  of  tho  concretions,  sometimes  a  dozen  or  more  ;  utter 
which,  the  blackness  of  the  countenance  will  begin  to  disappear,  the 
indurations  found  in  the  region  of  the  liver  become  lessened,  the  appe- 
tite returns.  When  attacks  of  Bilious  Colic  occur,  it  is  not  always 
certain  that  the  gall-duct  is  obstructed  with  stones.  Therefore,  Colocynth, 
in  tho  usual  dose,  may  afford  prompt  relief;  even  when  gall-stones  have 
been  present,  and  the  suffering  and  agony  are  indescribably  great,  Pulsa- 
tilla has  cured.  When  there  is  severe  jiain  and  induration  in  tiie  region 
of  the  liver,  a  dark,  sallow  countenance,  and  black  circles  around  the  eyes, 
much  relief  has  been  obtained  by  the  use  of  Arsenicum.  When  tliero 
remain  black  spots  or  discolorations  upon  the  face,  dcpia.  When 
there  is  much  vomiting  during  an  attack.  Ipecac.  External  applications 
sometimes  prove  useful.  Emollient  poultices  applied  to  the  region  of 
the  pain  have  proved  beneficial.  The  pain  attending  the  passage  of 
biliary  concretions  has  sometimes  been  mistaken  for  chronic  Inflamma- 
tion of  the  Stouach  ;  and,  on  this  account,  the  remedies  have  failed  to 

8.S9 


840 


DISKASLS  1>K  VARIOUS  ORGANS  AND  REGIONS. 


control  tlie  sutFc'iiii<i;.  Very  many  persons  suffering  from  chronic  Liver 
Cniiiiilaint  become. victims  to  the  suffering  produced  by  gall-stones,  and 
should  restrict  themselves  to  n  simple  but  nutritious  diet.  After  an 
attiiek,  the  olivo  oil  should  he  taken  for  at  least  six  months,  a  table- 
spoonful  on  retiring?,  each  night. 

Oancer  of  the  Liver.  —  Schirrua. 

In  the  event  of  a  constant  sufiering  in  tiie  right  side,  with  ap])arent 
liard  protuberances,  while,  at  the  same  time,  there  are  dark  circles 
around  the  orbits  of  the  eyes,  and  when  there  are  shooting  or  lancinat- 
ing pains  darting  from  the  indurated  protuberances,  a  cancer  may  be 
suspected.  If  not  too  far  advau'^ed.  it  may  be  cureil  by  the  administra- 
tion of  Arsenicum^  when  there  is  much  thirst  and  dryness  of  the  mouth, 
a  white  coating  upon  the  tongue,  and  considerable  prostration.  Coniam 
maculatum  may  be  given  three  times  a  day  when  there  is  pain  in  the 
righi  side,  as  if  constricted  by  a  band,  or  tearing  and  stretching  in  the 
region  of  the  liver,  and  colicky,  abdominal  si)asms. 


Cancer  of  the  Stomach. 

This  formidable  disease  often  comes  on  insidiously,  and  the  victim 
supposes  himself  to  be  a  sufferer  from  an  aggravated  form  of  Dyspepsia. 
Severe  anxiety  and  trouble  are  supposed  to  have  a  serious  influence  in 
the  p»"oduction  of  the  disease.  A  constant  irritation  -of  the  mucous  lining 
of  the  stomach  may  terminate  in  the  difficulty.  The  chief  symptoms 
denoting  the  presence  of  Cancer  in  the  Stomach  are  great  dspression  of 
spirits,  a  downcast  countenance,  a  pinched  appc^raiice  of  the  nose,  with 
the  corners  of  the  mouth  drawn  down,  and  also  a  constant  inclination  to 
retch  and  vomit  dark  matter,  somewhat  resembling  coflee-grounds,  and 
also  se%'ere  cutting  or  shooting  pains  in  the  stomacl, ,  with  intense  thirst. 
Mux  vomica  has  sometimes  cured  Cancer  of  the  Stomach.  The  indica- 
tions for  its  use  are  intensely  bitter  eructations,  and  spitting  up  of  dark 
matter;  and  also  when,  the  eructations  are  followed  by  vomiting;^  of 
sanious  or  bloody  matter.  When  the  patient  has  suffered  greatly  from 
anxiety  and  Dyspepsia,  Ignatia  may  be  given,  instead  of  iVkr  vomica. 
WIrmi  the  tumor  can  be  diagnosed  or  discovered  by  external  manipu- 
I  ition,  Arsenicum,  and  also  Conium,  may  be  given  twice  a  day.  Coccvr 
ills  also  may  be  given  when  the  nausea  and  vomit  ng  are  similar  to  thai 
pioduced  by  riding  in  a  carriage,  or  sea-sicknesf;.  When  one  has  suf- 
fered many  years  from  Dyspepsia,  and  then  begins  to  emaciate  and  spi' 
up  this  dark  matter,  Nux  vomica  given  persistently  is  most  likely  to  be  of 
service.  The  patient  should  subsist  upon  broths,  beef-tea,  and  the  most 
delicate  farinaceous  diet. 

Ganoer  of  the  Intestines. 

The  symptoms  which  denote  the  presence  of  Cancer  of  the  Intestines 
are  constant  pain  in  the  bowels,  and  acrid  discharges  of  blackish  stoqia, 
a  very  black  or  dark  appearance  of  the  countenance,  downcast  expres- 
sion, a  constant  inclination  to  relieve  the  pain  by  pressure  of  the  handf 


\^' 


jhronic  Liver 
ill-stones,  and 
et.  After  an 
nths,  a  table- 


with  ap])arent 

dark    circles 

rr  or  lancinat- 

aiicer  may  be 

10  adminislra- 

of  the  mouth, 

tion.      Conium 

is  pain  in  the 

etching  in  the 


and  the  victim 
of  Dyspepsia. 
)us  influence  in 
p  mucous  lining 
iliief  symptoms 
it  depression  of 
the  nose,  with 
it  inclination  to 
3e-grounds,  and 
1  intense  thirst. 
Ii.  The  indica- 
;ing  up  of  dark 
by  vomitint^  of 
30  greatly  from 
of  Nux  vomica. 
eternal  manipu- 
a  day.  Coccur 
similar  to  thai 
ill  one  has  suf 
laciate  and  spi' 
st  likely  to  be  of 
a,  and  the  most 


)f  the  Intestines 

blackish  stogie, 

jwncast  expres- 

ire  of  the  handi 


DISEASES  OF  VARIOUS  OBGANS  AND  REOIONS. 


841 


and  arms.  This  affection  generally  terminates  fatally,  —  the  result  being 
perforation  of  the  bowels.  When  autopsy,  or  post-mortem  examination, 
reveals  the  fact,  it  is  then  called  to  mind  that  the  victim  has  worn  the 
expression  and  complained  for  a  long  time  in  a  way  that  mi^ht  have 
excited  suspicion  of  the  trouble.  To  note  these  symptoms  when  they 
first  occur  may  sujigest  a  treatment  that  possibly  might  avert  a  lata!  ter- 
mination. Arsenicum  may  be  given  when  the  patient  has  thirst,  burn- 
ing pain  in  the  bowels,  and  hot,  acrid  stools  ;  Conium,  when  the  puiua 
appear  to  be  of  a  neuralgic  character,  and  persistent ;  Belladonna,  when 
there  is  a  painful  distention  of  the  abdomen.  The  diet  should  be  tho 
same  as  that  directed  tor  Cancer  of  thp  Stomach. 


Cancer  of  the  Skin. 

When  inflammation  of  the  skin,  or  any  persistent  irritation,  terminates 
in  Cancer,  there  is  a  rough,  liard  tumor  of  a  bluish  apjiearance,  at  first 
about  the  size  of  a  common  wart.  It  sometimes  grows  into  the  shape  of 
a  tumor,  and  is  the  seat  of  sharp,  shooting  pains.  The  remedy  that  has 
apparently  cured  this  affection  is  Silicea,  in  daily  doses.  It  is  particu- 
larly indicated  when  there  is  painful  soreness  or  sensitiveness  of  the  skin, 
and  an  itching  of  the  whole  body ;  and  als(  when  there  is  stinging  in 
the  sore.  To  prevent  cutaneous  ulcers  of  the  skin  from  becoming  can- 
cerous, the  same  remedy  may  be  used.  To  prevent  horny  excrescences 
from  assuming  a  cancerous  character,  Qoniam  or  Cauntiatim  may  be  given 
in  daily  doses.  Almost  any  persistent  irritation  may  assume  the  cliarac 
ter  of  a  cancer.  Ichorous  ulcers,  fetid  sores,  malignant  boils  or  ulcers, 
should  be  carefully  treated  and  cured,  or  otherwise  they  may  take  on  a 
settled  or  constitutional  schirrous  character.  The  skin  should  be  kept 
clean  ;  a  flesh-brush  sliould  be  frequently  used,  and  exercise  in  the  open 
air  is  commended.     Diet  free  from  condiments,  but  nutritious. 


Fig-Warts, 

These  are  excrescences  upon  the  skin  in  the  shape  of  a  fig,  and  hence 
ihcir  name.  Nitric  acid  and  TJuija  are  remedies  for  these  excrescences. 
Tlt'ija  is  more  particularly  indicated  when  they  bleed  ;  Nitric  acid^ 
when  they  are  flat ;  Nux  vomica,  when  they  are  dry.  When  they  sup- 
purate, or  are  humid.  Thuja;  when  they  split  or  crack,  Nitric  acid.  Of 
the  remedy  selected,  give  a  dose  every  day.  For  Coaimiin  Warts, 
Thuja  is  also  the  chief  remedy,  and  should  be  given  every  two  or  three 
days. 

Gangrene.  * 

When  one  has  been  so  long  sick  as  to  acquire  bed  sores,  and  these 
become  black  and  fetid  and  deathlike,  they  are  said  to  be  gangrenous. 
They  indicate  a  low  condition  of  the  system,  and  generally  indicate  the 
employment  of  Araenicum  in  daily  doses,  or  else  Lachesin.  For  Dry 
Gangrene,  give  Arsenicum,      For  that  which  \%  humid,   give  China. 

106 


Hi 


H- 


842 


DISEASES  OP  VARIOUS  ORGANS  AND  REGIONS. 


For  that  which  emits  an  offensive  odor,  give  Seoale  comutum.  This 
last  remedy  may  be  given  for  gangrenous  blisters.  The  patient,  if  he 
take  \t,  should  have  a  generous  diet. 

Zona,  or  Shingles. 

In  some  cases,  there  is  a  zone  or  belt  of  vesicles,  four  or  six  incliey  in 
width,  that  extends  iialf  round  the  body,  on  the  right  side,  over  the  region 
of  the  liver.  These  vesicles  appear  to  be  filled  with  lymph,  and  are 
prone  to  burn  and  itch  to  almost  an  unbearable  extent.  It  is  believed  to 
be  a  concomitant  i"  chronic  Liver  Complaint,  and  indicates  an  exceedingly 
lov  rondition  of  the  blood.  RhvAttox.^'m  daily  doses,  will  generally  c.ire 
the  disease.  Graphites  may  be  given  after  Rhu»  tox.  When  there  is 
pain  in  the  right  side  and  a  sallow  complexion,  give  Mercurius.  Bryo- 
nia will  eliminate  the  eruption,  and  aid  materially  in  the  invigoration 
of  the  system.  If  there  is, much  headache,  give  Belladonna.  If  the 
patient  is  scrofulous,  give  Arsenicum  or  Calcarea.  The  diet  of  the  patient, 
if  his  appetite  «ill  permit,  should  be  quite  generous.  A  little  wine  every 
day  is  recommended.  Beef  or  mutton  without  condiments,  and  the  usual 
vegetables,  are  allowed.  ,    , 

Nasal  Polypus. 

rhis  fungous  growth  in  one  or  both  nostrils  sometimes  proves  a  serious 
ot}struction  to  respiration  through  the  nose,  and  can  be  cured,  in  most 
instances,  with  well-chosen  remedies.  When  both  nostrils  are  affected, 
give  a  dose  of  Calcarea  every  twenty-four  hours.  When  the  Polyptia 
18  in  the  right  nostril,  give  Pulsatilla ;  when  in  the  left,  give  Sangwi- 
naria.     If  the  nostril  seems  plugged,  give  Sepia  or  Silicea. 

Warts  on  the  Nose. 

Warts  on  the  nose  are  sometimes  quite  annoying,  as  they  not  only 
are  inconvenient,  but  often  painful.  It  is  difficult  to  let  one  of  these 
excrescences  alone  ;  and,  by  constant  irritation,  it  may  become  cancerous: 
thoret()re,  prompt  treatment  when  they  make  their  appearance  is  requisite. 
Causticum,  given  at  first,  will  soon  relieve  the  nose  of  this  appendage. 

Warts  on  the  Hands. 

When  warts  on  the  hands  are  prone  to  grow  thick  and  large,  and 
appear  to  bo  seedy,  Thuja  in  the  form  of  lotion  may  be  applied  exter- 
nally, while  the  usual  dose  of  the  same  may  be  taken  internally.  Cu- 
prum asceticum  also  may  be  taken  internally,  and  a  wash  of  Cuprum 
sulph.,  one  dram  to  half  a  pint  of  water,  may  be  applied  externally. 

loflammatioQ  of  Glands  under  the  Arms. 

A  sore  upon  the  back  of  the  thumbs,  and  sometimes  an  irritable  sore 
upon  the  backs  of  the  fingers  and  hands,  may  cause  soreness  and  inflam- 


jomutum.    This 
he  patient,  if  be 


or  six  inches  in 

,  over  the  regimi 

lymph,  and   are 

it  is  believed  to 

as  an  exceedingly 

ill  generally  c.ire 

When  there  is 

'ercuriv^.     Bryo- 

the  invigoration 

Uadonna.     If  the 

liet  of  the  patient, 

.  little  wine  every 

[Its,  and  the  usual 


es  proves  a  serious 
be  cured,  in  most 
strils  are  affected. 
V^hen  the  Polyptxa 
left,  give  Sangui- 
icea. 


,  as  they  not  only 
o  let  one  of  these 
become  cancerous: 
arance  is  requisite, 
this  appendage. 


ick  and  large,  and 
•  be  applied  exter- 
1  internally.  Ou- 
wash  of  Cuprum 
ed  externally. 

Lrms. 

es  an  irritable  sore 
^reness  and  inflam- 


DISEASES  OF  YAKIOUS  ORQANS  AND  REGIONS. 


843 


mation  of  the  glands  in  the  arm-pits;  that  is,  the  inflammation  may  be 
transferred  to  this  locality  from  the  thumb,  fingers,  or  hands.  At  first,  a 
slight  soreness  is  felt  under  the  shoulder  in  the  arm-pit,  and  the  glands 
will  swell  and  become  sore  to  the  touch  ;  more  cr  less  fever  will  manifest 
itself  at  the  time  :  and  not  unfrequently  pain,  throbbing,  and  suppuration 
supervenes  upon  the  inflammation.  Aconite  may  be  given  to  subdue  the 
fever  and  inflammation  ;  Hepar  sulphur  may  be  given  to  promote  sup 
puration;  Belladonna  or  Bryonia  to  prevent  it.  Phytolacca,  also, 
is  a  rr'      useful  specific,  given  every  three  houra  until  relieved. 

-   Inflammation  of  the  Groin,  logoinal  Glands. 

The  inguinal  glands  are  situated  in  the  groin  ;  and  sometimes  sores  «>f 
an  .rntable  character  upon  the  toes  may  operate  so  as  to  transftM-  these 
influences  to  this  region,  causing  swelling  and  suppuration.  If  takpn  in 
time,  this  soreness  may  amount  to  nothing  more  than  an  uncomi'ortable 
lameness,  rendering  it  difficult  to  walk.  If  not  arrested,  the  inflamma- 
tion will  pass  into  suppuration.  Sores  or  chancres  upon  the  integuments 
of  the  penis  may  also  cause  inflammation,  swelling,  and  even  suppura- 
tion, of  the  inguinal  glands.  When  caused  by  sores  on  the  toes,  poul- 
tices of  bread  and  milk  may  be  applied  to  them,  to  draw  the  inflamma- 
tion from  the  groin  ;  and  Nux  vomica  may  be  given  internally,  to  aid  in 
curing  the  difficulty.  When  this  inflammation  occurs  in  scrofulous  per- 
sons, Arsenicum  may  be  given  twice  a  day.  When  the  inflaramatiLi 
proceeds  from  a  chancre,  give  Merc.  iod.  three  times  a  day  ;  when  from 
suppressed  Gonorrhoja,  give  Sulphur.  Mercurial  ointment  may  be  ap- 
plied to  the  sores,  when  of  syphilitic  origin.  If  they  occur  from  Syphilis, 
Merc.  iod.  may  be  given  internally  three  times  a  day. 


Milk  Leg.  —  Phlegmasia  Dolena. 

This  affection  frequently  occurs  one  week  after  delivery.  It  consists 
in  a  swelled  condition  of  the  thigh  and  leg  of  either  the  right  o:'  left  side. 
The  skin  becomes  tense,  sore  to  the  touch,  adematous  or  dropsical,  and 
very  sensitive.  It  rarely  affects  both  limbs  at  the  same  time,  although 
in  some  instances  such  is  the  case.  It  may  sometimes  be  arrested  in  the 
incipient  stage  by  a  single  dose  of  Aconite.  In  a  more  advanced  stage, 
BeUadonna  will  have  a  curative  action ;  and,  where  there  is  great  sen- 
sitiveness of  the  skin,  Mhus  tox.  When  the  victims  of  Milk  Leg  have 
been  af3icted  with  dropsy  before  confinement,  Arsenicum  may  be  given. 
In  cases  where  women  are  suffering  from  rheumatic  pains  In  the  knees, 
or  where  there  is  suppressed  lochia,  Pulsatilla.  When  the  bowels  are 
constipated,  Lycopodium  may  be  given,  and  not  repeated  for  several 
days.  , 

Stone  Bruise.     -,       .      , 

By  a  Stone  Bruise  is  understood  an  injuiy  upon  the  plantar,  or  under 
surface  of  the  foot,  which  becomes  inflamed,  painful,  and  supj)urative. 
It  mostly  occurs  with  boys  and  girls  who  run  barefooted  through  the  warm 


.  -   1 

n 


15 '4 


844 


DISEASES  OF  VARIOUS  ORGANS  AND  REGIONS. 


weather ;  and  it  is  believed  to  be  tlio  result  of  stepping  forcibly  upon 
pebbles  or  otlier  hard  substances.  Arnica  given  once  or  twice  internally, 
and  a  lotion  of  the  same  applied  externally,  will  often  remove  the  pain 
speedily ;  but,  after  suppuration  has  taken  place,  the  sooner  the  matter 
is  iet  out  with  a  lancet  the  better. 


Bunions. 

These  protuberances  upon  the  joint  of  the  great  toe,  or  upon  the  side  of 
the  toot  imnic'diateiy  back  of  the  little  toe,  frequently  grow  so  large  as  to 
interfere  with  the  wearing  of  a  slioe  or  a  boot,  and  so  painful  as  to  interfere 
willi  the  comfort  of  the  patient.  In  order  to  derive  any  benefit  from  treat 
nienl,  all  mechaiiieal  interference  must  be  removed,  the  boot  or  shoe 
must  be  shai)ed  to  favor  the  tumor,  and  then  wet  the  tumor  a  number 
of  times  during  tlie  day  with  Arnica.  Antimoniam  crud.  may  be  given 
ii'ternally,  or  else  Culcarea,  Sepia,  or  Sulphur.  Give  but  a  single  dose 
of  eu(;h  remedy;  after  which,  wait  with  patience.  If  the  bunion  is  vciy 
painful,  give  t'alearca ;  and,  after  two  days,  give  Nitric  acid.  If  the  pains 
are  sti.iging,  Li/copodium,  Silioea,  or  Sulphur.  Give  a  single  dose  of  either 
remedy,  and  wait  forty-eight  hours.  A  weak  solution  of  Nitric  acid 
will  ol'ten  moderate  the  severe  pain  of  a  bunion  in  dry  weather;  Bryonia 
will  do  the  same  in  cold,  damp  weather.  Silicea  or  Ithux  tox,  will 
afford  great  relief  when  eveiy  change  of  weather  aggravates  the  pain 
and  sutferiufj.  In  case  of  the  bunions  becominji  the  seat  of  neural<;ic 
pain.  Belladonna  may  be  given ;  and  when  they  are  made  sore  by  cliil- 
i)lains,  as  in  scrofuhms  persons,  Arsenicum  must  be  given.  The  patient 
must  not  walk  much,  but  keep  the  feet  dressed  and  warm  until  the  sore- 
ness disappears.  A  poultice  of  bread  and  milk  will  soften  and  mollify 
the  achint;  during;  a  storm. 

Heotio  Fever. 

The  importance  of  this  fever  is  so  great,  that,  instead  of  elaborating 
upon  it  under  the  head  of"  Fevers,"  it  is  introduced  here,  because  it  should 
not  be  confounded  with  other  febrile  diseases.  There  is  a  conution  im- 
pression that  Hectic  Fever  and  Consumption  are  one  and  the  same 
thing;  but  this  impression  will  be  corrected  when  we  consider  briefly 
tl.e  origin  of  this  fever.  It  is  sometimes  intermittent,  and  sometinie^ 
remittent.  Often  a  slight  chilliness  is  felt  some  time  during  the  day  ;  and 
this  is  followed  by  a  febrile  re-action,  more  or  less  severe,  and  <jf  a  pros- 
trating character  Extreme  debility  may  cause  a  fever  of  this  kind  to 
spring  into  existence ;  and,  under  such  circumstances,  it  may  take  the 
form  of  a  low  nervous  fever,  very  slow,  and  wearing  upon  tlie  nutritive 
system.  But  Hectic  Fevers  show  themselves  where  there  are  local 
chronic  inflammations  and  suppurations,  as  in  the  case  of  abscesses,  car- 
buncles, &c.  They  are  sometimes  caused  by  grief,  or  emotions  of  any 
kind.  They  are  caused  by  the  loss  of  animal  fluids ;  or  they  may 
supervene  upon  any  prostrated  condition  brought  on  by  acute  cfisease. 
They  result  also  from  Scrofula  and  Syphilis,  and  from  the  poisonous  influ- 
ences of  Quinia  or  mercurial  medicines.  It  is  probable,  therefore, 
tliat  Hectic  Fever,  taken  in  time,  is  curable,  provided  the  organic  lesions 


IS. 


lug  forcibly  upon 
1  twice  internally, 
remove  tiie  pain 
joner  the  matter 


upon  the  side  of 
ow  so  large  as  to 
ful  as  to  interfere 
jenefit  from  treat 
'the  boot  or  shoe 
tumor  a  number 
]fid.  may  be  given 
but  a  single  dose 
10  bunion  is  veiT 
lacid.    If  the  pain's 
|ngle  dose  of  either 
<n  of  Nitric  aoid 
jweatlier ;  Bryonia 
or  Ilhux  tox.  will 
^ravates  the  pain 
seat  of  neuralgic 
lade  so.-e  by  cliil- 
K'n.     The  patient 
irm  until  the  sore- 
soften  and  mollify 


Bad  of  ekborating 
;,  because  it  should 
!  is  a  common  im- 
ne  and  the  same 
e  consider  briefly 
It,  and  sonietinu^s 
I'ing  the  day  ;  aiui 
re,  and  of  a  pros- 
M-  of  this  kind  to 
,  it  may  take  the 
pon  the  nutritive 
re  there  are  local 
of  abscesses,  car- 
emotions  of  any 
s;    or  they  may 
by  acute  disease. 
le  poisonous  influ- 
'bable,  therefore, 
le  organic  lesions 


DISEASES  OF  VARIOUS  ORGANS  AND  RKOIONS 


845 


on  which  it  depends  are  not  of  a  fatal  or  incurable  kind.     That  wliicli 
usually  accompanies  pulmonary  tubercles  can  only  be  overcome  by  curing 
the  Tuberculosis  of  the  lungs.     We  will  proceed  to  specify  the  treatment 
according  to  particular  indications.     Those  springing  from  debility,  and 
of  a  slow  nervous  fever,  require  the  use  of  China  and  Anienicum.     Give 
the  China  every  time  the  fever  remits  or  intermits,  —  a  single  dose.    Give 
Arsenicum  in  the  same  way  when  there  is  extreme  prostration  and  thirst. 
Give  Phosphoric  acid  when  there  is  diarrhoea.      VVi\en  the  fever  attends 
local  inflammation,  Arsenicum  may  be  given,  when  tliei-e  is  great  ema- 
ciation and  debility,  with  palpitation  of  the  lieart,  hot,  dry  skin,  and  night- 
sweats  ;   Calcarea,  when  there  is  constant  heat  and  little  thirst,  frequent 
flushes  of  heat,  especially  in  the  evening,  with  red  eiieeks.      Calcarea 
is  also  indicated  when  there  is  loss  of  appetite,  great  debility  and  ema- 
ciiition,  and  also  paroxysms  of  anguish.      China  h  indicated  when  there 
is  great  paleness,  sunken  cheeks  and  eyes,  great   listlessness,  dry  and 
Huccid  skin,  great  hunger,  or  else  loss  of  appetite,  and  a  tendency  to 
Diarrliiea.     For  Hectic  Fever  brought  on  liy  emotions  or  grief,  give  Flmn- 
nhoric  (icid,  followed  I)}'  Capsicum  wlicn  there  is  painless  diarrhoea,  sad,  op- 
jjrc^sed  inood,  febrile  heat  in  the  evening,  and  sweat  towards  morning     CJive 
Jijii'it'ui  when  tiic  patient  weeps  during  tlie  lever,  and  has  much  heat  in  the 
|i:dnis  of  the  hunds.     Give  Graphites  when  the  patient  is  pale,  and  the 
lieart  is  prone  to  puljiitate.     If  the   fever   is   produced  by  debilitating 
idsses,  give    Cliina  when    from   hemorrhage;   give    Nux   vomica  when 
iiDui  sexual  excesses  ;  Phosphoric  acid  when  from  diarrhoea,  and  there 
is  accelerated  pulse,  anguish,  and  sweats  in  the  morning.     When  tiie 
(jver  comes  on  after  Dysentery  or  Typhus  Fever  oi-  Cholera,  give  Arsen- 
icum, if  tiiere  are  dysenteric  discharges,  and  if  the   patient  is  greatly 
emaciated,  and  has  laborious  breathing,  with  debility  and  palpitation  and 
thirst,  obliging  one  to  drink  frequently.      Give   Cocculus  when  Hectic 
Fever  sets  in  after  Typhus,  when  there  is  great  debility,  and  trembling 
after  the  least  exertion,  blue  margins  around  the  eyes,  dry  mouth,  and 
loss  of  appetite,  oppression  of  the  chest,  and  with  great  sadness  and 
anguifli.    Give  Veratrum  album  when  licctic  comes  on  after  Cholera,  if 
tiiere  is  great  weakness,  or  cramps,  or  pain  in  tiie  hack  of  tiie  head  during 
the  fever.     When  Sj'philis  is  attended  with  Hectic  Fever,  and  if  the  patient 
has  taken  much  Mercury,  give  Aurum  mur.  or  Stannum,  when  there  is 
great  emaciation,  and  pains  in  the  bones,  and  loss  of  appetite.     Nitric 
acid  may  be  given  when  the   hectic  fever  has   been  brought  on    by 
mercurial  medicines,  and  when  there  is  gi'eat  dryness  of  the  throat,  and 
varices  of  the  tongue.     In  many  cases  of  Hectic  Fever  springing  up  like 
those  named  above,  a  careful  selection  of  the  remedy,  and  corresponding 
adaptation  of  diet  and  regimen,  will  bring  about  a  large  jirojiortion  of 
cures.     Persons  suffering  from  any  form  of  Hectic  Fever  should  be  kept 
in  an  atmosphere  of  uniform  temperature,  —  from  68°  to  70°  Farenheit , 
and  should  be  supplied  with  generous  food  when  the  appetite  will  take  it, 
and  in  some  cases  the  best  of  grape  wine.  ^ 

Night-Sweats. 

If  night-sweats  break  out  in  particular  diseases,  they  do  not  reqture 
any  special  consideration,  unless  it  happens  to  be  one  of  the  most  promi- 


■:mi 


846 


DISEASES  OF  VARIOUS  ORGANS  AND  REGIONS. 


nent  symptoms  ;  in  which  case,  it  maj  constitute  an  important  indica- 
tion for  tlie  selection  of  a  remedy.  A  profuse  perspiration  of  tliis  kiniJ 
wliich  affords  no  relief  indicates  Mercurius  or  CJiina.  Exiiausting  night- 
sweats  in  the  case  of  persons  tliat  liavo  become  weakened  by  disease  or 
other  causes,  point  to  Carbo.  vegetnbilis,  Veratrum  albitm,  Sulphur.  I5iit 
then;  are  indiviiUials,  who  appear  to  he  well  euoiigli  otlicrwiso,  who  per- 
spire copiously  every  night,  and  sometimcrt  so  profusely  as  u>  wet  the  bed- 
clotiiinj.  It  wouhl  seem  that  sleep  induced  some  kind  <if  labor  tliat 
wrought  tlie  system  up  to  this  pitch  of  perspiration.  Jt  is  said  to  i»e  most 
common  witli  corpulent  persons.  Such  cases  us  only  exhibit  the  onij 
8ym])tom  of  sweating  for  consideration,  must  bo  treated  as  follows ;  When 
one  begins  to  sweat  as  soon  as  he  lies  down  to  rest  at  night,  Arsenicum 
may  be  administered.  When  he  fails  to  sweat  so  long  as  he  keeps  awake, 
give  Jlepar,  if  he  is  corpulent;  or  Calcarea  if  he  finds  the  sweats  to 
diminish  his  strength.  If  "exercise  of  mind  sets  him  to  perspiring  after 
getting  into  bed,  give  Nux  vomica,  if  there  is  a  sanguine  temperament. 
If  the  person  is  a  good  feeder,  and  eats  heartily,  anil  has  these  prostrat- 
ing sweats  at  night,  let  him  eat  less,  and  take  Pulsatilla.  Exhausting 
night-sweats  that  occur  after  fatigue  require  Arnica  and  China.  If  after 
severe  mental  labor,  give  Cocculua  or  Nux  vomica.  If  from  no  cause 
that  can  be  determined,  Qarbo.  animalis.  When  no  fever  precedes  one 
of  these  exhausting  sweats,  and  there  is  great  debility  after,  China,  Fer- 
rum,  and  Graphites  are  appropriate  remedies.  For  the  exhausting  night- 
sweats  that  occur  aflter  masturbation,  China  is  also  the  remedy.  If  there 
is  uncomfortable  feeling  about  the  head,  —  a  dull  feeling,  —  give  Phos- 
phoric  acid.  Those  night-sweats  that  occur  after  excessive  sexual  indul- 
gence require  China.,  Arsenicum,  and  Graphites.  For  morbid  sweats  in 
general,  Arsmiciim,  Arnica,  Bryonia,  China,  Ferrum,  Qraphites,  Uclle- 
borus  nig.,  Hyoscyamus,  Ignatia,  Mercurius,  Nux  vomica,  and  Sulphur 
may  be  consulted. 


Pulmonary  Oonsamption. 

There  is  reason  for  a  distinct  monograph  upon  this  disease.  Much  that 
can  be  done  to  ward  off  the  disease  by  domestic  treatment  should  be  done ; 
and,  therefore,  to  point  out  a  plain  description  and  treatment  of  the  incip- 
ient stage  is  at  least  desirable.  The  cause  of  Consumption  may  be  hered- 
itary taint  or  overpowering  influences  that  break  down  the  strongest 
constitutions.  When  hereditary,  it  frequently  exists  as  a  predisponent  in 
the  system  until  aroused  by  some  exciting  cause.  It  is  therefore  of  the 
first  importance  to  become  familiar  with  the  means  of  protecting  one  thus 
disposed  from  surrounding  influences  that  may  develop  the  hereditary 
taint.  When  a  child  of  consumptive  parents  appears  to  thrive  well  and 
grow,  betraying  no  signs  of  disease,  it  is  well  to  keep  him  surrounded  by 
such  atmosphere,  food,  and  clothing,  as  contribute  to  his  healthy  develop- 
ment, until  the  age  of  puberty.  It  is  at  this  period  that  changes  occur, 
more  or  less  fraught  with  danger.  With  the  male,  there  is  danger  of 
arousmg  any  latent  tendency  to  pulmonary  tubercles ;  with  the  female, 
there  is  danger  of  the  menstrual  function  becoming  so  feebly  developed, 
that  it  acts  as  an  excitant  upon  any  latent  discrasia  of  the  blood.     Treat 


DISEASES  OF  VARIOUS  ORGANS  AND  KE(iluN3. 


84-; 


iportant  indica- 

ion  of  this  kiiiH 

xliausting  night- 

1  by  cliseaso  or 

Sulphur.     Hut 

rwisc,  who  per- 

lo  wet  the  hed- 

lul  of  labor  that 

said  to  1)0  most 

I'xliibit  the  oiin 

foMows;   WhoM 

i^ht,  Arsenicum 

u;  keeps  awake, 

Js  tho  sweats  to 

0  perspii'iiig  after 
11(3  temperament, 
as  these  jirostrat- 
lla.     Exhausting 

1  China.  If  after 
If  from  no  cause 
ver  precedes  one 
ifter,  China,  Fer- 
exhaustingniglit- 
•emedy.  If  there 
ng,  —  give  Pho8- 
ssive  sexual  indul- 

morbid  sweats  in 

Graphites,  HeUe- 

xica,  and  Sulphur 


isease.  Much  that 
it  should  be  done ; 
ment  of  tlie  incip- 
ion  may  be  iiered- 
)wn  tho  strongest 

a  predisponent  in 
is  therefore  of  the 
rotecting  one  thus 
op  the  hereditary 
to  thrive  well  and 
lim  surrounded  by 
3  healthy  develop- 
at  changes  occur, 
there  is  danger  of 

with  the  female, 
» feebly  developed, 
he  blood.     Treat 


inent  is  therefore  required  at  this  period,  not  only  to  obviate  any  dcrange- 
au'iit  consi'ciuent  upon  its  occurrence,  but  to  aid  a  burthcncd  system  in 
bringing  about  this  physiological  change,  so  ns  to  answer  uU  tho  de- 
mands upon  it.     Separate  beds  should  bo  insisted  upon. 

For  males  at  the  ago  of  puberty,  children  of  scrol'uloufi  parents,  give 
a  dose  of  Calc  carb.  twice  a  w-^ek,  and  restrict  them  to  a  strictly  nutri- 
tious diet,  free  from  fat  or  gravy.  In  case  of  their  being  children  of 
|i;ireiits  who  had  tuljercular  disease  of  the  lungs,  give  them  Lyeopinlliim 
iwice  a  week,  or  perhaps  Oraphites,  and  direct  for  them  a  good  diet  of 
iiiimal  and  vi-getable  food  ;  let  them  avoid  exposure  to  extremes  of  tem- 
I't'tiiture;  let  them  sleep  in  well-ventilated  apartments:  and  any  hered- 
itary tendency  to  Consumption  can  be  overcome.  Should  a  cough  emue 
iipmi  the  period  of  pul)escence,  give  Li/copoditan  or  Calcarea  ;  if  a  shoit, 
hacking  cough,  give  Phosphorus ;  if  a  tickling  cough,  give  Pulsatilla  or 
Sepia.  By  thus  watching  the  first  development  of  cough,  and  by  giving 
the  Hppro|)riate  remedy  at  once,  tho  same  can  be  cured.  h\  females, 
when  there  is  iireat  debility  of  the  chest,  and  sometimes  a  slijiht  bleedins 
occasioned  by  a  trifling  cough,  give  Sauro  cerasus.  Thus,  by  noting  the 
slightest  development  of  cough  at  this  ])eriod,  and  by  being  prompt  in 
selecting  the  appropriate  remedy,  this  incipient  form  of  Consumption  can 
be  cured,  and  sound  health  be  established,  and  will  remain  until  some 
other  revolution  occurs  to  unsettle  the  system.  Any  excesses  on  the 
part  of  the  male  must  be  avoided.  Whatever  weakens  or  deteriorates 
any  of  the  functions  may  prove  an  exciting  cause,  so  long  as  there  is  any 
predisposing  influence  in  the  system.  On  the  part  of  females,  there  is 
danger  at  the  period  of  the  first  pregnancy.  This  revolution  will  either 
make  further  improvements  in  the  direction  of  sound  health,  or  it  will 
arouse  unfavorable  influences  that  depress  and  ruin  it.  Thus  it  may  seem 
plain  that  Consumption  may  be  successfully  treated  in  its  incipient  stage, 
whether  it  shows  itself  early  or  late  in  life.  If  there  is  indication  of  its 
approach  after  a  fever,  give  China;  if  after  excessive  fiitigue,  give  Lyco- 
podium  or  Stannum.  If  excessive  venery  causes  a  development  of  con- 
sumptive symptoms,  give  Arsenicum  or  China;  if  the  shock  of  labor 
produces  depressing  effects,  give  Arnica,  China,  and  Arsenicuvi;  and  if 
cough  ensues,  give  Bryonia  or  Phosphorus,  and  a  well-regulated  diet. 
It  is  believed,  that,  in  a  m.njority  of  instances,  Hereditary  Consumption  can 
be  erased  from  the  family  record  by  carefully  waging  a  warfare  upon  the 
first  approach  of  the  enemy. 

But  a  different  aspect  presents  itself  in  that  form  of  Consumption 
which  coines  on  by  reason  of  a  good  constitution  having  been  over- 
taxed and  worn  out.  A  c^ld,  badly  treated,  may  leave  behind  a  perma- 
ni'ut  irritatitm  even  upon  the  most  naturally  healthy  constitutions.  A 
uaigh  from  a  cold  is  not  to  be  trifled  with  ;  therefore,  attend  to  the  slight- 
est cough.  Nuj;  vomica  may  remove  a  cough  brought  on  by  a  cold,  if 
given  at  once ;  a  dry,  hollow,  or  hoarse  cougii  may  be  cured  with  Hepar 
iulph. ;  a  cough  with  heat  of  the  chest  and  soreness  of  the  lungs  may  be 
cured  with  Bryonia.  Long  exposure  to  cold  that  chills  the  whole  sys- 
tem may  be  followed  by  a  violent  fever  that  fixes  itself  u.pon  the  lungs, 
producing  violent  inflammation  ;  and  this,  if  improperly  treated,  ma^r  end 
in  Consumption.   Almost  any  acute  disease,  bauly  treated,  may  terminat- 


'  < 


r/ 


848 


DISEASES  OP  VARIOUS  ORGANS  AND  REUIONS. 


in  fatal  Consumption  ;  therefore,  when  any  interrnptitm  occurs  in  the 
function  of  respiration,  it  is  more  or  less  dangerous.  The  slij^hter  the 
interruption  the  better,  and  tlio  more  easily  can  it  bo  removed,  liut  it 
must  not  be  ne<j;lected.  An  exceedingly  slight  capilliiry  congestion,  if 
neglected,  may  become  chronic,  and  end  in  Tuberculous  Consumption  ;  a 
sligiit  bronchial  disiurbance,  not  properly  treated,  may  terminate  in  Bron- 
cliial  Consumption:  in  short,  any  of  the  ailments  of  a  trJTial  charucter, 
wiiieh  can  be  made  worse  by  neglect,  may  demand  the  most  careful  treat- 
ment, or  otherwise  they  may  terminate  in  Consumption. 

llltluenzil,  or  Grippe,  comes  on  like  a  cold,  with  sneezing  or  snivelling, 
pain  in  the  chest,  and  a  general  appearance  of  Catarrh.  Toe  frequentiv  it 
has  been  neglected  in  the  first  stage,  and  it  has  run  into  the  chronic  fonn 
of  Bronchitis,  and  thence  into  Consumption.  Such  being  the  known  ten- 
dency, it  is  well  to  seek  the  best  of  treatment  for  this  disease  at  once. 
Arsenicum^  in  the  incipient  stage,  will  relieve  somo  of  the  symptoms:  it 
will  relieve  tlie  thin  discharge  from  the  nose  and  eyes,  the  pain  in  the  Uinbs, 
and  general  ucliing  in  the  bones.  Euphrasia  relieves  many  cases  in  tiie  be- 
ginning which  reseml)le  Arnenicutn.  Mercitrius  viv.  is  also  a  fine  remedy  for 
tlie  stoppage  of  the  nose,  eyes,  and  general  rcstlessncs  of  the  whole  system. 
Influenza  has  been  reckoned  among  the  causes  of  Consumi)tion,  because  in 
many  instances,  it  has  been  the  means  of  calling  into  action  oortuin  latent 
tendencies  that  have  ever  been  dormant  until  set  upon  by  this  exciting  cause. 
Intluenza  is  but  an  acute  form  of  IJrouchitio,  and  as  sueli  it  must  be  treated. 
Aconite  may  be  given  if  there  is  a  (juick,  full  pulse.  After  Aconite  has  softened 
the  pulse,  and  pnxhiced  moisture  upon  tlie  skin,  if  tlie  head  continues  to  ache, 
give  Belladonna  ;  if  there  is  soreness  of  the  throat,  give  Merc  vio.;  if  much 
thirst,  Amenicuin;  if  pains  in  the  batik  and  loins,  Nkx  vomica  In  females, 
Pulsatilla  ni.ay  remedy  many  of  the  derangements  which  intliienza  produces. 
If  a  sudden  clieek  of  inenstniation  supervenes  upon  an  attack  of  tiiis  disease, 
give  Aconite,  and  follow  with  PalsatiUa;  ami,  finally,  if  inlluenzi  shows  itself 
in  an  epidemic  f  "nn.  and  almost  every  man,  wo.,.an  and  cliild  I) jcome  victims, 
Aconite,  Belladonna,  Mercurius,  and  Nux  voni.,  or  else  Arsenicum,  Api» 
mel.,  Bryonia,  Culcarea  carb..  Phosphorus,  and  Sulphur,  may  constitute 
the  group  from  which  is  to  be  selected  a  remedy,  according  to  symptoms. 
It  is  an  old  saying,  with  regard  to  diet, "  to  starve  a  fever,  and  stuff  a  cold ; " 
but  all  proverbs  are  not  true.  There  is,  in  every  cold,  some  degree  of 
fever  that  must  be  heeded,  because  a  too  generous  diet  would  be  likely  to 
do  harm.  A  moderate  diet  of  black  tea,  rice,  barley,  toast,  and  fruit,  is 
best.  Thus,  by  judicious  medication  and  an  appropriate  diet,  there  need 
be  no  sequel  that  causes  the  patient  to  sink  rapidly  into  the  grave.  If 
otherwise,  it  will  arouse  some  constitutional  diathesis,  and  this  will  render 
the  joint  action  tbrniidable  in  the  extreme.  As  in  Tubercular  Consump- 
tion, or,  rather,  in  that  which  is  hereditary,  a  constant  vigilance  is  re- 
quired to  put  in  action  certain  antagonistic  influences  to  overpower  the 
disease,  so  in  Bronchial  Consumption,  or  that  which  is  generated  by  a 
succession  of  ailments  that  implicate,  in  a  less  or  greater  degree,  the  mu- 
cous membrane  that  lines  the  bronchial  tubes,  an  effort  must  be  made  to 
bring  any  and  every  assault  upon  the  bronchia  to  a  successful  termina- 
tion, —  whether  a  common  cold,  a  trivial  cough,  a  slight  soreness  upon  the 
air-pasaages;  or  even  Pneumonia :  let  each  be  treated  persistently,  accord 


occurs  in  the 
riiu  slii^liter  flio 
Imoved.  But  it 
[y  confj;estion,  if 
Joiisiitnption  ;  a 
J'iniiiate  in  Bron- 
liiTial  character, 
lost  careful  treat- 

nrj  or  suivclliii;/, 

Tog  t'requoj\tlv  it 

tho  chronii.'  toVin 

Ir  the  known  teii- 

(hsease  at  once. 

10  syiniitoins:  it 

pain  in  tho  Umbs, 

y  casca  in  the  be- 

:i  line  remedy  for 

tlie  whole  Hystem. 

)tion,  luMause   hi 

tion  oortuin  latent 

lis  exeitin^i  cause. 

it  uuist  be  treated. 

\conite  has  soflened 

1  continues  to  ache, 

>/('/•(■  vio.;  if  much 

mica      In  fcniah^s, 

inlliienza  pro(hicc8. 

iaekof  tiiis  disease. 

(luenz.i  shows  itseli 

ild  hjcoine  victims, 

Arsenicum,  Apis 

ur,  may  constitute 

ding  to  symptoms. 

,  and  stuH'a  cold;" 

1,  some  detfree  of 

would  be  likely  to 

toast,  and  fruit,  is 

ie  diet,  there  need 

ito  tho  pravo.     If 

id  tiiis  will  render 

lercular  Consump- 

it  vigilance  is  re- 

to  overpower  the 

is  generated  by  a 

T  degree,  the  mu- 

I  must  be  made  tu 

jccessful  terraina- 

soreness  upon  the 

irsistently,  accord 


DISEASKS  OF  VARIOUS  ORGANS  AND  RRQIUNS. 


«4t! 


wig  to  symptbms,  until  perfectly  cured,  so  as  to  leave  no  eutiiihnent  in  the 
form  of  a  sequel,  to  prey  unon  the  constitution.  Hygienic  treatment 
must  correspond  with  tho  aclministration  of  remedies.  Well-ventilated 
apartments,  sufficient  clothing,  and  good,  nourishing  food,  cannot  fail  of 
jmtting  the  system  in  a  favorable  condition  for  recovery.  Jlegular  sleep, 
regular  meals,  and  a  well-regulated  temperature,  are  things  indispensable 


Weakness  of  the  Sight.  —  Amblyopia. 

The   term  Amblyopia  signifies  a  wcnljiess  or  morl)id  alteration    (•\ 
light  ;  and  there  is  every  grade,  from  mere  dimness  of  vi^ion  to  conij  lel» 
liliiidiiess.     A  sense  so  important  as  that  of  sight  is  entitled   to  a  distinct 
lonsideration,  inasmuch  as  a  variety  of  causes  may  o|)crate   to  impair  it. 
riio   difficulty  may   be   attended   with   many   morbid   conditions  of  the 
(irganism,  and  a  variety  of  remedies  may  be  required  to  treat  the  affection, 
We  will  therefore  point  out  the  treatment  for  the  various  grades,  in  order, 
l"\tr  .Simple  WKAiiNEss  of  Sight  in  plethoric  persons,  give  Belladonna ; 
fur  scroliiloiis  individuals,  Calcarea  ;  for  weak  or  debilitated  individuals, 
C/iiiui ;  for  nervous  persons,  Hyoscyamm.     For  those  whose  sight  is  iin- 
|i:iiied  from  biliary    derangement.  Sepia   or  Sulphur.      For  Incivient 
Amaiiiosis,  Auruin,  Sepia,  Sulphur.     For  Complete  Amauuohis,  not 
incurable,  give  Belladonna  to  persons  of  full  habit  ;   Calcarea  to  personi 
who  have  a  scrofulous  tendency;   Mercurius,  for   those  suffering   from 
heuatic    derangement;    Phosphorus    for  those  suffering  from  catarrhal 
jtfi'Ctions ;  and  for  those  subject  to  iick  headache.  Sepia.     For  Tokimd 
Weakness  of  Sight,  Phosphoric  add.     For  weakness  of  sight  brought 
on  by  line  work,  give  Belladonna  or  Jtuta.     For  that  which  occurs  fioui 
old  age,  give  Baryta  carb.,  Opium,  or  Secale  cornutum.     Where  weak- 
ness of  vision  occurs  after  suppression  of  the  menses,  or  hemorrhoids, 
give  Pulsatilla  or  Lycopodium.     For  that  occasioned  by  suppression  of 
Measles,  Causticum,  Stramonium,  or  Sulphur.      For  that  super\ening 
upon  Rheumatism,  give  Belladonna,  Pulsatilla,  or  Bhus  tox.     For  that 
attendant  on   Gout,  give  Nux  vom.  or  Colchicum.     For  that  caused  by 
the  abuse  of  mercury,  give  Nitric  acid.     For  that  caused  by  worms,  give 
Cina.     For  that  occasioned  by  Diarrhoea,  give   Merc.    v'v.     For  tiial 
brought  on  by  loss  of  blood,   China.     For  that  produced  by  Scrofula, 
give  Arsenicum,  Calcarea,  or  Nitric  acid.     When   produced  by  ?ol.|   it 
the  eyes.  Dulcamara  or  Nux  vomica.      That  produced  by  blows  or  con 
tunHiom  letin'iras  Arnica,  Ruta,  Euphrasia.     The  remedies  chosen  miHt 
not  be  repeated  oftener  than  once  a  day.     When  weakness  of  sight  is 
attended  with    nervous  headache,   give  Aurum,   Belladonna,    Bryonia. 
Sepia,  or  Sulphur.     If  by  congestion  of  blood  to  the  head,  give  Bella- 
donna, China,  and  Phosphorus.  For  that  attendant  on  deafness,  or  noises, 
give  CiciUa,  Nitric  acid,  or  Pulsatilla.  The  remedies  need  not  be  repeated 
more  frequently  than  once  or  twice  in  twenty-four  hours.     If  weakness 
of  vision  is  attended  by  gastric  or  abdominal  ailments,  give   Cocculus, 
Nux  vom.,  Ignatia,  or  Pulsatilla.     If  attended  by  derangements  of  the 
womb,   gwQ  .Calcarea   or   Sepia.     If   by   pulmonary   complaints,   give 
Vliosphorus,  Lycopodium,  Calcarea,  and  S\jdphuT.     If  by  disease  uf  the 

107 


heart,  Lachesia,  Phosphorus,  Pulsatilla,  Sepia,  and  Spigelia.  If  by  Epi» 
Ie[)8y,  Spasm,  or  Hysteria,  Iluoscyamus,  Opium,  Stramonium,  or  Sulphur. 
Tlio  rcmeily  "lay  bo  ropeuteu,  it  neccssai-y,  awsy  twi'iity-tbur  bourH. 

Tlio  particular  indications  tor  sovoral  of  tbe  remedies  maybe  ntated 
as  fiillows:  Aurum,  tor  black  spots  or  scintiliatioiis,  or  balf-sicrjitedness, 
or  tensive  pain  in  the  eyes,  or  in  caseofsudclen  attack  alter  Scarlet  Fever, 
or  (Inrinji;  conlinement  after  delivery.  Belladonna  tor  dilated  pnpila,  or 
insensible  pupils,  spasmodic  twitcliing  of  tlie  lids,  or  mist  before  tlit 
eves,  acliinjj  and  distensive  pains  in  tlie  orbits  and  forehead,  and  red  face. 
Calcarea,  for  mistiness  of  sight,  as  if  gauze  were  before  iho  eyes,  espp. 
ci  illy  when  reading  ;  for  dilated  pupds,  and  for  pre.'isuro  or  feohn;;  of 
coldness  in  the  eyes.  Causticum,  for  sudden  and  frccpient  loss  of  sight, 
with  sensation  as  if  something  wera  stretched  over  tiio  eyes,  or  for  dim- 
siyhtedncss,  as  if  looking  througii  a  veil  or  mist.  China,  lor  weak  sight: 
the  patient  only  sees  the  outlines  of  things  near  him  ;  letters  took  |ialti, 
and  a|i])ear  to  be  surrounded  by  white  borders;  dilated  and  not  very 
Bcnsiblo  pupils  ;  dinniess  of  the  cornea,  as  if  the  eyes  were  filled  with 
smoke,  or  black  motes.  The  eyes  feel  better  after  sleeping.  Cicuta, 
is  indicated  when  the  sight  frequently  vanishes,  and  when  there  is  vertigo 
or  absent-mindedness,  or  aching  pains  in  the  orbits.  Cina,  for  dimness 
of  sight  improved  by  wiping  the  eyes,  and  for  pressure  in  the  eyes  when 
reading,  as  if  sand  had  got  in.  Cimicifuga,  when  there  is  aching  pain  in 
the  centre  of  both  eyeballs,  and  black  specks  before  the  eyes.  Drosera,  for 
frequent  vanishing  of  sight,  or  when  the  eyes  are  dazzled  with  the  glare 
of  light  or  of  tire.  Q-elseminum,  when  there  is  a  thirst  for  light  after 
Apoplex}',  or  Congestion  of  the  Brain.  Hyoscyamus,  for  squinting,  illu- 
iovy  sight,  and  stupefying  pains  over  the  eyes.  Mercurius,  for  i)arox- 
ysms  of  momentary  blindness,  sensitiveness  of  the  eyes  to  light  or  the 

f;lare  of  (ire.  Nux  vomica,  for  red  face  and  sensitiveness  of  the  eyes  to 
ight  only  in  the  morning.  Phosphorus,  for  paioxysras  of  sensations  as 
if  things  arc  covered  with  a  gray  veil.  Pulsatilla,  for  paleness  of  the 
face,  and  disposition  to  vomit,  and  a  sensation  as  if  dimness  of  sight  could 
be  removed  by  wi[)ing;  for  frequent  and  copious  flow  of  tears,  and  con- 
craction  of  the  pupils.  Ruta,  for  mistiness  of  sight,  and  boring  pains 
in  the  orbits,  and  the  filling  of  the  eyes  with  water  in  the  :pen  air. 
Sepia,  for  dimness  of  sight  when  at  work,  stripes  before  the  eyes  and 
aching  pains  in  the  eyeballs,  with  sick  headache.  Sdioea,  paroxysm.! 
of  sudden  obscuration  of  sight,  as  if  a  colored  veil  were  before  the  eyes. 
Sulphur,  for  general  mistiness  of  sight,  as  if  looking  through  featiier-dusl 
or  black  ^au3<j ;  great  dryness  of  the  eyes.  Veratrum  album,  for  proiusn 
shedding  of  tears,  or  the  copious  filling  of  the  eyes  with  water.  Vira- 
trum  viride,  when  walking  brings  on  blindness,  with  fainting  vertigo 
and  dilated  pupils.  When  any  one  of  the  remedies  is  indicated,  let  the 
dose  be  repeated  only  once  in  twenty-four  hours.  In  all  affections  of 
the  sight,  the  patient  should  avoid  hearty  meals  or  excessive  overloading 
of  the  stomach  ;  he  should  be  regular  in  his  habits,  and  free  as  ])ossible 
from  mental  anxiety ;  and,  above  all,  his  habits  should  bo  strictly  tem|)cr- 
ate,  and  late  hours  should  be  avoided.  In  most  cases  of  defective  sight, 
the  eyes  require  rest.  An  attempt  to  exorcise  them  in  reading  in  any 
defective  light  is  pernicious  ;   and  so  is  prolonged  reading  in  any  light. 


DISEASES  OR  VARIOL'S  OROANS  AND  RKOIONS. 


851 


la.  If  by  Epi- 
M/n,  or  Sulphur. 
tour  liourH. 

muy  bo  stated 
liiiU'-siglitednoss, 
rScurlot  Fevor, 
hit*-(l  |)U|)ilu,  or 
mist   botinv   tlit 
t(l,  and  rod  fucu. 
llio  eyes,  espp. 
o  or  I'eolin^j  of 
lit  loss  of  sifjlil, 
-■yes,  or  lor  dim' 
lor  weak  siglit : 
ctters  look  jiule, 
h1  and  not  very 
WL-re   filled  with 
seping.      Cieuta, 
1  there  is  vertigo 
Jina,  for  dimness 
[I  the  eyes  wlien 
is  aching  pain  in 
es.     Drosera,  for 
ed  with  the  glare 
rst  for  light  after 
ur  squinting,  illu- 
uriua,  for  i)arox- 
i  to  liglit  or  the 
'S3  of  tine  eyes  to 
of  sensations  as 
p  paleness  of  the 
ess  of  sight  could 
f  tears,  and  con- 
md   boring  pains 
n  the  :pen   air. 
)re  the   eyes  and 
iliflea,  paroxysnii 
before  the  eyes. 
3ugli  featiier-dust 
Ibum,  for  proliist^: 
h  water,      l^tra- 
fainting  vertigo 
ndicated,  let  the 
all  aifections  of 
ssive  overloading 
1  free  as  j)ossible 
)  strictly  temjKjr- 
r  defective  sight, 
t  reading  in  any 
g  ni  any  light. 


Paralysis  of  the  EjeMB.^Hlepharoplegia, 

This  affection  sometimoa  occurs  in  children,  but  very  rarely  in  aduitt, 
ancl  requires  remedial  treatment.  The  best  remedies  are  Belladonna, 
Spigelia,  Sepia,  and  Stramonium.  Belladonna,  if  there  is  redness  of 
the  fiice  ;  Spigelia,  if  there  is  any  sign  of  spasms  ;  Sepia,  if  it  follows 
sevcro  hcadncho,  nnd  sickness  o^the  stomiuli ;  Stramonium,  if  there 
is  pale  face,  nnd  inclination  to  sleep.     Cuunlicum  for  chronic  cases. 

Whooping-Ooagh.  —  Tuftais  Spaamodiccu 

Atnong  the  diseases  of  children,  we  find  this  mala<ly  quite  common. 
The  cause  is  only  conjectured.  As  it  is  a  disease  much  dreaded  by 
parents,  wo  shall  not  only  be  particular  in  describing  the  disease,  but 
also  in  pointing  out  the  remedies  for  tho  various  stages  and  complications. 
The  cough  begins  in  the  form  of  an  oi'dinary  catarrh  arising  from  a  cold. 
The  chifd  has  cory^ui,  and  coughs;  tjie  mother  or  nurse  may  bo  aware 
that  the  disease  commences  in  this  way,  and  liieir  fears  may  be  that  it 
will  turn  out  VVhooping-Cough.  The  catarrhal  stage  may  last  ten  days 
or  two  weeks,  and  then  a  (tiilerent  and  characteristic  cough  sets  in.  This 
cough  comes  on  in  paroxysms,  in  which  a  number  of  rapid  expirations 
follow  each  other,  as  in  the  act  of  coughing,  and  with  much  violence, 
and  without  any  intervening  inspiration,  till  the  patient  turns  black  in 
the  face,  and  seems  on  the  point  of  being  suffocated ;  then  one  long- 
drawn  act  of  inspiration  takes  place,  attended  with  that  peculiar  rough, 
crowing  noise,  which  is  denominati>d  a  whoop,  and  gives  tho  disease  its 
name.  Immediately  after  this  long-drawn  inspiration,  a  series  of  short 
expiratory  coughs,  repeated  till  the  breath  is  almost  exhausted ;  and  then 
a  second  whoop,  until  a  white  glary  mucus  is  thrown  up,  and  this  ends  the 
paroxysm.     After  a  lapse  of  some  little  time,  the  paroxysm  will  bo  re- 

ftcatcd.  During  the  urgency  of  some  of  these  paroxysms,  the  face 
lecomes  '^'d  and  swollen,  tlip  nose  bleeds,  the  eyes  start  from  the  sockets, 
the  lit'ie  sufferer  stamps  with  impatience,  and  clings  to  some  object  near 
him  ;  and  this  frenzy  continues  till  vomiting  or  expectoration  ends  the 
paroxysm.  The  victim  pants  a  little  while,  and  appears  quite  well  again, 
«nd  Ix'gins  to  have  a  craving  for  food.  The  number  of  paroxysms  thai 
jccur  every  twenty-foui  hours  varies  in  different  subjects.  Children 
are  very  susceptible  to  the  disease,  and  it  spreads  by  contagion.  The 
ordinary  duration  of  the  disease  is  from  six  weeks  to  three  months ;  but 
it  may  inn  itf  course. ir  three  weeks,  and  sometimes  not  for  four  or  five 
months. 

As  long  as  this  disease  is  uncomplicated,  —  unmi.xed  with  inflamma- 
tion, and  therefore  without  fever,  or  with  that  slight  inflammatory  con- 
dition proper  to  a  mild  catarrh,  —  it  is  not  a  dangerous  disease.  In  all 
probability,  it  will  run  its  couree  under  the  most  favorable  circumstances 
How  much  it  can  ^-^  abridged  by  appropriate  remedies  is  yet  a  question , 
but  the  violence  of  the  disease  may  be  moderated,  its  sequel  may  be 
guarded  against,  and  its  complications  may  be  teranered,  by  the  right  use 
of  rcm<;dies.     The  most  fai'orable  season  for  the  disease  to  rage  is  in  the 


1 


a 


852 


DISRAflEH  OP   VARIOUS  ORGANS  AND  RK0I0N8. 


anrinp,  when  t!io  weather  is  becoming  warmer.     The   most   unfavor- 
nl)le  in  Intu  in  tlio  full,  when  tiie  weather  in  auf!;tnentinf;;  in  colilness. 
(\)i(l  or  (lani|)  weather  is  thought  to  protract  the  disease,  and  warm 
wentlicr  to  nbridgo  it.     Wo  have  thus  betm  somewhat  pnrticuhir  in  de- 
tcrihing  this  malady,  in  order  to  facilitate  its  treatment  by  mothers  and 
nurses.     We  will  now  proceed  to  direct  the  use  of  appropriate  remedies. 
In  the  cntarrhul  stage,  give  Aconite.     If  there  is  fulness  of  the  nose,  and 
'leadaclie,  give  lielladonna.     In  case  of  asthmatic  Ireathing,  give  ipecao. 
Aconite  is  the  remedy  for  a  dry,  wheezing  cough,  with  fever  or  burning 
pain  in  the  larynx,  or  windpipe.     Belladonna  is  the  remedy  I'or  severe 
paroxysms,  with  congestion  of  blood  to  the  head,  expectoration  of  l)lood, 
and   bleeding  from   the  nose,  the  eyes   appear  congested,  involuntary 
stool  and  urine,  and  also  when  the  paroxysm  is  announced  with  crying, 
which  arises  from  pain  in  the  stomach,  but  not  accomi>aiiied  by  vomiting. 
Also,  in  tlio  first  stage,  Carho  veg.  may  be  given  when  the  cough  is  con- 
vulsi>e,  especially  in  the  evening,  and  when  there  is  great  exhaustion 
after  each   cougliing-spell.     Dulcamara   is   a   good   remedy  when  tl»e 
cough  is  moist  from  the  commencement.     Ipecac,  for  the  incipient  stage, 
when  the  c'mW  has  coughing-spella  so  rapid  as  not  to  bo  able  to  get  his 
breath,  and  when  the  open  air  is  reqiisite  to  relieve  him.     Pulsatilla  is 
uset'id  when  the  cough  is  loose  from  tlie  beginning,  and  worse  towards 
evening.     In  the  second  stage,  after  whooping  sots  in,  with  vomiting, 
and  bleeding  from  the  nose  and  mouth,  give  Uaulophyllum.     If  without 
bicedmg  at  the  nose,  give  Dro$era.     If  the  children  suddenly  become 
rigid,  giv'^  Cina.     This  remedy  is  specific  when  children   are  affected 
with  the  nsuf.l  worm  symptoms,  and  the  paroxysm  is  followed  by  a 
gurgling  noise  from  the  abdomen.     CoralUa  rubrum  is  believed  to  be  a 
sure  remedy  lor  violent  spasmodic  cough  ;    short,  bai'king  cough  all 
Jay,  and  towaids  evening  becoming  violent  and  spasmodic.     Cuprum 
is  indicated  when  every  paroxj'sm  is  attended  with  cataleptic  fits,  so  that 
in  most  every  paroxysm  the  child  appears  as  dead.     Veratrum  is  very 
suitable  aftor  Cupritm.     Droaera  is  the  remedy  when  tlio  paroxj-sms  come 
on  at  midni^iit   and  cease  before  noon,  and  are  very  Hcver-!  ami  sufTocat- 
ing.      Vcmtrntn   (ilbum   is   iudicuted,   after    Droaera  and   Cuprum    have 
been  employed,  when  the  patient  is  very  feeble,  qui.;k  pulse,  and  with  a 
sort  of  hectic  fever,  and  cold  sweat  upon  the  forehead,  and  great  thirst; 
and  also  when  the  coughing  causes  an  emission  of  uritie,  and  pain  in 
the  chest  and  loins,  and  when  the  patient,  between  the  paroxysms,  is  in  a 
comatose  state,  and  cai-es  not  either  to  move  or  converse  ;  and  also  when 
there  is  excessive  weakness  of  the  neck,  so  that  the  victim  is  scarcely 
able  to  keep  the  head  erect ;  and  also  when  there  is  rash  over  the  body, 
Of  face  and  hands.     For  the  most  severe  or  convulsive  stage  of  whoop- 
ing-cough, give  Belladonna,  when  there  is  pain  in  the  head,  or  convul- 
sions ;  give  Bryonia  when  the  child  coughs  immediately  after  eating 
or  drinking,  and  vomits  what  he  has  eaten,  and  returns  immediately  to 
finish  his  meal,  and  then  coughs  and  vomits  again ;  give  Chamomilla 
when  the  cough  and  vomiting  are  more  frequent  during  a  meal,  fi-etfiil 
disposition,  and  worse  at  night ;  give  Causticum  when  the  cough  is 
better,  and  when  it  is  dry  and  hollow ;    give   Hj/08cyamus  when   the 
patient  is  worse   lying  down,  and  better  on  sitting  up ;  give   Arnica 


most   unfavor* 
n;^  in  colilnoas. 
vnso,  and  warm 
mrticular  in  do* 
by  mothers  and 
)rinto  remcdieji. 
of  tliu  noso,  and 
nj;,  givo  Ipecao. 
i'Vcr  or  bnrninj» 
mi'dy  lor  scvito 
ration  of  blood, 
ted,  invoiunfiiry 
cd  with  cryinj*, 
lied  by  vomiting. 
he  cough  is  con- 
j^ieat  cxiiaustion 
niedy  when  the 
0  incipient  stage, 
5  able  to  get  his 
Pulsatilla  is 
d  worao  towards 
1,  witii  vomiting, 
Hum.     If  without 
suddenly  become 
Iren   are  affected 
is  followed   by  a 
s  believed  to  be  a 
arking  cough  ah 
imodic.     Cuprum 
ileptic  fit3,  80  that 
Veratrum  is  very 
0  paroxj-sms  come 
ver-!  and  sufFocat- 
iid   Cuprum    have 
pulse,  and  with  a 
and  great  thirst ; 
rine,  and  nain  in 
paroxysms,  is  in  a 
e  ;  and  also  when 
victim  is  scarcely 
sh  over  the  body, 
stage  of  whoop- 
head,  or  convul- 
ately  after  eating 
IS  immediately  to 
give  Chamomilla 
ng  a  meal,  fretful 
len  the  cough  is 
yamuf  when   the 
lip ;  give   Arnica 


DISEASES  OK  VARIOUS  ORaANS  AND  REGIONS. 


663 


when  the  patient  feels  sore  from  coughing.  After  the  cou'^h  subsides. 
and  there  is  any  seiiuel  left  beiiiiid,  givo  whatever  remedy  is  indicated  ; 
as  Aconite  for  fever,  Nux  vom.  for  constipation,  Phoftphoricn  for  catarrh, 
Cliina  for  extreme  weakness,  <tc.  If  there  is  no  loss  of  appetite,  allow 
A  Bubstuntial  diet  in  all  the  stages  of  the  disease.  Cluingo  i)f  air  i? 
very  benetieial,  even  if  but  u  short  journey  fro. a  homo,  ospeciully  to 
the  Hea-shore. 


«  / 


H 


w 


AFFECTIONS  OF  THE  MIND. 


\\: 


It  is  well  known  to  physiologiats,  that  soundness  of  mind,  as  well  as 
entire  soundness  of  bocly,  indicates  a  condition  of  perfect  health.  The 
two  are  so  intimately  blended,  that  one  can  hardly  exist  without  the 
lither,  and  vice  vend.  An  unsound  condition  of  the  |)hysical  system  is 
often  attended  with  manifest  unsoundness  of  mind.  It  is  not  intended 
to  include  the  mental  phenomena  frequently  attendant  on  acute  fevers, 
as  in  Nervous,  Scarlet,  and  other  fevers,  but  such  only  as  appear  to  exist 
as  the  chief  symptom  of  disturbance  in  the  entii*e  system  j  and  we  will 
begin  with  simple 

Mental  Derangement. 

What  is  understood  by  mental  derangement  is  a  disordered  mind, 
which  may  have  been  occasioned  by  one  or  more  of  a  variety  of  caujes 
It  is  ind:Cttted  by  irrational  expressions  of  illusory  notions,  incohejii.) 
ideas,  strange  fancies,  and  not  unfrequently  by  vicious  inclinati-.rs 
TlxM'e  is,  nevertheless,  some  specific  caise  lor  every  case  of  ment'.l 
alienation  that  occurs  ;  and  tha  treatment  has  to  be  adapted  with  nter 
ence  to  the  cause,  when  there  "s  a  chain  of  circumstances  tiiat  indiocci 
it.  Nevertheless,  the  cause  is  not  always  apparent,  and  therefore  j/ar 
ticular  symptoms  must  be  oar  guide  in  affiliating  remedies.  Wi.er 
insanity  takes  the  form  of  rage,  and  the  patient  appears  to  be  governed 
by  angry  and  revengeful  feelings,  and  is  inclined  to  utter  imprecation* 
and  threats  towards  his  best  friends,  give  Aconite  in  daily  doses.  If  liis 
face  appears  flushed,  and  his  eyes  sufftised,  and  exhibit  a  fiery  red  ap- 
pearance, give  Belladonna,  If  in  a  scrofulous  subject,  give  Calcarea. 
If  strarge  fancies  seem  to  beset  the  patient,  or  complaints  are  made  ol 
illusory  sights,  give  Hyoscyamus.  If  the  patient  is  inclined  lO  run  aw.ay 
from  home,  or  hide  in  some  secret  place,  give  a  dose  of  Sulphur,  nml 
follow  with  a  few  doses  of  Stramonium  every  three  or  four  luius. 
If  the  patient  seems  depressed,  and  sighs  frequently,  give  Lav?,csi8. 
If  much  distress  is  evinced,  and  there  is  dLtective  nutrition  give 
Nnx  vomica.  For  violent  rage,  followed  by  soporific  sleep,  give  Opu 
urn.  If  the  patient  laui^hs  and  talks  continually,  give  HyoHcyamua , 
or  if  given  to  crying,  sobbing,  or  constant  weeping,  give  J^nat.j.     U 

854 


m 


■ 


AFFECTIONS  OF  THE  MIND. 


855 


the  patient  is  subject  to  cold  sweats,  give  Veratrum.  If  thirsty,  give 
Armmicfum.  If  there  is  great  weakness  and  prostration,  give  China. 
If,  during  paroxysms  of  rage,  there  is  intense  perspiration,  give  TiTerou- 
rius,  Disposition  to  suicide,  Aurum.  None  of  the  medicines  need  be  re- 
peated oftoner  tlian  twice  a  day.  Great  care  should  bo  taken  to  keep  tlie 
stomach  of  the  patient  at  ease,  by  furnishing  for  it  light  but  nutritious  food. 


Mania  Produced  by  Depression  of  Spirits. 


mind,  as  well  as 
ct  health.  The 
sxist  without  the 
hysical  system  is 
t  is  not  intended 
on  acute  fevers, 
as  appear  to  exist 
;em ;  and  we  will 


disordered  mind, 
variety  of  causes 
otions,  incohoiuf 
ious  inclinati-.ra 
/  case  of  ment'.l 
apted  with  ri.ter 
ces  that  indie accc 
id  therefbro  )<ar 
•emedies.  Wl.er 
rs  to  be  govcnv't! 
itter  imprcca.tlMiis 
lily  doses.  l(  his 
)it  a  fiery  red  !i|i- 
ct,  give  Calcarea. 
lints  are  made  of 
lined  lO  run  awa> 

of  Sulphii}\  Hiul 
B  or  four  liJiirs. 
,',  give  Loo^A^sis. 
0    nutrition    give 

sleep,  give  Opt- 
ive  Hyo»cynwus, 
;ive  ^naLs.     If 


iVOtructed  Grief*  —  Extreme  mortification  or  chagrin,  or  intense  an - 

/r,  may  ciul  in  mental  derangement.     Wiien  grief  wears  out  the  mind, 

11(1    strange  fancies  begin   to   show  themselves,  give  Ignatia.     Wlirn 

.icat  mortification  on  account  of  some  expi^sure  to  censure,  or  on  acconni 

f  some  humbling  of  family  pride,  give  Phoa.  acid.     Wiion  disappoint- 

aea  t  unsettles  the  mind,  and  chagrin  gives  rise  to  insane  imaginings, 

.rive  Pulsatilla;  or,  if  there  is  a  manifest  inclination  to  liido  away  trim 

li  ends,  give  Sulphur,  and  follow,  in  four  or  six  hours,  with  a  dose  of 

Hyosoyamus.     If  the  face  is  red,  and  the  temples  beat  and  throb,  give 

Belladonna.     When  excessive  anger  and  general  moro:5oness  of  spirit 

snsue,  with  general  antipathy  towards  every  one,  give  Sulphur,  and,  in 

oix  hours,  follow  with  a  few  doses  of  Nux  vomica. 


Mania  from  Excited  Emotions. 

The  mind  is  often  beset  with  emotions  of  one  kind  or  another,  that 
often  tend  to  unsettle  and  derange  it.  Anguish  or  foreboding  often  has 
this  disastrous  etfijct,  and  one  of  the  principal  remedies  is  Aconite.  If 
there  is  an  attending  inclination  to  weep,  give  Ignatia.  If  there  is  dul- 
ness  or  stupor,  give  Opium,  or  if  in  females,  give  Pulsatilla.  If  mania  is 
produced  by  fright,  give  Aconite,  Coffea,  or  iVua;  vom.  When  fear  un- 
settles the  mind,  give  Lachesis,  Hyoscyamus,  Gelsemium,  Opium,  or 
Pulsatilla.  When  excessive  joy  produces  derangement  of  the  mental 
faculties,  and  gives  rise  to  strange  fancies,  give  Coffea,  Opium,  or 
Fulsatilla.  When  homesickness  unsettles  the  mind,  give  Phos.  acid. 
When,  fancied  neglect  of  friends  distracts  the  imagination,  give  Gaus- 
ticum  or  Capsicum.  For  unhappy  love,  and  the  derangement  of  mind 
consequent  thereon,  give  Hyoscyamus,  Ignatia,  or  P/iospltoric  acid^ 
or  perhaps  Coffea,  or  Nux  vom. 

If  disappointed  affection,  or  any  cause,  produces  the  mania  of  suicide,  give 
Aurum.  If  excessive  jealousy  ends  in  mania,  give  Hyosct/amnn.  Jf  rage 
ensues  upon  insults,  give  VeratmmaJb.,  Belladonna,  or  Chnniomilla,  if  upon 
contrad"'''ou,  give  Aconite^  and  afterwards /r/na<(V.  or  Nii.v  vom.  For  the 
concomitant  symptoms  of  iusanity  from  excited  emotions,  give  Ac<Jiiite  whi-n 
there  is  headache,  feverish  heat,  or  tendency  of  bh)i)d  to  the  iu:.  .. 
Give  Belladonna  when. there  is  loss  of  conscioiLsiiess,  or  constant  anx- 
iety, with  fear,  weeping,  howling,  and  malice  (i  \  children),  ami  also 
wlien  Aconite  and  Opium  had  proved  insufficient  \\n'  the  conseipiences 
of  fright.  Give  Bryonia  when  there  is  chilliness  and  shuddering  over 
the  wliolo  body,  great  tendency  to  vehement  anger,  loss  of  iippetitu, 
nausea,  vomiting,  and  bilious  state  in  consequence  of  anger.     Give  Cap 


iicum  for  sleeplessness  caused  by  homesickness,  with  heat  and  redness  of 
the  checks.  Give  Chamomilla  when  anger  produces  bitter  taste  of  the 
moutli,  nausea,  disposition  to  start,  and  vomiting  of  bilious  matter, 
Give  Coffea  when  there  is  much  nervous  excitement  after  great  joy. 
Give  Colocynth  when  chagrin  or  mortification  produces  Spasmodic  Colic, 
or  cramps.  Should  this  condition  persist,  give  Causticum.  Give  Hyom/. 
amns  whoii  fear  prothices  stupefaction  or  convulsions,  involuntary  laughter 
during  sleep,  or  a  desiiT  to  riui  uway.  (Uve  Ignatia  for  grief,  disappoint- 
moiit  or  unliiippy  love,  wlien  tliere  is  deep,  gnawing,  irresistible  grief,  vomit- 
ing, luiidiuhe,  vertigo,  pale  face,  convulsions,  or  epilepsy,  and  in  children 
when  tli'y  occrur  from  the  shock  of  fright  or  fear.  When  homesickness,  fright, 
or  iMortillciition  is  attended  with  great  anguish,  restlessness,  and  trembling, 
or  sudden  starting  from  sleep,  or  accelerat(Kl  circulation  on  the  least  exor- 
tion,  slei'plessni'ss.  and  inability  to  bear  the  warmth  of  the  bed,  great  ner- 
vousness, a  disposition  to  be  quarrelsome,  and  to  complain  of  everybody  as 
being  hat«ful,  and  the  patient  takes  a  dislike  to  his  own  family,  and  wishes  to 
leave  tliem,  and  also  whe:;  there  is  shivering  and  night  sweats,  give  Mer- 
i-urius.  Give  Nux  vomica,  when,  alter  an  angry  tit,  there  is  chilliness 
without  heat.  Give  Opium  when  diarrhoia  follows  excessive  joy  or  fear, 
or  when  a  sudden  start  or  fright  produces  sudden  and  involuntary  diar- 
rh(ca,  with  heaviness  of  the  abdomen.  For  chronic  diarrhoea  from  fright, 
Gehemium.  Give  Phosphoric  cicid  in  all  oases  after  deep  grief,  homesick- 
ness, or  unhappy  love,  when  the  patient  is  taciturn,  dull,  or  listless,  and 
has  a  constant  deshe  to  sleep,  and  has  night-sweats  towards  morning,  after 
hectic  fever  in  the  evening.  Give  Pulsatilla  when  fear  produces  ccld  hands 
and  feot.  Give  Veratrum  album  when  any  emotional  excitement  produces 
diarrhea  or  involuntary  evacuations  from  the  bowels,  with  coldness  of 
the  whole  abdomen. 


^' 


Morbid  Emotions. 

A  celebrated  writer  on  insanity  considers  all  morbid  emotions  under 
this  head,  and  for  this  reason :  that  all  morbid  states  of  the  mind  may 
become  so  augmented  as  to  result  in  complete  Mania  or  Monomania. 
It  is,  therefore,  well  to  understand  the  best  method  of  bringing  remedial 
action  to  bear  upon  the  first  departure  from  sound  health  of  any  faculty 
or  emotion  cf  mind.  For  anguish  or  anxiety,  no  remedy  seems  bettei 
adapted  than  Arsenicum,  to  be  given  morning  and  evening,  or,  perhaps, 
Pulsatilla  for  females  at  the  menstrual  period,  or  Veratrum  album  for 
very  weak  and  exhausted  persons.  For  apprehension  or  fear,  give  Aconite 
morning  and  evening,  especially  if  the  sufferer  is  a  plethoric,  full-blooded 
person.  Give  Belladonna  to  one  who  suffers  much  from  headache,  or 
rush  of  blood  to  the  head  ;  or  Bryonia  if  there  is  anxiety,  with  heat  of 
the  chest  and  difficult  respiration  ;  or  Hyoscyamu»  for  anxiety  about  one's 
safety,  or  religious  anxiety ;  or  Opium  for  a  kind  of  anguish  and  depres- 
sion of  spirits  that  confuses  one's  ideas,  and  is  attended  by  a  stupidity  and 
headache.  When  one  is  constantly  vexed  and  irritable,  it  niay  be  in- 
ferred that  a  corresponding  physical  condition  requires  Arsenicum  once 
or  twice  a  day,  or  perhaps  Nux  vomica.  Jgnatia  is  suitable  when  tliere 
is  a  tendency  to  be  vexed,  and  to  weep  on  account  of  trifles.     For  one 


I 


3 


IC 


and  redness  of 

ter  taste  of  the 

bilious   matter, 

after  great  joy. 

pusniodic  Colic, 

Give  Hyomi- 

luntary  laughter 

^rief,  (lisappoint- 

tiblc  grief,  voinit- 

and  in  children 

isickness,  fright, 

ill  id  trembling, 

n\  the  least  exor- 

le  bed,  great  uer- 

1  of  evci'yl)ody  as 

ily,  and  wishes  to 

weats,  give  Mer- 

lerc  is  chilliness 

issive  joy  or  fear, 

involnntary  diar- 

rrhoja  from  fright, 

>  grief,  homesiek- 

11,  or  listless,  and 

rds  morning,  after 

■oduces  ccld  hands 

citement  produces 

with  coldness  of 


d  emotions  under 
of  the  mind  may 
ia  or  Monomania, 
bringing  remedial 
1th  of  any  faculty 
nedy  seems  bcttei 
ening,  or,  perhaps, 
'.ratrum  album  for 
r  feai*,  give  Aconite 
thoric,  full-blooded 
from  headache,  or 
?iety,  with  heat  of 
mxiety  about  one's 
iguish  and  depres- 
by  a  stupidity  and 
ible,  it  may  bo  in- 
18  Arsenicum  once 
litable  when  there 
>f  trifles.     For  one 


AFTKCTIONS   OF   THE   MIND. 


857 


always  in  haste  to  get  angry  without  reason,  give  Aurum  or  Sulphur. 
When  one  is  morbidly  sr.spicious  and  distrustful,  and,  in  fact,  is  a  hater  of 
his  fellow-men,  and  wi?ihes  to  avoid  every  one,  and  to  spend  his  time  iu  se- 
clusion, give  Arsenicum,  Hyosci/amnn,  Pulsatilla,  or  Rhus  tox.  For  nervous 
excitement,  which  may  lead  to  mental  derangement,  give  Aconite  or  J'l  Isa- 
tilla;  and  especially  if  there  is  great  tendency  to  start.  For  a  morltidl}'^ 
malicious  disposition,  give  Belladonna,  Jlyosci/ainus,  and  Lacheds.  For  a 
disposition  to  kill  somebody,  or  to  commit  acta  of  violence,  give  Stramo- 
nium, Belladonna,  or  Veratrum  album,  morning  and  evening  until  a  change. 
For  a  morbid  disposition  to  be  audacious  or  impertinent,  give  Ignatia,  Opium, 
or  Sulphur.  For  headstrong  obstinacy,  and  disposition  to  be  quarrel- 
some, give  Bcllad'yana,  Nux  vomica,  Ignatia,  Lachesis,  and  Veratrum.  For 
an  artful  disposition,  or  an  involuntary  disposition  to  practise  deception  with 
no  definable  motive,  give  Lachesis  and  Nux-  vomica.  When  tlie  mind 
is  either  beset  with  fancies  or  fixed  ideas,  give  Belladonna,  Vocealus, 
Stramonium,  or  Sulphur.  For  sad  and  melancholic  foncies  and  lore- 
bodings,  give  Calcarea,  China,  or  Pulsatilla,  and  Petroleum.  For  a 
morbidly  serious,  silent,  and  untalkative  disposition,  give  Belladonna, 
Uyoscyamus,  and  Pulsatilla.  For  morbid  indifference  and  apathy,  give 
Arsenicum  morning  and  evening,  or  else  Phosphoric  acid.  Sepia,  and 
Sulphur,  in  daily  doses.  Moaning  and  lamenting  without  any  special 
cause  indicates  a  degree  of  insanity  that  demands  prompt  attention  ;  and 
Hyoscyamus  may  be  given  three  times  a  day,  or  else  Chamomilla, 
Coffea,  or  Ignatia.  Despondency,  despair,  and  being  tired  of  life,  as 
well  as  an  inclination  to  suicide,  are  severally  alFcctions  of  the  mind  that 
are  subject  to  medical  treatment.  Arsenicum  may  be  given  morning 
and  evening  for  despair ;  Lachesis  for  despondency,  especially  where 
there  is  sighing,  as  if  something  awful  was  weighing  upon  the  mind. 
For  inclination  commit  suicide,  give  Aurum  and  Araenicum,  especially 
if  there  is  great  anguish,  melancholy,  and  morbid  disgust  of  life.  For 
one  simply  tired  of  life,  and  anxiou^  to  get  out  of  this  world  by  natura. 
death,  give  China,  Lachesis,  or  Nitric  acid.  For  illusions,  and  illusory 
notions,  showing  mental  difficulties,  give  Lacliesis,  China,  or  Pulsatilla. 
Many  of  these  mental  difficulties  are  the  result  of  selfishness  or  mor- 
tified self-love,  and  can  be  overcome  by  strong  detcimination  of  the 
will  and  moral  training,  which,  of  course,  involves  more  or  less  of  jelf 
denial.  ^ 

Beligious  Maniai 

This  mental  affection  is  simply  a  morbid  excitation  of  religious  senti- 
ment and  feelings,  producing  strange  and  fanciful  ideas  of  God,  heaven, 
and  the  importance  of  certain  missions  to  which  the  victims  believe  them- 
selves specially  called.  Religious  Mania  is  characterized  by  morbid 
inclination  to  be  always  singing,  praying,  preaching,  and  performing  reli- 
gious rites,  out  of  time  and  place,  and  in  a  disconnected  and  incoherent 
manner.  The  cause  of  this  mental  affection  may  be  excitement  upon 
religious  topics,  or  during  what  is  ordinarily  termed  religious  revivals. 
The  effect  of  any  thing  of  the  kind  is  to  unsettle  the  healthy  condition  of 
the  nerves  and  that  of  the  nutritive  system.     For  Beligious  Mania  in 

108 


'■  I 


858 


AFFECTIONS   OF  THE  MIND. 


general,  give  Hyoacyamus  or  Stramonium;  for  that  which  is  attended 
with  indigestion,  give  Nux  vomica;  for  that  which  is  accompanied 
by  tori)idity  of  the  liver  and  melancholic  temper,  give  Arsenicum, 
jMercurius,  Podqpki/llin,  and  Ignatia.'  Let  the  patient  avoid  all 
surroundings  calculated  to  unsettle  the  mind  or  emotions. 

Hypochondria. — ^y  ochondriasis. 

Pinel  classes  Hypochondria  among  the  various  fornn  of  insanity,  as  it 
18  characterized  by  morbid  imaginings  concerning  one's  health.  Somo- 
tiines  the  victim  imagines  himself  void  of  strength,  or  sadly  diseased  at 
tlio  heart;  ho  fancies  ho  sees  death  staring  him  in  the  (ace,  and  bcliovea 
himself  otlen  in  a  dying  condition,  wlien,  in  fact,  there  is  not  the  sliglitost 
reason  for  such  apprehension.  In  the  future,  ail  is  darkness :  the  next 
hour,  the  next  day,  week,  or  year,  is  believed  by  him  to  be  j)regnant  with 
sometliing  awful.  He  never  enjoys  a  laugh,  for  every  thing  is  clothed 
in  gloom.  If  the  subject  is  of  a  bilkous  temperament,  and  has  black  hair 
and  eyes,  give  Mercuriua;  if  of  a  lymphatic  temperament,  and  inclined 
to  obesity,  give  Pulsatilla;  if  of  a  sanguine  temperament,  and  has  red 
hair  and  blue  eyes,  give  Nux  vom. ;  if  addicted  to  the  use  of  intoxicating 
liouors,  give  Arsenicum  or  Nux  vom. ;  if  of  a  downcast  countenance,  and 
Buojcct  to  indigestion,  give  Niix  vopiica,  Lycopodium,  or  Petroleum.  If 
caused  by  sexual  abuse,  give  China  or  Sulphur;  when  caused  by  sedentary 
habits,  Nux  vomica  and  Sulphur,  or  if  by  derangement  cf  the  abdominal 
functions,  and  constipation,  give  Calcarea,  Lachesis,  or  Lycopodium ;  for 
one  sufTering  from  languor,  mental  dulness,  or  mental  distress  and  discour- 
agement, give  China.  If  the  victim  bos  the  fixed  idea  tliat  he  is  unhappy 
and  has  no  friends,  and  imagines  himself  surrounded  by  enemies,  China  is  also 
the  remedy.  For  a  hypochondriac  troubled  with  weak  digestion  and  disten- 
sion of  the  abdomen,  ill-humor  and  indolence  after  eatmg,  give  China; 
when  he  laments  on  account  of  the  future,  and  desires  to  be  alone,  give 
Natrum  muriaticum;  when  he  is  beset  with  ill-humor,  despondency,  and 
aversion  to  life,  give  Nux  vomica ;  when  with  painful  anxiety  of  mind 
and  lowness  of  spirits,  julphur ;  when  he  has  great  dread  of  death,  and 
is  in  restless,  whining  mood,  give  Aurum;  if  indifferent  about  his  busi- 
nois  or  his  own  family,  give  Sepia.  Any  of  the  remedies  named  may  l»e 
jjiven  three  times  a  day. 

Weak  Memory. 

There  are  many  conditions  of  the  physical  system  that  mav  operate  to 
impair  the  memory  ;  the  most  prominent  of  which  are  those  that  produce 
debility,  —  such  as  loss  of  blood  and  other  animal  fluids,  and  intense  ap- 
plication of  the  mind.  When  occasioned  by  the  former,  give  China,  Nux 
i;om.,  and  Sulphur^  in  daily  doses ;  when  by  the  latter,  Nux  vom.,  J'uha- 
lilla,  or  Sulphur  ;  if  caused  by  external  injuries,  give  ^nu'ca  or  Rhus;  if 
by  Inebriation,  Arsenicum,  Opium,  or  Nux  vom  ;  if  caused  by  violent  emo 
tions,  as  fright,  grief,  or  anger,  give  Aconite,  Opium,  Phos.  avid  ;  if  caused 
by  dampness,  give  Carbo  vpff.,  lihus,  Veratrum  album;  if  by  rusli  of 
blood  to  the  head,  give  Belladonna.    In  nearly  all  instances  of  weakness 


iVfK 


AFFKcriUNS  OF  THE  1\IND. 


lich  is  attended 
is  accompanied 
ive  Arsenicum, 
tiont  avoid  nil 
ona. 


8oy 


of  the  memory,  it  is  coiuK-ited  witli  somo  form  of  debil't^'.  Tiiiit  follow- 
ing epileptiform  disease  iv(]iiirea  /Sulphur;  that  followiii"^  uliildliiitli 
requires  China ;  and  also  weakness  of  memory  [bllowing  an  acute  li-vcr, 
or  any  other  prostrating  disease,  requires  China,  Jynatia,  Niix  voin.,  aiul 
Arteniaum,     Give  the  remedy  selected  twice  a  ilay. 


f  insanity,  as  it 

health.     Somc- 

sadly  diseased  at 

ice,  and  hdieves 

not  the  slightest 

kness:  the  next 

je  pregnant  with 

tiling  is  clothed 

1(1  has  black  liair 

ent,  and  inclined 

ent,  and  has  red 

so  of  intoxicating 

countenance,  and 

or  Petroleum.     If 

used  l»y  sedentary 

of  the  abdominal 

Lycopodium;  for 

itress  and  discour- 

tliat  he  is  unhappy 

(mies,  Cliina  is  also 

gestion  and  disten- 

tnig,  give  China  ; 

i  to  be  alone,  give 

despondency,  and 

I  anxiety  of  mind 

ead  of  death,  and 

It  about  his  busi- 

ies  named  may  Ite 


lat  mav  operate  to 
those  tliat  produce 
is,  and  intense  ap- 
,  give  China,  Nux 
Nux  vom.^  I'uha- 
.mica  or  Rhus  ;  if 
led  by  violent  cnio 
o8.  acid  ;  if  caused 
m;  if  by  rush  of 
ances  of  weakness 


Hy&terif  Derangement. 

The  ordinary  forms  of  Hysteria  sometimes  degenerate  into  insanity. 
The  nervous  system  becomes  shattered,  and  such  patients  become  tor- 
mented with  all  kinds  of  fancies,  —  sometimes  sexual,  frivolnus,  and  even 
foolish.  For  Hysteric  Insanity  in  general,  give  Ignatia,  Fhonpliorus,  or 
Platina;  or,  if  attended  with  uterine  derangement,  give  Auriim,  CrO' 
au8,  or  Sejna  ;  for  those  tormented  with  excessive  sexual  fancies,  give 
Phosplwrus,  Pulsatilla,  or  Platina;  if  the  patient  acts  foolishly,  with 
much  frivolity  and  levity,  give  Apis  mel. ;  if  fitful,  luughing  at  one  time 
aisd  crying  at  another,  give  Crocus  or  Stramonium  ;  if  there  are  marked 
heavings  of  the  chest,  g}ve  Phosphorus ;  and  if  the  bowels  are  consti- 
pated, persistent,  and  tedious,  giv^  Lycopodium, ;  if  in  any  way  connected 
with  the  menstrual  function,  give  Pulsatilla  ;  if  the  patients  are  prone  to 
lie  and  deceive,  give  Veratrum  album  ;  when  they  evince  an  insane  pas- 
sion for  work,  give  Lachesis  and  Hyoscyamus  ;  when  full  of  suspicion  and 
distrust,  give  Hyoscyamus,  Mercurius,  and  Pulsatilla  ;  if  excited  exces« 
sively  in  body  and  mind,  give  Aconite  and  then  Nux  vomica,  after  whicl 
give  Plu}splu)rus  or  Lachesis  ;  if  disposed  to  be  imperious,  and  exhibit  a 
passion  to  order  their  friends  about,  give  Lycopoclitim  or  Cuprum  ;  if  thev 
betray  a  tricky  and  maUcious  disposition,  gwoNux  vom.  ;  if  there  is  great 
obstinacy,  give  Belladonna,  Ignatia;  if  disposed  to  hide  or  be  alone, 
give  Calcarea;  if,  on  the  contrary,  there  is  a  mania  for  com])any,  and  a 
dread  of  being  alone,  give  Arsenicum,  Lycopodium,  Phoi^phorus, 
and  Belladonna ;  for  great  loquacity,  give  Stramonium ;  if  excessive 
mirthfulness,  give  Hyoscyamus ;  if  there  is  a  disposition  to  ol>- 
scenity,  and  a  great  want  of  modesty,  give  Hyoscyamus,  Phosphorus, 
or  Veratrum;  if  there  is  a  great  disposition  to  sing,  warl>le,  or 
whistle,  give  Belladonna  or  Stravionium ;  "\i  ihcve  is  a  disposition 
to  make  faces  and  cut  antics,  give  Cuprum  or  Stramonium;  if  there 
is  a  disposition  to  scold  or  swear,  give  Lycnpodiuin;  if  given  to 
self-importanco  and  pride,  give  Cuprum  to  men  and  Platina  to 
women.  Let  whatever  remedy  is  selected  be  administered  twice  a 
day.     Diet  should  be  moderate,  and  easy  of  digestion. 

Imbecility. 

Loss  of  mind,  as  well  as  the  derangement  of  its  faculties,  comes  under 
the  head  of  Mental  Difficulties.  Tiiere  are  several  causes  that  may 
operate  to  destroy  the  intellect.  Epileptic  fits  will  in  time  render  the 
brain  an  unfit  organ  for  the  mind,  and  consequently  there  can  be  but 
little  power  or  force  in  the  mental  manifestation.  A  softening  of  the 
brain  that  may  supervene  upon  inflammation  is  also  attended  with  imbe- 
cility.    Self-pcllution  is  also  a  fruitful  source  of  mental  weakness.     Con- 


genital  idiocy  results  from  causes  not  possible  to  describe ;  but  many  a 
hiiiriit  child  has  become  the  victim  of  idiocy  by  the  mal-treai.nent  it  lias 
iiud  in  the  nursery.  To  quiet  crying  children,  resort  has  been  had  to  a 
variety  of  sedatives,  instead  of  exercising  patience,  to  initiate  tiiem  into 
sleep  and  quietness.  How  often  do  nurses  give  poppy,  or  lettuce-tea,  to 
|.ut  a  crying  infant  to  sleep,  little  dreaming  that  they  inflict  a  permanent 
injury  upon  the  mind  of  the  child.  The  effect  of  paregoric,  sootliing-sirup, 
imd  poppy-cordial  is  often  disastrous,  and  the  source  of  spasms,  fits,  or 
convulsions,  that  impair  the  tender  textures  of  the  brain  so  much,  that, 
even  if  the  children  live,  they  are  apt  to  be -the  victims  of  imbecility. 
Fear  and  fright  also  are  causes  of  imbecility.  If  epilepiy  is  the  cause, 
give  Cuprum  or  Sulphur,  in  daily  doses,  or  else  Belladonna,  Hellebcrua, 
Lacheais,  Hyoscyamua,  or  Opium.  If  caused  by  a  soltening  of  the  brain, 
there  is  not  much  hope  of  the  patient  deriving  nnich  benefit  from  reme- 
dies. There  is  only  a  bare  possibility  that  the  ditficulty  may  be  arrested. 
Hyoscyamus,  Sulphur  and  Apis  mel.  may  do  something  to  ward  oft  total 
and  hopeless  idiocy.  When  imbecility  is  caused  by  onanism,  give  Arseni- 
cum or  China  twice  a  day ;  when  by  sexual  excesses,  give  Nux  vomica 
every  evening,  and  Sulphur  every  morning  ;  when  from  the  effects  of 
opium,  a  persistent  course  of  restorative  treatment  must  bo  decided  upon 
Give  Coffea,  in  usual  doses,  every  three  hours ;  give  also  Sulphur,  ii 
the  foil  strength  of  the  tincture,  in  drop  doses ;  also,  give  Ammonia  carK , 
and  when  from  the  use  of  other  narcotics,  give  Nux  vomica  or  lynatia 


Monomania. 

This  term  signifies  insanity  upon  a  single  matter,  when  in  every  othei 
respect  the  mind  is  sound.  When  a  single  idea  seizes  the  mind,  and  mor- 
bidly dwells  there,  however  erroneous,  it  is  difficult  to  dislodge  it.  Some- 
times a  most  singular  and  absurd  idea  will  be  cherished  ;  as  that  one  is 
dead.  Dr.  William  Rush  once  had  a  patient  in  Pennsylvania  Hospital, 
who  claimed  to  be  dead  ;  and,  after  exhausting  his  ingenuity  to  convince 
him  of  the  contrary,  he  told  him  abruptly  that  he  was  dead,  and  should 
be  buried  ;  for  ho  would  not  have  his  stinking  remains  there  to  pollute  the 
room  any  longer.  This  had  the  tendency  to  fire  up  the  anger  of  the 
pretended  dead  man  ;  and,  on  cooling  down,  his  singular  illusion  left  him. 
I'he  treatment  of  monomania  is  for  the  most  part  moral.  It  is  never 
prudent  to  contradict  the  patient,  or  to  show  disfavor  to  any  absurd  idea 
tliat  may  be  besetting  him,  but  rather  to  indulge  him  in  it,  A  celebnited 
French  writer  on  this  malady  says  of  a  case  at  the  Maison  des  Invalides, 
that  he  fancied,  that,  if  he  urinated,  it  would  cause  a  flood  ;  and,  after  find- 
ing that  \iie  patient  must  die  unless  there  was  an  evacuation  of  the  l)lad- 
der,  the  atteodnnt  hit  upon  the  idea  of  crying  "  Fire  I  "  and  exclaiming  at 
the  top  of  his  voice  tliat  the  city  was  on  fire,  and  wanting  in  water  to  ex- 
tinguish it,  said  to  the  patient,  "  to  let  tJie  flood  come  ;  "  it  was  wanted  to 
save  the  city  from  ruins:  and  this  appeal  had  the  desired  effect.  For  a 
mania  to  kill  some  one  person,  under  the  idea  tliat  it  must  be  done,  Arsen- 
icum has  apparently  proved  to  be  a  remedy.  In  a  case  quite  similar,  ia- 
cftesis  proved  of  great  service.   For  some  of  the  fixed  ideas  in  monomania, 


•-  I 


D  ;  but  many  a 
reai.nent  it  has 
s  been  had  to  a 
itiute  them  into 
>r  lettuce-tea,  to 
ict  a  permanent 
,  soothing-sirup, 
spasms,  fits,  or 
II  so  much,  tiiat, 
13  of  imbecility. 
)iy  is  the  cause, 
nm,  I£ellebcru8, 
ing  of  the  brain, 
nefit  from  rerae- 
may  be  arrested, 
to  ward  oft  total 
sm,  give  Arseni- 
rive  Nux  vomica 
n  the  effects  of 
bo  decided  upon 
also  Sulphur^  it 
i  Ammonia  carK , 
ica  or  lynatia 


len  in  every  otbet 
\\e  mind,  and  mor- 
islodge  it.     Some- 
jd  ;  as  that  one  is 
sylvania  Hospital, 
snuity  to  convince 
dead,  and  should 
there  to  pollut"  the 
the  anger  of  the 
ir  illusion  left  him. 
loral.     It  is  never 
to  any  absurd  idea 
II  it.    A  celebrated 
dson  dea  Invaliiien^ 
3(1 ;  and,  after  Hiut- 
uation  of  the  lilad- 
and  exclaiming  at 
ing  in  water  to  cx- 
"  it  was  wanted  to 
ired  effect.     For  a 
list  be  done,  Anm- 
3  quite  similar,  ia- 
leas  in  monomania, 


AFrEOTIONS   OF  THE  MIND. 


861 


remedies  may  have  a  good  effect.  When  one  has  the  idea  of  beino;  great 
above  all  created  beings,  give  Aconite  or  Coniiim.  Wlien  ono  has  an 
idea  that  I»e  is  hatel,  and  liis  mind  appears  sound  in  other  resp'X'ts,  givo 
Aiirum  or  Ignatia.  Wlion  he  is  tormented  with  the  idea  that  his  family 
or  friends  are  all  connivin<;  aL'ainst  liim,  and  appears  sane  on  other  ?\\h- 
jects,  give  Sulphur,  and  then  Nar  vom.  If  he  seema  right  on  ill  qu<'s- 
lions,  except  that  his  mind  is  cogitating  theft,  so  thr.t  ho  has  r.n 
irresistible  inclination  to  steal  wh.Mi  occasion  o^ors,  give  i*- 
FulsafiUo: 


'o/i«; 


/ 


I 


INSIDIOUS  DISEASES. 


Malignant  Pustule. 

Th/xf  .s  sometimes  a  low  and  viriated  state  of  the  blofd,  and  so  pow« 
piCuliy  rrcdisposed  to  take  a  malignant,  if  not  a  fatal  tendency,  that  a 
very  slii^lif  exciting  cause  will  arouse  a  disturbance  not  easily  quelled. 
Such  i.s  IjchevcJ  to  be  the  origin  of  what  is  usually  termed  "  the  Malig- 
nant Pustule,  ii  small  pimple  upon  the  face,  regarded  of  little  account  by 
the  i)erson,"  who,  unconscious  of  the  vitiated  condition  of  his  blood,  pinches 
it  and  irritates  it.  It  begins  to  inflame  ;  a  determination  of  all  the  subtle 
im|)urities  of  the  fluid  takes  place  at  this  spot ;  and  a  malignant  and  disor- 
ganizing fever  pervades  the  entire  economy,  and,  if  not  arrested,  it  runs  a 
rapid  course,  and  terminates  fatally,  often  in  a  single  day,  or  before  any 
remedial  agent  can  be  brought  to  bear  to  arrest  the  process.  Pimples 
upon  the  face  should  never  be  pinched  or  squeezed,  for  fear  of  inviting 
inflammation  to  the  spot,  that  might  re-act  in  calling  up  or  setting  fire  to 
a  discrasia  of  a  malignant  quality.  Individuals  apj)arently  well  in  the 
morning  have  gone  to  business,  and,  ere  another  morning  came  round, 
have  found  themselves  fatally  prostrated  by  this  disorder.  As  soon  as 
suspected,  give  Arsenicum  every  hour  for  three  or  four  hours,  and  then 
follow  with  Nitric  acid;  and,  if  there  is  any  indication  of  change  tor  the 
better,  well;  if  not,  give  Muriatic  acid,  or  La<Iiesis.  Jii it  m  soon 
!i.s  any  pustule  upon  the  face  begins  to  intlanic  like  a  boil,  and  there 
are  chilly  rigors  running  down  the  back,  retire  to  bod,  take  Ar  mi- 
ri(»),  and  a  change  in  the  febrile  condition  may  take  jylacc  for  the 
better,  and  the  life  of  the  patient  may  be  saved.  \\  hen  the  face 
begins  to  swell,  and  there  is  delirium,  give  Belladonna  every  half- 
hour,  to  hold  in  check,  if  possible,  the  tendency  to  the  brain.  After 
lielladonua,  give  Rhus  tox.  Very  many  cases  of  "  the  Malignant 
Pustule  "  have  been  cured  by  a  timely  resort  to  proper  remedies. 
But  celerity  of  action  is  required ;  one  moment's  unnecessary  delay 
may  be  too  hazardous  for  the  patient.  It  is  believed  that  the  brain 
and  nervous  centres  elsewhere  are  mosfTliable  to  speedy  implication. 
A  resort  to  such  remedies  as  will  guard  these  will  undoubtedly 
furnish  the  best  protection.  Consult  Arsenicum^  Apis  mel.,  Bell., 
Graphites,  Merc,  Conium,  and  Sulphur, 
862 


INSIDIOUS  DISEASES. 


863 


lofd,  and  so  pow« 
tendency, that  a 
ot  easily  quelled, 
■med  "  the  Malig- 
'  little  account  by 
his  blood,  pinches 
n  of  all  the  subtle 
ilignant  and  disor- 
arrcsted,  it  runs  a 
lay,  or  before  any 
process.     Pimples 
ar  fear  of  inviting 
p  or  setting  fire  to 
•ontly  well   in   the 
niiig  came  round, 
[ler.      As  soot)  as 
r  hours,  and  then 
of  change  tor  the 
is.     Jn  <t  !i  ^  soon 
a  ))()il,  and  there 
)0(l,  take  .Ircni- 
iko  i)lacc  for  the 
\\  hen  the  face 
lonna  every  half- 
tho  l)rain.    After 
[  "the  Malignant 
proper  remedies, 
innecessary  delay 
ed  that  the  brain 
leedy  implication, 
will  undoubtedly 
Apis  met.,  Bell,, 


Spotted  Fever.  —  Febria  PeiecMaUa. 

This  fever  usually  begins  with  great  lassitude ;  the  patient  feels 
fatigued,  and  unable  to  be  about ;  and  then  a  headache  ensues,  without 
mtlch  fever  ;  the  pulse  is  not  much  accelerated,  the  tongue  is  coated  with  a 
dark  or  brown  coating,  nutrition  becomes  interrupted,  and  rapid  emacia- 
tion takes  ])lace.  After  a  while,  the  ]iatient  begins  to  suffer  from  intense 
pain  in  the  back  and  limbs;  a  cold  chill  comes  over  him,  and  a  fehriiu 
re-action,  that  is  characterized  usually  by  great  thirst,  entire  loss  of  appetite, 
and  inclination  to  vomit.  During  the  febrile  excitement,  the  skin  becomes 
discolored,  and  red  or  purple  spots  appear  in  great  numbers  u|)on  tiie  sur 
face  of  the  body.  This  is  believed  to  be  the  crisis,  and  afl'oKtls  an  indi 
cation  of  the  malignant  character  of  the  disease.  For  the  most  pari,  the 
patient  lies  in  stupor,  or  perhaps  at  times  evinces  a  low,  muttering  deli- 
rium, and  inclination  to  pick  the  bed-clothes.  The  cause  of  this  fever  is 
supposed  to  be  some  malarious  poison  acting  upon  the  blood.  The  prog- 
iKisis,  or  prospect  of  the  result,  is  by  no  means  favorable  ;  yet  many  such 
cases  recover  under  pro|)er  treatment.  In  the  first  stage,  when  the 
patient  is  complaining  of  great  weariness  and  lassitude,  give  Arnica 
every  three  hours.  When  the  head  begins  to  ache,  give  Belladonna,  and 
especiallv  if  there  is  any  twitching  of  the  muscles,  or  redness  of  the 
eyes.  If  there  is  any  derangement  of  tho  kidneys,  following  checked 
jierspinition,  give  Jihus  tox.  For  the  intense  pain  in  the  back,  give 
Belladonna,  and  follow  with  Verat.  viride.  When  the  cold  chill 
ensues,  and  the  countenance  looks  pallid  and  sunken,  give  Carho 
vef/etabilia.  When  the  fever  appears,  and  there  is  thirst,  and  incli- 
nation to  vomit,  give  Arsenicum,  or  perhaps  Veratrum  alhum,  and 
repeat  the  remedy  every  three  hours.  When  the  low,  muttering 
delirium  shows  itself,  give  Stramonium.  Let  the  surface  of  the 
body  be  rubbed  gentl}'  with  a  crash  or  Turkish  towel,  and  wet  with 
tepid  water.  If  the  patient  becomes  quiet,  and  the  spots  gradually 
begin  to  disappear,  and  the  coating  upon  the  tongue  begins  to  break 
up,  and  a  normal  secretion  upon  the  tongue  begins  to  show  itself,  — 
these  are  signs  of  convalescence  ;  and  then  it  is  well  to  give  China, 
and  supply  the  patient  with  beef-tea  or  broth  in  moderate  quantities, 
and  then  with  something  more  substantial,  as  be  can  bear  it. 

Oold  Fever, 

In  some  parts  of  the  country,  there  has  prevailed  endemically  a  kind 
of  fever  which  at  first  makes  its  appearance  with  general  prostration 
and  coldness  of  the  surface  of  the  entire  body.  The  face  appears  as 
cold  as  marble,  the  nose  pinched,  the  eyes  sunken  in  their  sockets,  the 
tongue  covered  with  a  thick  white  coating,  no  appetite,  hut  intense  thirst. 
This  cold  stage  lasts  for  a  longer  or  shorter  period  ;  and  then  it  is  followed 
by  a  febrile  re-action,  and  the  entire  body  becomes  intensely  heated,  the 
pulse  becomes  quick  and  feeble,  the  head  and  back  become  the  scat  of 
pain  for  a  while  ;  and  then  all  these  symptoms  disappear,  and  another  cold, 
sunken  condition  of  the  system  ensues,  and  sometimes  the  body  is  covered 
with  a  cold  perspiration,  which  lasts  for  an  indefinite  period  ;  and  then  a 


864 


INSIDIOUS  DISEASES. 


more  fierce  febrile  re-action  comes  on  again,  .:nd  elevates  the  pulso  and 
temperature  of  the  skin,  givinjj;  a  fluilied  appearance  of  tlie  comitcniince, 
redness  of  the  eyes,  and  heat  of  the  head  ;  when  a  warm  perspiiiitinn  ti-r- 
minatcs  the  febrile  heat,  and  then  then  gradtmlly  appears  the  coldness  of 
the  surface  apain.  These  alternations  of  the  extremes  of  teinp»'ratnru 
upon  the  surfiace  go  on  until  a  crisis  occurs  that  terminates  the  life  of 
the  patient,  or  the  disease  I>cgin8  to  wane.  But,  to  mitigate  the  severity 
of  the  disease  by  treatment^  in  the  cold  stage,  give  Carbo.  veg.  avpry  t'oxu 
hours  until  the  re-action  commences,  and  then  give  Bn,oma  or  lihw* ;  and 
these  remedies  may  moderate  the  re-action.  If,  in  the  cold  stage,  the 
piiiient  is  stupid,  give  Belladonna;  after  Carbo  vw^.,  and  for  the  cold  peh 
spiration,  give  Carbo  animalia.  At  the  recurrence  of  the  lever  upon 
the  surface,  give  Arsenicum  and  Bryonia.  If  the  patient  has  nnich 
heat  in  the  head,  and  is  delirious,  give  ^eWacionnc  ;  and,  until  thecoj'ting 
upon  the  tongue  begins  to  disappear,  do  not  thrust  any  food  other  than 
liglit  gruel  upon  the  patient,  but  as  soon  as  the  natural  secretion  of  saliva 
appciirs  upon  tlie  tongue,  give  beef-tea,  or  good  mutton-soup,  a  little  wine, 
and  other  nutritious  stimulants;  and,  as  the  appetite  returns,  increase  the 
strength  of  the  diet.  The  same  process  of  rubbing  must  be  employed  aa 
in  tho  Spotted  Fover.  If  the  urine  is  turbid,  give  Knx  vom.  If 
the  feet  swell  during  the  convalescence,  give  Arsenicum,  Apia  mel., 
or  IJellebore. 


Putrid  Fever. 

This  fever,  as  its  name  implies,  emits  an  unpleasant  cr  fetid  odor.  It 
comes  on  much  like  those  just  described,  only  the  brefith  appears  to  be 
tainted  with  something  of  a  putrid  character,  and  very  often  there  are  pu- 
trid discharges  from  tho  bowels.  The  urine  has  a  pv.tiid  odor ;  and,  when 
there  is  any  perspiration  upon  the  surface,  it  has  tlie  same  smell.  The 
disease  comes  on  unobserved,  and  is  attended  with  lassitude  and  inappe- 
tency.  There  is  seldom  any  noticeable  cold  stage,  and  yet  tliere  is  very 
little  if  any  heat  upon  the  surface.  The  tongue  becomes  coafeU  with  a 
dark-brown  coating,  and  sordes  collects  upon  the  teeth  in  large  quantities. 
The  pulse  is  feeble  and  quick  ;  the  skin,  for  the  most  part,  is  dry  and  of 
low  ''itality.  There  is  often  more  or  less  pain  in  the  bowels,  and  a  dis- 
tension of  the  abdomen.  The  urine  is  thick  and  high  colored,  and  of  an 
ofTensive  odor.  The  patient  rejects  all  kinds  of  food  and  drink,  except 
water ;  and  this  uniformly  has  to  him  a  disagreeable  taste.  His  nose 
is  dry  and  sore,  and  his  lips  become  dry  and  cracked ;  and  sometimes 
a  black  or  dark-colored  saliva  runs  out  of  the  corners  of  his  mouth, 
which  discolors  them,  and  gives  to  his  pale  and  sunken  countenance  a 
distressing  appearance.  The  progress  of  this  fever  is  slow  and  low,  and 
often  terminates  in  ulceration  of  the  bowels.  There  is  from  the  first  a 
labored  respiration  and  a  putrid  breath.  For  the  commencing  stage, 
give  Arnica;  if  this  fails  to  relieve  lao  sjTnptoms  in  twenty-four  Iiours,  give 
Baptisia;  when  the  mouth  becomes  dry  and  the  lips  cracked,  and  the 
sordes  collects  upon  the  teeth,  give  NUric  atnd,  and  follow  witii  Arseni- 
cum; when  the  patient  complains  of  pain  in  the  bowels,  and  there  are 
pitrescent  discharges  th)m  them,  give  Phoftphorua;^  if  there  is  involun- 
tarv  and  painless  diarrhoea,  give  Phosphoric  acid;  in  case  of  great  proa- 


^Mfa 


'1 


lies  tlic  piilso  luid 
tliu  comitcnanco, 
m  perspiration  ti-r- 
irs  tliL'  cdldiU'ss  of 
OS  of  tompcratuni 
iiiimtes  tlie  life  of 

if^ntc  tlio  soverity 
■bo,  veff.  c'vory  fbof 
onia  or  Uhu^ ;  nnd 

he  cold  stage,  the 

(1  for  the  cold  peb 
of  the   fever  upon 

patient  has  much 
until  thecoi'ting 
iv  food  otlier  than 
1  secretion  of  saliva 
i-9oup,  a  little  wine, 
etunis,  increase  the 
mat  be  employed  as 
ive  iVMX  vom.  If 
nicutn.  Apis  mel., 


[it  cr  fetid  odor.     It 

jrefith  appears  to  be    I 
f  often  there  are  pu-    | 
•.id  odor ;  and,  when    j 
e  same  smell.     The 
issitudo  and  inappe- 
nd  yet  there  is  very 
comes  coated  with  a 
h  in  large  quantities. 
it  part,  is  dry  and  of 
be  bowels,  and  a  dis- 
rh  colored,  and  of  an 
k1  and  drink,  except 
ble  taste.     His  noso 
;ked ;  and  sometimes 
jrners  of  his  mouth, 
anken  countenance  a 
is  slow  and  low,  and 
ere  is  from  the  first  a 
5  commencing  stage, 
wenty-four  hours,  give 
[ip8  cracked,  and   the 
d  follow  witn  Arseni- 
Kjwels,  and  there  are 
if  there  is  involuQ- 
in  case  of  great  pros- 


mSIDIOUS   DISEASES. 


865 


tmtion,  give  Arsenicum,  followed  in  twolvo  hours,  if  no  relief,  by 
Muriatic  acid.  Putrid  fevers  are  often  fatal,  and  especially  where 
a  ptjtrid  diarrhoea  is  kept  up  by  the  fever.  For  distension  of  tito 
nbdoinen,  give  N^iix;  for  the  thick  and  offensive  urine,  Sulphur, 
Carho  veff.,  or  Arsenicum;  should  the  i)utrid  stage  pass  off,  leaving 
the  patient  prostrate,  give  China,  wine,  egg-nog,  i»ud  even  a  little 
ftrantly,  to  keep  up  the  vitality  of  the  system.  The  sooner  any  one 
recovering  from  this  fever  oau  take  light,  Bolid  alimonta,  the  better. 


y  r 


u 


^11 


...i;iaSi.i>i^;_i:?ei.4&-CA^:«  "^.J-: 


u 


»    t 


SPECIFIC  INDICATIONS  FOR  REMEDIES  IN  FEVERS. 


In  giving  specific  indications  for  tlie  selection  of  remedies  in  B'evors,  ■ 
lur;;o  ground  is  covered,  inasmuch  as  nearly  all  the  diseases  to  which 
(Ic'sh  is  lu'ir  nru  attended  by  some  specifically  characterized  fever,  which 
i-all.i  for  the  pro|)er  remedy.  It  is  therefore  deemed  important  to  state, 
in  connection  with  the  names  of  the  important  remedies,  the  particular 
characteristic  symptoms  that  they  represent.    " 

AcouUe  is  indicated  for  violent  heat  and  chill,  heat  about  the  head  and 
face ;  and  red  cheeks,  palpitation  of  the  heart,  phnritic  stitches,  anguish, 
Siidiicss  or  ID-lnnnor,  desi)ondcncy,  and  drcud  of  death,  bodily  ro.st- 
lesssess. 

Autiiuouluili  is  indicated  when  there  is  little  thii-st,  yellow  coating  upon 
tiio  toii<:;uo,  bitter  taste  in  the  mouth,  eructations,  nausea,  loathing,  vomit 
iiig,  and  other  gastric  derangements  ;  constipation  or  diarrhoea. 

Arnica  is  indicated  when  there  is  thirst  before  the  chill,  and  when  tht 
chill  conies  on  in  the  evening  after  considerable  aching  of  the  bones  ;  and 
also  when  there  is  constant  desire  to  change  one's  position  during  the 
tovcr ;  fui'  apathy,  and  pains  in  the  stomacli ;  for  want  of  appetite,  and 
aversion  to  meat  when  the  fever  has  gone  off.  It  is  particularly  indicated 
whoix  thoro  is  weariness,  listlessness,  yellow  color  of  the  skin,  and 
bitter  tasto,  and  following  a  blow  or  concussion. 

Arsenicum  illbum  is  called  for  when  the  chill  and  heat  set  in  simulia 
neously,  cr  when  they  rapidly  alternate  with  each  other,  or  when  there 
is  internal  chilliness  and  external  heat,  and  vice  versa  ;  also  for  burning' 
heat,  as  if  boiling  water  was  flowing  through  the  veins  ;  no  sweat  until  tht 
commencement  of  sleep,  oppression  of  the  chest,  anguish  and  uneasinesM, 
pressure  in  the  head,  vertigo,  pains  in  the  liver  and  spleen,  great  debility, 
burning  pain  in  the  stomach,  and  disposition  to  vomit,  great  uneasiness 
and  anguish  in  the  region  of  t)ie  heart,  violent  pains  and  lameness  of  tne 
extremities,  and  tendency  to  dropsy. 

Belladonna,  when  the  fever  comes  on  with  violent  headache  with  stu 
peiiiction,  marked  chilliness  and  slight  heat  or  the  opposite;  redness  of  the 
face  with  heat  and  throbbing  of  the  temporal  arteries  and  carotids ;  entire 
absence  of  thirst  or  the  reverse ;  and  ako  when  the  patient  is  irritab'^  and 
in  a  whining  mood. 

8«« 


\ 


N  FEVERS. 


nedies  in  Fevers,  • 
diseases  to  wliicli 

>rizcd  fever,  which 
important  to  stftte, 

dies,  the  particular 

about  the  head  and 
ic  stitches,  anguish, 
leath,  bodily  ro.st- 

^eliow  coating  upon 
ea,  loathing,  vomit 
diarrhosa. 

chill,  and  when  th( 
(f  oi'  the  bones  ;  and 
position  during  the 
mt  of  appetite,  and 
articuliuly  indicated 
r  of  the  skin,  and 

heat  set  in  siniulia 
ther,  or  when  tlierc 
I ;  also  for  burniii".' 
; ;  no  sweat  until  tht 
uish  and  uneasiiiesM, 
)leen,  great  debilitVi 
lit,  great  uneasiness 
and  lameness  of  tne 

headache  with  stu 
osite ;  redness  of  the 
and  carotids ;  entire 
itient  is  irritab'*  and 


SrECmO   INDICATIONS   FOR  REMEDIES   IN   FEVERS. 


867 


Bryonia,  for  coldness,  chill  with  red  cheeks,  heat  about  the  head,  and 
yawniiiji  ;  or  \*'lu'ii  the  heat  prevails  with  HiibseqiK'nt  chilliuosH,  heat  of  tiie 
chest  with  Hl'^lit  pains  indicating  pleurisy  ;  or  when  there  is  a  coattnl  tongue^ 
or  lieadache  and  vertigo  during  tbo  beat,  nausea  and  faintuess  on  sitting  up. 

Calcnrea  carbonlca,  for  heat  in  the  face,  then  chills  ;  or  with  cold  hands, 
hoaviiums  of  tlie  head  and  linii)s,  pains  in  the  small  of  the  back,  and  rest- 
IcHsnesH  ;  cold,  Hour-smelUng  sweat  on  the  bead. 

CjpNicuill,  when  there  is  thirst  during  the  chill  and  fever,  and  much 
tnnciis  in  the  mouth,  throat,  and  stomach  ;  also  when  there  is  diairhu>a 
with  siiniy  and  burning  evacuations;  ai:d  when  the  patient  is  irritable, 
nnxious,  and  oppressed  during  tlio  chill,  and  wh'ju  the  chill  begins  in  tho 
back. 

Curbo  vc|p.,  when  tho  chill  occurs  in  the  evening  or  at  night ;  thiint 
during  the  chill  only,  which  is  followed  with  fever  and  copious  sweat  and 
chilliness;  afterwards  rheumatic  pains  in  tho  teeth  and  limbs  before  or 
during  the  fever;  and  when  there  is  vertigo,  nausea,  and  red  face  during 
tho  heat. 

Chamomllla,  when  there  is  pressure  in  the  i)it  of  the  stomach,  hot  sweat 
on  tho  fort'liead,  despair,  tossing  about  or  bilious  v  >iuilinLC,  diuniuca  and 
colic,  —  the  thirst,  heat,  nnd  sweiit  pn-vailiusi;.  rncinenf  iiriiuitiun. 

China  is  indicated  when  tiiere  is  nausea,  canine  hunger,  headache,  an- 
guish, palpitation  of  the  heart,  or  other  ailment  previous  to  the  paroxysm  ; 
when  there  is  thirst  generally  before  or  after  tho  chill  and  heat,  or  during 
tho  sweat ;  when  there  is  no  thirst,  but  tendency  of  blood  to  the  bead, 
headache,  red  face,  uneasy  sleep,  and  yellow  complexion.  China  is  also 
indicated  when  there  is  drowsiness,  pains  in  the  liver  and  spleen,  bilious 
or  dropsical  symptoms,  or  enlargement  of  tho  liver  and  spleen. 

Cina,  for  vomiting  and  canine  hunger,  both  before  and  after  the  parox- 
ysm of  lever ;  the  face  is  pale  during  the  fever,  and  a  tendency  to  emacia- 
tion exists,  and  dilated  pupils. 

Ferram  is  indicated  when  tho  fever  comes  on  with  chill  and  thirst, 
headache,  and  tendency  to  congestion  of  various  organs  ;  swelling  of  the 
external  veins,  swelling  of  the  face,  especially  around  the  eyes  ;  great 
ilebility,  vomiting  of  the  food  when  partially  digested,  and  laborious. 
Iireathing. 

iKIiatifl,  when  there  is  thirst  only  during  the  chill,  and  when  this  is 
moderated  by  external  heat,  or  when  there  is  external  heat  with  partial 
internal  shuddering;  nausea  and  vomiting,  pide  color  of  the  skin,  and 
pains  in  the  back  during  the  chill ;  and  also  when  there  is  no  thirst,  with 
headache,  vertigo,  and  delirium,  and  particularly  when  there  is  paleness 
of  the  face,  or  else  alternately  pale  and  red,  or  only  one  cheek  red  during 
the  heat;  great  languor,  deep  sleep,  with  snoring;  after  or  during  the 
fever,  eruption  on  the  lips  and  in  the  corners  of  the  mouth.  This  rem 
edy  is  also  indicated  for  the  fever  attending  Nettle  Rash  and  other  erup- 
tions of  the  skin. 

Ipecacuanha  is  indicated  for  a  fever  of  much  chilliness  and  little  heat, 
or  vice  versa,  and  when  the  chill  is  increased  by  external  heat,  or  when 


868 


SPECIFIC  INDICATIONS  FOB  BE&lEDIES  IN  FEVEBS. 


■m 


A 


there  is  little  or  no  thirst  during  the  chill,  and  great  thirst  during  the 
heat ;  and  also  when  there  is  nausea  and  vomiting,  and  other  gastric 
Bymptoms,  previous  to,  or  during  and  between,  the  paroxysms  of  fever  ; 
and  when  tiiere  is  a  coated  tongue  and  an  oppression  of  tlie  chest. 

Lachesis  is  particularly  indicated  when  chills  occur  after  a  meal  in  .  le 
latter  part  of  the  day,  with  violent  pains  in  the  limbs,  and  pleuritic  stitches, 
oppression  of  the  chest,  and  convulsive  motions  ;  and  v/hen  there  is  violent 
headache  during  the  heat ;  delirium,  burning  thirst,  red  face,  restlessness, 
internal  shudderings  during  the  heat,  livid  complexion,  debility,  prostra- 
tion between  the  paroxysms,  heat  especially  at  night,  sweat  after  the  heat, 
»nd  when  the  fever  is  easily  excited  by  eating  lemons  or  other  soui  things 

Hercai'ius  is  indicated  when  heat  and  sweat  appear  togetlier,  ard  when 
there  is  violent  thirst,  pains  in  the  right  side,  acid  stomach,  and  regurgi- 
tatiun  of  sour  or  bilious  matter  from  the  stomach  ;  and  when  there  are 
pains  in  the  bones,  and  an  aching  of  the  Hmbs. 

Nux  Yomica  is  suitable  for  a  fever  that  comes  on  with  great  debility, 
then  chill  and  heat ;  constant  desire  to  be  covered,  even  during  the  heat 
and  sweat;  and  when,  during  the  chill,  the  skin,  hands,  feet,  and  fiice  are 
blue  ;  and  when  there  are  pains  in  the  chest  and  abdomen,  back,  and  par- 
ticularly in  the  small  of  the  back,  or  drawing  in  the  limbs ;  and  when 
there  is  headache,  buzzing  in  the  ears,  distress  in  the  chest,  heat  about 
the  face,  red  cheeks  and  thirst  during  the  chill  and  heat ;  and  also  when 
there  are  gastric  or  bilious  symptoms,  vertigo,  anguish,  and  constipation. 

Opium  is  called  for  when  there  is  sleep  during  the  heat,  and  even  dur- 
ing tlie  chill,  w'th  snoring  respiration  with  the  mouth  open  ;  convulsive 
twitchings,  warm  sweat,  suppression  of  the  secretions.  This  remedy  is 
suitable  for  old  people  and  children. 

Pulsatilla  is  wanted  when  there  i"?  no  thirst  during  the  fever,  or  thirst 
only  during  the  heat,  and  when  there  is  an  aggravation  in  the  afternoon  or 
evening,  with  headache,  anguish,  and  oppression  during  the  entire  period 
of  the  fever  ;  and  when  there  is  a  red  and  bloated  face,  sweat  in  the  face, 
and  shuddering  as  soon  a?  the  patient  recovers  himself;  and  also  wlien 
there  are  gastric  or  bilious  symptoms,  bitter  taste  in  the  mouth,  bilious, 
slimy,  or  sour  vomitings,  or  diarrhoea,  alternating  witli  constipation, 
jppression  of  the  chest,  moist  cough,  or  headache.  Pulsatilla  is  fre- 
quently suitable  after  Laeheais,  or  when  the  fever  comes  on  agai  i  altei 
overloading  the  stomach  in  any  way.  Often  beneficial  after  the 
abuse  of  Quinine. 

RllUS  tox  is  suitable  for  an  evening  or  night  fever,  wlien  the  chilliness 
and  heat  both  make  their  appearance  simultaneously,  and  a  cojjious  sweat 
comes  on  after  midnight  or  towards  morning;  and  wlien,  during  the  chill, 
tiiere  are  pains  in  tlie  limbs,  headache,  vertigo,  or  tootliache  ;  or  when, 
between  the  paroxysms,  there  are  convulsive  twitchings  if  the  limbs,  net- 
tle-rash, colic,  diarrhoea,  and  gastric  derangement ;  or  when  there  is  jaun- 
dice, sleeplessness,  and  tossing  about,  thirst  at  night,  palpitation  of  the 
heart,  with  anguish  and  pressure  in  the  pit  of  the  stomach. 

Terdtrum,  when  there  are  external  chill  and  cold  sweat,  or  internal 
heat,  with  dark-red  urine,  delirium,  and  flushed  face  ;  or  when  there  is 


DBS. 


lirst  during  the 
nd  other  gastric 
sysins  of  fever ; 
the  chest. 

ter  a  meal  in  .  le 
jleuritic  stitches, 
n  there  is  violent 
'ace,  restlessness, 
debility,  prostra- 
at  after  the  heat, 
other soui  things 

gether,  ard  when 

ch,  and  regurgi- 

when  there  are 

th  great  debility, 
during  the  heat 

feet,  and  face  are 

en,  back,  and  par- 
imbs ;  and  when 

chest,  heat  about 
and  also  when 

ind  constipation. 

at,  and  even  dur- 

open  ;  convulsive 

This  remedy  is 

the  fever,  or  thirst 
n  the  afternoon  or 
;  the  entire  period 

sweat  in  the  face. 
If;  and  also  when 
he  mouth,  bilious, 
ivith    constipation, 

Pulsatilla  is  fre- 
(les  on  agai  1  af'tei 
aeficiul  after  the 

'hen  the  chiiliueM- 
nd  a  copious  sweat 
n,  during  the  chill, 
(tiiache  ;  or  when, 
;  i.f  the  limbs,  net- 
j^hen  there  is  jaun- 
palpifation  of  the 
ach. 

sweat,  or  internal 
;  or  when  there  is 


SPECIFIC  INDICATIONS  FOR  BEMEDIES  IN  FEVEK8. 


869 


chill,  with  nausea,  vertigo,  pains  in  the  small  of  the  back  and  back  ;  or 
when  there  is  chill  alternating  with  heat,  constipation,  or  vomiting  with 
diarrhcea  ;  and  when  there  is  thirst  during  the  chill  and  heat. 

With  the  above  remedies,  or  any  of  them,  the  following  remedies  may 
be  employed ;  as  Cantharia,  when  the  urinary  passages  are  involved  ;  or 
Cocculus,  when  the  patient  is  nervous  and  threatened  with  spasms,  cardi- 
rtlgin,  and  constipation.  When  the  fever  for  wliich  any  of  the  remedies 
nre  indicated  is  in  sensitive  persons,  made  restless  by  great  nervousness, 
ijive  Coffea  ;  and  especially  when  there  is  sweat  with  thirst,  soft  stools,  or 
lianiifca.  Give  Drosera,  when  there  is  violent  chilliness  with  cold  face, 
icy  cold  hands  and  feet,  nausea  and  bilious  vomiting,  headache  and  spas- 
mitdic  cough  during  the  heat,  and  gastric  symptoms  between  the  paroX' 
ysnis.  Give  Ilcpar,  when  the  patient  has  coryza,  cough,  or  distress  in  the 
chest,  or  chill  and  thirst,  precedetl  by  bitter  taste,  followed  by  heat  and 
sleep.  Give  Ifi/u8cyamv,8,  when  the  fever  is  attended  by  cough  at  night, 
or  even  epileptic  attacks.  Mercurius^  sour  and  fetid  sweat,  with  palpita- 
tion of  the  heart.  Sulphur^  when  the  fever  is  from  suppressed  Itch,  with 
chills  every  evening,  heat  and  sweat  towards  morning,  fever  with  palpi- 
tation of  the  hea't,  and  violent  thirst  even  before  the  chill. 

In  case  of  an;  fever  occurring  with  symptoms  described  a"  being  par- 
ticular indications  for  the  employment  of  any  one  remedy,  always  select 
that  remedy  ;  and,  in  all  probability,  but  few  doses  will  be  required  to 
effect  a  cure,  provided  the  patient  is  placed  in  the  most  favorable  condi- 
tion fur  recovery  :   for  this  is  as  essential  as  the  employment  of  remedies. 

In  many  instances,  only  a  single  symptom  may  present  itself,  while  in 
othci  respects  the  patient  may  be  well.  A  brief  consideration  of  some  of 
these  may  bo  useful ;  as, —  -  - 

Aversion  to  Food.  —  J-noreario. 

When  this  exists  as  a  mere  symptom,  or  dislike  for  food,  give  Tart, 
emetic.  If  after  gastric  affections,  give  China.  '*  For  aversion  to  food, 
accompanied  with  hunger,  give  Bryonia  or  RhiLa  tax.,  or  else  Ignatia  or 
Nux  vomica.   For  complete  loathing  of  food,  give  Ipecac,  or  Pulsatilla. 


Loss  of  Smell.  —  Anosmia. 

Thia  symptom  may  show  itself  independently,  and  consists  in  a  mere 
insujcoptibility  of  the  olfactory  nerves,  which  may  be  quickened  by  one 
or  two  doses  of  Belladonna,  Calcarea,  or  Sanguinaria.  If  from  paralysis 
of  :' c  olfactory  nerves,  give  Nux  vomica  or  Sepia.  If  from  catarrh, 
give  Calcarea,  Hepar,  JSiiicea,  or  Sulphur. 


Loss  of  Taste.  —  Agust'a.  ' 

For  the  absence  of  this  sense,  independently  of  other  affections,  give 
Natrum  mur.  and  Silicea.  For  loss  of  taste  from  purely  nervous  causes, 
such  as  paralysis  of  the  gustatory  nerves,  give  Hyoseyamus,  Nux  vom.,  or 


870 


SPECIFIC  INDICATIONS  FOB  REMEDIES  IN  FEVERS. 


Sepia,  For  the  same  attended  with  catarrh,  corywi,  and  other  effects  of 
cold,  give  Pulsatilla  or  Sulphur,  or  else  ffepar  or  Sepia.  Give  the  usual 
dose,  and  repeat  twice  a  day  as  long  as  is  necessary. 

For  alterations  of  taste,  viewed  as  mere  symptoms,  the  following  rems- 
dies  may  be  employed:  Aconite,  Arsenicum,  Belladonna,  Bryonia,  Met' 
curias,  jRhus,  Pulsatilla,  &c.  For  bitter  taste,  give  Aconite,  Bryonia, 
Msrcurius,  or  Nux  vomica.  For  the  taste  of  blood,  give  Ipecac,  or  Sul- 
phur. For  the  taste  of  pus,  Pulsatilla.  For  clayey  taste,  China,  Ilepar, 
Pulsatilla.  For  flat,  watery  taste,  or  insipid,  give  Bryonia  or  China.  Foi 
the  liiste  of  bad  eggs,  cheese,  &c.,  give  Arnica,  Rhus,  or  Stdphur.  Fm 
greasy  taste,  CauitL-um.  For  metallic  taste,  give  Calc,  Lachesis,  Nhj 
vomica,  or  Rhus.  For  clammy  or  slimy  taste.  Arnica  or  Belladonna. 
For  rancid  taste,  give  Bryonia  or  Ipecac.  For  salt  taste,  Arsenicum, 
C%rbo  veg.,  or  Sulphur.  For  sour  taste,  give  Calc,  China,  JS/ux  somiea, 
.■yr  Sulphur.  For  other  forms  of  illusory  or  bad  taste  in  ger.cral,  give 
Nux,  Pulsatilla,  or  Sepia.  For  sweetish  taste,  give  Belladotma,  Bryonia, 
China,  Merc,  or  Pulsatilla.  When  food  tastes  bitter,  give  Colocynth.  For 
bitter  taste  after  eating  and  drinking,  ^ryowia,  China,  Pulsatilla.  When 
food  has  a  salty  taste,  give  Carbo  veg.  When  it  tastes  sour,  give  Calc.  or 
China.  When  there  is  a  sour  taste  after  eating,  Nux  vom.  or  Pulsatilla. 
Sour  taste  after  drinking.  Sulphur.  If  after  drinking  milk,  Nux  vomica. 
When  bread  tastes  sweet,  give  Merourius.  When  those  who  use  tobacco 
imagine  that  it  has  an  acid  taste,  Staphysagria.  When  there  is  an  illusory 
<  f  sweetness  of  beer,  Pulsatilla.     For  nauseous  taste,  Ipecac.     A 


taste 


single  dose  of  the  remedy  indicated  for  illusions  of  taste  will  generally 
correct  the  disorder.  Nearly  all  these  departures  from  the  normal  condi- 
tion of  the  sense  may  be  indicative  of  some  peculiar  derangement  of  the 
animal  or  organic  functions,  that  the  chosen  remedy  may  avert  or  correct. 
The  value  of  these  isolated  symptoms  in  pointing  to  remedies  that  may 
be  used  as  timely  preventives  of  more  serious  derangements  can  hardly  he 
appreciated.  As,  tor  instance,  a  bitter  taste  may  forebode  a  serious  biliary 
derangement,  that  Aconite  may  prevent.  And  so  with  all  the  other  varie- 
ties of  illusory  taste  :  what  might  follow,  if  neglected,  no  one  can  tell.  It 
is  better  to  prevent  than  to  cure  a  malady  ;  and  when  the  sentinels  of 
taste  and  smeK  stand  ready  to  guard  against  the  approach  of  diseases,  it 
is  always  best  to  give  hee  1  to  their  admonitions. 


;!^Bl.^^iHIWPiL<i»!JM^ 


IBS. 


other  effects  of 
Give  the  usual 

following  rems- 
I,  Bryonia.,  Met' 
conite,  Bryonia, 
Ipecac,  or  Sul- 
f,  China,  Ilepar, 
or  China.    Foi 
Sulphur.     Yin 
,  LachfHis,  Nuj 
or  Belladonna. 
iste,  Arsenifjum, 
na,  JSux  Vomica, 
in  gei.eral,  give 
■donna,  Bryonia, 
!  Colocynth.  For 
uUatilla.    When 
our,  give  Calc.  or 
m.  or  Pulsatilla. 
jilk,  iVwa;  vomica. 
i  who  use  tobacco 
leie  is  an  illusory 
taste,  Ipecac.     A 
5te  will  generally 
|the  normal  condi- 
rangement  of  the 
y  avert  or  correct, 
medies  that  may 
nts  can  hardly  tie 
e  a  serious  biliary 
11  the  other  varie- 
one  can  tell.     It 
the  sentinels  of 
ich  of  diseases,  it 


/I 


POISONS,  AND  THEIR  ANTIDOTES. 


SunsTANCES  which  derange  the  vital  functions,  and  produce  death  by  an 
K  tion  not  mechanical,  are  denominated  poisons ;  and  distinguished  writ- 
iMs  have  noted  three  classes  of  these  substances,  which  may  be  noted  aa 
liillinvs :  — 

1st.  Irritant  Poisons,  or  those  which  produce  irritation  or  inflamma* 
iion,  as  mineral  acids,  Arsenic,  Copper,  ^c. 

2d.  Narcotic  Poisons,  or  those  which  produce  stupor  or  delirium,  and 
jther  affections  of  the  brain  and  nervous  system,  as  Opium,  Prussia 
ijid,  ^c, 

3d.  Narcotic-acrid  Poisons,  or  those  which  sometimes  produce  irrita- 
tion, and  sometimes  narcotism  ;  sometimes  both  together.  These  are  all 
derived  from  the  vegetable  kingdom  ;  as  Strychnia,  Nux  vomica,  ^c. 

As  most  everybody  is  obliged  to  be  so  situated,  that,  through  mistake  or 
accident,  poison  of  one  or  another  of  these  classes  may  be  taken  into  the 
system,  it  seems  desirable  to  be  well  instructed  in  the  use  of  antidotes, 
and  the  treatment  of  the  supervening  irritation  or  inflammation. 

If,  through  mistake  or  accident,  either  sulphuric,  nitric,  or  hydrochlo- 
tie  acid  is  taken  into  the  stomach  in  poisonous  doses,  give  Chalk  or  Mag- 
nesia ;  or,  if  this  is  not  at  hand,  beat  down  the  plaster  from  the  wall,  and 
make  into  a  thin  paste  with  water,  and  give  this.  Soap-suds  is  another 
antidote.  Drink  freely  of  any  mild  fluid,  or  milk,  both  before  and  after  the 
antidote  is  administered.  For  the  supervening  inflammation,  such  remedies 
may  be  employed  as  in  Gastritis  from  any  other  cause :  Aconite,  in  case 
of  much  fever ;  Bryonia,  if  glairy  vomitings ;  Nux  vomica,  if  there  is 
sense  of  weight,  &c. 

In  case  of  Oxalic  add  being  taken  into  the  stomach  by  mistake,  as 
this  may  occur  from  its  resemblance  to  Epsom  salts,  it  will  be  necessary 
to  excite  vocaiting  at  once  by  tickling  the  throat  with  a  feather,  or  by  an 
emetic  ;  and,  after,  to  administer  Chalk  or  Magnesia  in  large  doses  sus- 
pended in  water.  These  not  being  at  hand,  break  off  the  plaster,  and 
make  a  paste  as  before.  Alkalies  will  not  answer,  as  they  would  only 
form  neutral  salts.  For  the  after-symptoms,  give  Aconite  dissolved  in 
water,  —  a  tablespoonfiil  afker  every  paroxysm  of  vomiting,  until  they 
cease  ;  and  give  the  victim  at  the  same  time,  freely,  mucilaginous  drinksi 
•nd  also  Coffea  and  Opium  as  antidotes. 

fi71 


■"-  '■•i^r-T^fW.L.-.i. 


«-y.^    Tii*ir^^:U.j., 


I 


For  poisoning  with  Arsenic,  the  first  thing  necessary  is  to  thoroughly 
evacuate  tlie  stomach  ;  and,  for  this  purpose,  give  an  emetic,  and  then  fol- 
low with  iron-rust,  or  the  Sesqui-oxid  of  Iron,  largely  diffused  in 
water ;  and  let  the  patient  drink  freely  of  mucilaginous,  farinaceous,  or 
albuminous  drinks,  and  milk.  The  subsequent  inflammation  must  be 
treated  with  Aconite,  —  a  dose  every  two  hours  until  the  nausea  entirely 
disappears  ;  Nux  vomica,  also,  for  the  inflammation  and  soreness  of  the  gas- 
tric ri'gion  ;  Brj/onia,  if  the  slightest  motion  i)r()dnce8  pain  ;  aiul  P'llsafilla 
or  Xiix  V  mi.,  if  the  most  delicate  kinds  of  food  aggravate  the  aiifloriiig. 

For  Poisoning  with  Mercury,  and  Corrosive  eablimate.  —  This  is  the 
usual  form  of  Mercury  employed  for  committing  suicide  ;  and,  as  it  is  used 
for  bed-buy  poison,  it  is  liable  to  be  taken  through  carelessness  or  mistake. 
It  is  therefore  requisite  to  point  out  some  antidote  the  nearest  at  hand. 
Give  whites  of  eggs  in  abundance,  or  Gluten  if  egg.i  cannot  bo  had ;  or 
else  milk.  The  most  usual  form  of  the  supervening  irritation  is  Saliva- 
tion or  Mercurial  Fever.  For  these,  give  Nitric  acid,  Hepar  sulphur, 
and  obtain  for  the  patient  fresh  air  and  a  nourishing  diet  as  soon  as 
possible. 

For  Poisoning  with  Copper. — The  blue  vitriol,  or  Sulphate  of  Copper, 
and  Verdigris,  are  the  forms  in  which  this  poison  is  most  common  ;  and, 
when  taken  into  the  system,  the  most  ready  antidote  is  the  white  of 
eggs.  Great  care  should  be  taken  to  exclude  vinegar,  for  this  acid  would 
add  virulence  to  the  poison.  To  allay  or  cure  the  remaining  irritation, 
give  Sulphur  twice  a  day. 

Poisoning  with  Antimony,  or  Tart,  emetic,  is  liable  to  occur,  as  \h.v\ 
jubstance  is  sometimes  used  in  medicine  as  an  emetic.  When  given  to 
excess,  it  produces  vomiting,  attended  with  burning  pain  at  the  pit  of 
the  stomach,  followed  by  purging  and  colic,  stricture  of  the  throat,  and 
cramps.  As  an  antidote,  give  large  draughts  of  warm  water,  and  tickle 
the  throat  with  a  feather  to  induce  vomiting ;  also  the  decoction  of  any 
bark  containing  tannin,  as  oak,  hemlock,  or  cherry-tree  bark.  For  the 
subsequent  ailments,  give  Sulphur,  China,  Nux  vomica,  or  Opium. 

For  poisoning  with  Zinc,  or  white  vitriol,  which  is  denoted  by  violent 
vomiting,  sunken  eyes,  and  pale  face,  cold  extremities,  and  fluttering 
pulse,  give  the  infusion  of  any  of  the  substances  containing  tannin,  ana 
feed  the  patient  with  cream,  butter,  and  chalk  quite  freely. 

For  poisoning  with  Lead.  —  Red  lead  and  white  lead,  as  well  as 
sugar  of  lead,  arc  liable  to  be  taken  by  mistake;. and  their  poisonous 
effects  are  denoted  by  obstinate  colic,  spasms  of  the  muscles,  and  some- 
times apopicxy.  As  an  antidote,  give  water  of  ammonia,  or  hartshorn,  or 
pearlash-water,  or  any  of  the  earthy  sulphates,  as  lime,  etc.  For  Lead  Pa- 
ralysis, give  Sulphur,  and  afterwards   Nux  vomica.     For  colic,  Opium. 

For  poisoning  with  Cantharides,  which  is  denoted  by  intense  burning 
in  the  pit  of  the  stomach,  and  pain  in  the  lower  abdomen,  feeble  voice, 
laborious  breathing,  strangury,  and  tenesmus  of  the  bladder,  headache,  and 
delirium.  To  remove  the  Canthur-,s  /rom  the  stomach,  excite  vomiting 
in  the  quickest  and  most  speedy  fay,  —  by  tickling  the  thrOat  with  a 
feather,  or  drinking  a  strong  mustard-tea,  or  by  taking  snufF  upon  the 
tongue.  Give  Aconite  to  allay  the  fever  ;  give  Nux  vomica  and  Pulsa- 
tiUa  to  allay  the  irritability  of  the  Btomach,  and  Arnica  to  relieve  the 


"T:". 


to  thoroughly 

ic,  and  then  t'ol- 

ely  diffused    in 

farinaceous,  or 

lation   must  be 

nausea  entirely 

oness  of  the  pas- 

nnrl  Pulsalilla 

the  stifroring. 

—  This  is  the 

md,  asit  is  used 

noss  or  mistake. 

nearest  at  hand. 

mot  bo  had ;  or 

tat  ion  is  Saliva- 

,  Hepar  sulphur, 

diet  as  soon  as 

phate  of  Copper, 
common  ;  and, 
is  the  white  of 
this  acid  would 

laining  irritation, 

to  occur,  as  ihiri 

When  given  to 

ain  at  the  pit  of 

f  the  throat,  and 

water,  and  tickle 

decoction  of  any 

e  bark.     For  the 

,  or  Opium. 

enoted  by  violent 

es,  and  fluttering 

lining  tannin,  and 

ely. 

lead,  as  well  na 
i  their  poisonous 
uscles,  and  sotne- 
1,  or  hartshorn,  or 
tc.  For  Lead  Pa- 
'  coUc,  Opium. 
If  intense  burning 
men,  feeble  voice, 
ler,  headache,  and 
I,  excite  vomiting 
the  throat  with  a 
5  snuff  upon  the 
rmica  and  Pulsa- 
ica  to  relieve  the 


POISONS,  AND  THEIR  ANTIDOTSS. 


873 


lenetmus,  or  ttraining ;  or  else  spirits  of  Camphor.    This  is  believed  to  be 
the  brat  antidote. 

For  poisoning  with  Mo'yhine,  which  is  denoted  by  giddiness  and  stupor, 
the  person  becomes  iiivfiiui.less,  and  insensible  to  external  impressions, 
breathes  slowly,  and  lies  quite  still,  with  the  eyes  shut  and  the  pupils  con- 
tracted, the  whole  expression  of  the  countenance  being  tliat  of  perfect 
repose.  As  the  poison  advances,  the  features  become  ghastly,  the  pulse 
feeble  and  imperceptible,  the  muscles  excessively  relaxed  ;  and,  unless 
assistance  is  speedily  called,  death  soon  ensues.  The  first  thing  neces- 
sary is  to  remove  the  poison  from  the  stomach,  which  is  by  inducing 
vomiting.  If  soon  after  taking  the  morphine,  give  mustard- water  freely, 
or  inject  in  the  stomach  some  sulphate  of  zinc,  if  the  patient  is  too  insen- 
sible to  take  it  otherwise.  After  vomiting  is  induced,  arouse  the  victim, 
make  him  walk  up  and  down  the  room  for  hours,  until  the  inclination  to 
sleep  is  superseded  by  nausea,  headache,  and  vomitirg,  and  then  give 
him  strong  coffee;  and  afterwards,,  to  remove  the  entailed  symptoms, give 
Nux  vomica. 

For  poisoning  urith  Prussia  Add,  when  not  fatal,  resort  to  cold  shower- 
bath,  and  inhalation  of  diluted  water-of-ammonia  vapor;  give,  also,  solu- 
tion of  carbonate  of  potass. 

For  poisoning  with  Charcoal  Gas,  as  from  the  fumes  of  burning  char- 
coal in  a  close  room,  resort  to  cold  affusion,  and  give  Aconite,  in  drop 
doses,  in  a  spoonful  of  water.  The  same  treatment  may  be  resorted  to 
in  case  of  poisoning  with  any  of  the  poisonous  gases,  as  sulphureted  hy- 
drogen and  carbonic  add. 

Poisoning  by  Strychnia,  or  Nux  vomica,  is  denoted  by  convulsions,  with 
much  anxiety  and  agitation  during  the  fits.  The  whole  body  is  stiffened 
or  straightened ;  the  legs  pushed  out  and  forced  wide  apart, ;  no  pulse  or 
breatlung  can  be  perceived ;  the  face  and  hands  livid,  and  the  muscles 
violently  convulsed.  iVkc  vomica,  or  Strychnia,  in  poisonous  doses,  gen- 
erally proves  fatal,  in  spite  of  treatment.  If  emetics  are  given,  and  the 
stomach  is  made  to  disgorge  its  contents  sufficiently  early,  and  the  patient 
is  not  attacked  with  convulsions  in  two  hours,  he  will  generally  be  safe. 

In  treating  any  case  of  poisoning,  two  things  are  required :  1st,  re- 
mov  of  the  exciting  cause ;  2d,  treatment  of  llio  effects  that  remain. 
The  removal  of  the  poison  should  be  done,  if  possible,  with  little  violence, 
and  by  the  simplest  and  most  innocent  method,  either  with  the  finger,  or 
in  case  the  poison  has  been  a  long  time  swallowed,  excite  vomititig  oi 
stool  by  the  simplest  means.  Copious  administration  of  tepid  water,  irri- 
tating the  fauces  by  means  of  a  feather  or  something  similar,  or  by  salt, 
mustard,  and  snuff,  or  injections  of  tobacco-smoke;  and  neutralize  tlie 
poisons  by  means  of  albumen,  vinegar,  iemon-juice,  coffee,  camphor,  milk, 
oil,  soap,  mudlaginous  drinks,  tea,  urine,  sugar,  or,  as  it  has  oeen  seen, 
with  ammoniacal  gas,  iron-rust,  charcoal,  kitchen  salt,  Epsom  salt,  potash^ 
and  starch. 

It  is  well  to  be  familiar  with  these  antidotes  of  poisons,  and  to  bear  in 
min  I  the  particular  indications,  or  poisonous  substances  that  call  for  them, 
as  follows:  — 

AUmmen,  or  whites  of  eggs,  antidotes  such  metallic  substances  as  quick- 
silver, corrosive  sublimate,  verdigris,  tin,  lead,  and  Svdphwric  add,  when 
no 


>,  4,.^  :^-Lt'.^  ji;ai.  - 


M 


the  victim  complains  of  violent  pains  in  the  stomach,  with  tenesmus,  oi 
diarrhoea,  ur<d  pains  at  the  anus. 

Vinegar  antidotes  alkaline  poisons,  and  obviates  the  ill  effects  of  acon- 
ite, opium,  poisonous  mushrooms,  belladonna,  &c. 

Coffee.  —  Strong  black  coffee,  made  of  the  berry  lightly  roasted,  and 
drank  hot,  is  an  antidote  to  opium,  nux  vomica,  belladonna,  narcotica, 
mushrooms,  poisonous  sumac,  bitter  almonds,  and  all  those  substances 
containing  prussic  acid.  It  must  be  borne  in  mind,  however,  that  the 
cause  must  be  removed,  if  possible,  first. 

Camphor  anti''otes  the  ill  effects  of  poisonous  insects,  and  especially 
■•antharis,  whcthe.'  administered  internally  or  externally.  Camphor  also 
intidotes  the  toxical  effects  of  phasphorus,  spigelia,  and  santonin.  It  is 
also  useful  for  the  after-effects  of  acids,  salts,  metals,  &c.,  after  the  poi- 
sonous substance  itself  has  been  removed  from  the  stomach  by  means  of 
vomiting,  &c. 

Milk  is  frequently  alluded  to  as  an  antidote  for  poisons  ;  but  it  has  no 
real  merit.  Mucilaginous  substances  are  better,  and  much  to  be  pre- 
ferred. 

Olive  Oil  ranks  with  milk,  and  is  much  less  useful  than  is  believed.  It 
is  useless  in  metallic  poisons,  and  even  hurtful  in  poisoning  with  arsenic. 
It  is  of  some  service,  however,  in  case  of  poisoning  either  with  Nitric^ 
Sulphuric,  or  Phosphoric  acid.  Olive  oil  and  vinegar,  administered  in 
altei'nation,  has  proved  serviceable  in  cases  of  poisoning  with  alkalies. 

Soap. — Castile  soap,  dissolved  in  four  times  its  bulk  of  hot  water,  and 
drank,  will  antidote  many  cases  of  poisoning  with  Corrosive  sublimate 
and  also  with  arsenic,  or  with  any  of  the  numerous  forms  of  lead.  Soap' 
suds  h  likewise  a  valuable  antidote  for  poisoning  with  Sulphuric  and  Ni- 
tric acid.     Soap  is  nurtful  in  cases  of  poisoning  with  alkalies. 

Sugar,  or  sugar-water,  is  quite  as  good  as  any  of  the  antidotes,  and 
much  to  be  preferred  in  cases  of  poisoning  with  paint,  verdigris,  copper, 
sulphate  of  copper,  alum,  &c.  In  cases  of  corrosive  sublimate,  in  solu- 
tion, being  taken  into  the  stomach  by  mistake,  as  it  has  been,  sugar-water 
may  be  given  before  the  white  of  an  e*  Sugar  is  also  an  excellent  an- 
tidote in  cases  of  poisoning  with  arsenic.     The  other  antidotes  are, — 

Ammoniacal  gas,  or  the  volatile  odor  of  spirits  of  hartshorn,  for  poi- 
soning with  alcohol,  bitter  almonds,  or  prussic  acid. 

Iron-rust,  or  the  sesqui-oxido  of  iron,  for  poisoning  with  arsenic, 
freshly  prepared. 

Epsom  salt,  tor  the  various  alka.ine  poisons. 

Charcoal,  for  poisoning  with  putrid  fish,  meat,  or  mushrooms,  or  nmssels. 

Kitchen  salt,  for  poisoning '  with  nitrate  of  silver,  and  poisonojiu 
wounds. 

Magnesia,  for  poisoning  with  any  o^  the  mineral  acids. 

Potash  and  Sweet  Almond  oil  are  a.  o  good  antidotes  for  acids. 

Starch,  in  solution,  is  the  best  antidote  for  poisoning  with  iodine. 

Strong  tea  is  a  good  antidote  for  poisoning  with  honey ;  and  so  is 

Wine,  for  noxious  vapors  and  poisonous  mushrooms. 

And  here  it  may  be  repeated,  that  the  first  thing  we  have  to  do,  in 
treating  cases  of  poisoning,  is  to  remove  the  poison  by  vomiting,  and  then 
to  administer  the  suitable  antidotes.  In  case  we  should  not  be  able  to 
ascertain  what  kind  of  poison  has  been  swallonred,  we  should  first  admin« 


i,ii,M^.ii...m    ■(.  [  ,  m 


ith  tenesmus,  or 

I  effects  of  aeon- 

itly  roasteil,  and 
onna,  narcotica, 
those  substances 
owever,  that  the 

;s,  and  especially 

Camphor  also 

santonin.     It  ii 

c,  after  the  poi- 

lach  by  means  of 

ns  ;  but  it  has  no 
much  to  be  pre- 

an  is  believed.  It 
ling  with  ai-senic. 
ither  with  Nitrie^ 
r,  administered  in 

with  alkalies. 

of  hot  water,  and 
'orrosive  sublimate 
ms  of  lead.  Soap' 
Sulphuric  and  Ni- 
ikalies. 

the  antidotes,  and 
,  verdigris,  copper, 
sublimate,  in  solu- 
I  been,  sugar-water 
so  an  excellent  an- 
intidotes  aro,  — 
hartshorn,  for  poi- 

ning  with  arsenic, 


brooms,  or  nmssels. 
sr,  and    poisonaua 

ids. 

es  for  acids. 
y  with  iodine, 
ley ;  and  so  is 
I. 

g  we  have  to  do,  in 

vomiting,  and  then 

ould  not  be  able  to 

)  should  first  admin- 


POISONS,  AND  THiilB  AN TlDOl  ES. 


875 


ister  the  white  of  egg ;  and  in  case  there  should  bo  stupor,  give  coffee, 
quite  strong,  made  of  the  lightly-roasted  kernel.  But  if  we  shouhl 
know  the  poison  to  bo  mineral  or  metallic,  the  first  resort  may  be  to 
white  of  egg,  sugar-water,  soap-water,  or  soap-suds,  and  for  the  remain- 
ing effects  give  Sulphur,  which  has  been  ascertained  to  bo  a  real  antidote 
to  the  effects  of  metallic  poisons.  If  it  siiould  be  known  that  acids  or 
corrosive  substances  have  been  taken,  give  castile  soap  mixed  with  four 
times  its  bulk  in  warm  water,  or  magnesia  dissolved  in  water,  or  powdered 
chalk  stirred  up  in  water,  or  a  solution  of  saleratiis,  pcarlash,  or  super-car- 
bonate of  soda,  in  spoonful  doses,  after  each  paroxysm  of  vomiting,  as  long 
as  it  continues  ;  and  afterwards  give  mucilaginous  drinks,  and,  alternately, 
cortee  and  opium,  in  the  form  of  homoeopathic  remedies ;  and  for  the 
remaining  ailments,  give  Puhatilla.  After  the  antidotes  have  been  ad- 
ministered, give  Puhatilla  for  sulphuric  acid,  Bryonia  for  muriatic  acid, 
and  Aconite  tor  other  acids,  and  especially  for  cral>apple  vinegar.  In 
case  it  should  be  known  that  alkaline  substances  have  been  swallowed  in 
poisonous  quantities,  vinegar  and  water  may  be  given  in  large  quantities, 
and  also  lemon-juice  or  cranberry-sauce,  without  sugar,  or  sour  milk;  and 
for  the  secondary  effects  of  poisoning  with  potash,  give  Coffea  or  Carbo 
veg.  If  the  poisoning  is  known  to  be  the  effects  of  spirits  of  hartshorn, 
give  Hepar  sulph. ;  if  it  should  be  known  the  patient  had  been  inhaling 
noxious  vapors,  bathe  the  patient  freely  with  vinegar  and  water,  and  let 
him  inhale  the  vapor  of  a  solution  of  hydrochloric  acid ;  and,  after  a 
return  to  full  consciousness,  give  a  strong  decoction  of  partially-charred 
coffee,  or  a  few  doses  of  Opium  or  Belladonna. 

The  vapors  of  coal,  when  having  a  poisonous  effect,  may  be  antidoted 
by  copious  draughts  of  vinegar  and  water ;  and  for  poisoning  by  any  sub- 
stance not  mentioned,  fii-st  follow  the  rule  of  removing  the  poison  from 
the  stomach  by  vomiting,  and,  for  the  irritation  or  inflammation  left  bo- 
hind,  affiliate  any  homoeopathic  remedy  that  may  meet  the  case.  If  there 
is  much  fever  or  arterial  excitement,  give  Aconite  every  hour  ;  if  severe 
burning  at  the  stomach,  and  thirst,  give  Arsenicum  or  Mercurius  ;  if  there 
is  great  soreness  of  the  muscles,  give  Arnica,  and  let  the  patient  be  bathed 
with  a  lotion  of  the  same  ;  if  it  is  known  that  any  of  the  animal  poisons 
h%ve  been  taken  into  the  stomach,  give  a  teaspoonful  of  powdered  char- 
coal in  half  a  tumbler  of  water  at  a  dose,  and  repeat  after  each  vomiting 
until  the  stomach  becomes  quiet ;  and  if  a  poison  of  this  kind  has  come  in 
contact  with  the  eyes,  give  Aconite;  and,  finally,  to  guard  against  the 
infection  of  poisonous  wounds, -when  touched  with  the  fingers  or  hand,  let 
them  be  held  in  strong  heat,  as  strong  as  it  can  be  borne,  for  ten  or 
fifteen  minuteR,  and  afterwards  wash  them  with  soap. 


^'SU'^.i:!.':^--  -.  —  V-'  — .»-.! 


1/ 


REVISED   TREATMENT, 


>  FleuriBv.  —  Pleuritis. 

(^Treatment  continued  from  page  2V>.) 

XoTnixo  gives  so  much  and  such  immediate  relief  to  pain  as  a 
■'.il>cutano(>us  injection  of  morphine.  Aconite  also  is  a  valuable 
-nlative  in  this  stage.  It  may  be  given  in  half  or  whole-drop  doses 
every  fifteen  minutes  for  two  hours  ;  then  afterwards  a  drop,  to  be 
repeated  hourly  till  some  impression  is  made  upon  the  heart's  action. 
Snuiller  doses  are  to  be  given  if  the  pulse  becomes  feeble. 

In  the  second  stage,  it  the  acute  symptoms  have  yielded  to  treat- 
ment as  they  usually  do,  the  object  of  treatment  is  to  promote  the 
absolution  of  the  lluid.  This  is  done  by  the  judicious  use  of  saline 
catluirtics  and  by  duretics,  for  the  bowels  and  the  kidneys  are  the 
natural  pumps  of  the  system. 

Tlio  ap[)liciition  of  counter-irritants  is  also  of  use  for  this  purpose, 
such  as  the  tincture  of  iodine,  and  small  blisters,  which  are  to  be 
allowed  to  remain  on  till  vesication,  and  then  the  blister  is  to  be  dried 
up  and  a  new  one  is  then  applied.  If  at  any  time  during  this  stage 
the  effusion  is  rapid  and  excessive,  so  as  to  endanger  life,  it  is  to  bo 
drawn  off  by  puncturing  the  chest  lietween  the  fifth  and  sixth  ribs  on 
the  side  with  a  small  trocar,  and  the  fluid  is  to  be  drawn  off  by 
suction. 

Convalescence  commences  when  the  liquid  begins  to  bo  absorbed  ; 
and  active  medication  should  then  cease,  and  that  course  should  be 
pursued  which  will  lead  to  the  restoration  of  the  general  health. 
This  is  done  b}'  tonics,  a  nutritious  diet,  and  other  hygienic  means. 
If  the  effusion  ceases  to  bo  absorbed  or  the  process  tjikes  place  vt^ry 
slowly,  then  that  state  of  things  exists  which  is  called  chronic  pleu- 
risy. Then  the  main  objects  of  treatment  are  to  effect  the  rc^moval 
of  the  fluid,  and  to  develop  and  sustain  the  j)owcr,s  of  the  systoni. 
Under  these  circumstances,  it  is  better  to  discontinue  roniodics  which 
act  upon  the  bowels  and  the  kidneys,  at  least  for  a  time,  and  try  gen- 
eral treatment.  This  consists  of  tonics,  stimulants,  and  gentle  exor- 
cise in  the  open  air,  and  with  this  the  surgical  removal  of  the  fluids 
from  the  cavity  of  the  chest. 

The  operation  is  now  so  much  improved,  and  is  so  Safe  and  simple 
and  attended  with  so  little  pain,  that  it  has  become  an  every-day 
practice,  and  an  operation  which  was  only  resorted  to  as  an  extreme 
measure  to  save  life,  is  now  admissible  whenever  the  pleural  cavity 
remains  filled  with  liquid,  after  only  a  brief  trial  of  the  remedies 
designed  to  promote  absorption. 

870 


KEVI8KD   TREATMENT. 


877 


if  to  pain  as  a 
is  a  valuable 
lolo-drop  doses 
\s  a  drop,  to  be 

0  heart's  action. 
i!l»le. 

ioldcd  to  treat- 
to  prouiote  the 
(US  use  of  saline 
kidneys  are  the 

'or  this  purpose, 
which  are  to  be 
;cr  is  to  be  dried 
luring  this  stage 
r  life,  it  is  to  be 
and  sixth  ribs  on 
be  drawn  off  by 

1  to  bo  absorbed  ; 
course  should  be 
I  general  health. 

hygienic  ineans. 

takes  place  v«;ry 
ed  clu'ouic  i)lou- 
sftbct  the  removal 
rs  of  the  systom. 
0  remedies  which 
ime,  and  try  gcn- 

and  gentle  cxer- 
oval  of  the  fluids 

o  safe  and  simple 
me  an  every-day 
to  as  an  extreme 
the  pleural  cavity 
of  the  remedies 


Fracture  of  the  Bone. —  Treatment. 

{Continued  from  page  454.) 

In  the  treatment  of  fractures  of  the  shafts  of  the  bones  of  the 
lower  extrenjities,  three  indications  should  be  fuitiUcd  :  First,  coap- 
tution  and  fixation  of  the  fragments;  second,  nuxUirato  extension; 
third,  gentle  c(  ipi'ession  and  support.  Provid(ul  these  riHiuire- 
ments  are  carrie,  out,  it  matters  little  wuat  apparatus  may  be  em- 
ployed ;  but  that  which  can  be  a[>plied  with  the  least  disturbiuice  of  the 
fractured  bono,  and  is  most  conifortable  to  the  feeling  of  the  patient, 
should  be  preferred. 

The  best  mode  of  extension  and  counter-extension  now  in  use  is 
by  raising  the  foot  of  the  bedstead  about  eight  inches,  by  a  block  of 
wood  platiod  under  each  fore  leg.  This  makes  an  inclined  plane,  and 
the  body  conse(juently  tends  to  incline  towards  the  head  of  the  bed ; 
this  is  the  counter-extension. 

Then  extension  is  made  as  follows :  A  strong  piece  of  adhesive 
plaster,  about  two  and  one  half  inches  wide  and  al)out  three  feet  long, 
is  applied  to  the  sides  of  the  leg,  extending  from  a  little  ])elow  the 
knee,  leaving  a  loop  under  the  foot  four  or  five  inches  long.  This 
is  secured  firmly  in  place  by  a  bandage  to  the  whole  length  of  the 
leg.  A  piece  of  cord  is  fastened  to  the  loop  and  passed  over  a  pulley, 
which  is  fixed  to  the  foot-board  of  the  bed.  To  the  other  end  of  this 
cord  is  attached  a  weight.  This  need  not  exceed  ten  or  twelve 
pounds. 

In  this  way  we  get  our  counter-extension  and  extension  :  llu;  l)ody 
is  draAving  one  way  and  the  weight  is  pulling  the  other  all  the  time. 

This  is  a  simple  and  comfortable  way  of  treating  fractures  of  the 
shafts  of  the  bones  of  the  lower  extremities  which  require  extension. 
It  may  be  applied  to  the  different  fractures  of  the  neck  of  the 
thigh  bone,  to  fractures  of  the  shaft,  and  also  to  fractures  in  the 
shafts  of  the  bones  of  the  leg. 

It  is  the  best  and  most  effectual  way  of  preventing  undue  short- 
ening that  wo  have  in  use,  and  what  is  of  as  great  importance  to  the 
patient,  a  most  comfortable  way  of  keeping  the  painful  limb  in  the 
proper  shape.     C^-^e  page  454.) 

Fractures.  —  Counter-extenrion. 

Modern  surgery  has  developed  two  simple  mechanical  means  of 
making  extension  and  counter-extension  for  the  pur{)ose  of  overcom- 
ing muscular  spasm,  which  rarely  fail.  One  is  by  the  use  of  elastic 
rubber  bands,  and  the  other  by  the  attachment  to  the  limb  of  a  cord 
running  over  a  pulley  at  the  foot  of  the  bed  and  sustaining  a  suitable 
weight.  The  method  of  employing  these  will  be  given  in  detail  in 
connection  with  special  fractures.     (See  page  444.) 


! 
i 


■■"  t  iitIV-     '"n    '  ^;UJ»6_!.tijJrtCf^,^0«i.»-  -<iV  1 


Fractures.  —  Coaptation. 

A  great  point  i8  to  have  the  splints  accurately  adapted  in  each  case, 
luid  the  ability  to  uflect  this  is  an  iaipoi-tant  element  of  success  in  this 
l)niiuh  of  surgery.  Wood  may  be  generally  cut  into  suitable  shape, 
l)ut  it  is  perhaps  easier  to  use  moulded  splints  of  leather,  felt,  gutta- 
perclia,  or  shellac  cloth.  The  starched  or  plaster  bandage  or  gummed 
paper  n)ay  be  effectively  used ;  and  with  a  proper  pair  of  shears, 
sheets  of  tin  or  zinc  may  be  cut  into  splints,  which  will  answer 
admirably.  Woven  iron  wire  aplints  are  highly  recommended.  (See 
page  445.) 

Bleeding  from  Wounds. 

One  of  the  best  methods  now  in  use  of  arresting  hemorrhage  in 
cases  of  accidental  injuries  of  the  large  arteries  of  the  extremities, 
is  by  suiTounding  the  limb  a])ove  with  two  turns  of  a  piece  of  rublwr 
tubing,  .about  three  fourths  of  an  inch  in  dianu'ter,  and  tying  it  tight. 
This  safely  and  effectually  controls  all  bleeuing. 

Advantage  is  taken  of  this  elastic  property  of  rubber  in  controlling 
hemorrhage,  in  performing  what  is  called  bloodless  operations  of 
surgery.  It  is  called  Esmarch's  method,  from  the  name  of  the  origi- 
nator, It  may  be  resorted  to  in  all  operations  on  the  exti'emities, 
whether  of  amputations,  the  removal  of  tumors,  or  in  the  minor 
operations  of  removing  needles,  and  whenever  the  bleeding  interferes 
with  the  peri'onnance  of  the  operation. 

It  is  ai)plied  as  follows :  The  limb  should  first  be  tightly  bandaged 
with  an  elastic  rubber  bandage  about  three  inches  wide,  from  below 
upwards,  and  then  surrounded  at  the  highest  point  with  a  band  or 
tube  of  rubber  in  the  place  of  a  tourniquet.  The  bandage  is  then  to 
bo  removed,  when  the  operation  may  be  performed  in  temporarily 
bloodless  tissues. 

An  amputation  of  the  thigh  may  be  thus  performed  without  loss  of 
any  blood  of  consequence.     (See  page  493.) 


Antiseptic    Dressings. 

Antiseptics  have  lately  attracted  a  great  deal  of  notice  in  the 
treatment  of  inflammation,  especially  resulting  from  wounds. 

The  article  most  used  at  the  present  time  for  this  purpose  is  car- 
J>oli('  acid.  Lister  is  its  chief  advocate,  and  uader  his  authority  it 
has  estal>lished  a  position  which  deserves  attention. 
;  It  IS  based  upon  the  germ  theory  of  disease,  which  is  founded 
upon  the  observations  of  Pasteur.  The  theory  supposes  that  animal 
decomposition  is  due,  not  to  the  chemical  action  of  oxygen,  or  any 
other  gas,  but  to  the  presence  of  organic  germs  floating  in  the  atmos- 


^^^^. 


>(\  in  each  case, 
success  in  this 
.iiitublo  shape, 
•r,  felt,  gutta- 
:{\  or  gummed 
uiv  of  shears, 
I  will  answer 
imcudcd.   (See 


hemorrhaffe  in 
he  extremities, 
piece  of  rul)l)er 
d  tying  it  tight. 

Br  in  controlling 
is  operations  of 
me  of  the  origi- 
the  extiemities, 
)r  in  the  minor 
ceding  interferes 

tightly  bandaged 
ide,  from  below 
with  a  band  or 
andage  is  then  to 
I  in  temporarily 

id  without  loss  of 


of  notice  in  the 
wounds. 

3  purpose  is  car- 
r  his  authority  it 

ivhich  is  founded 
poses  that  animal 
f  oxygen,  or  any 
;ing  in  the  atmos- 


REVISED  TRUATMBNT. 


87J 


phore.      Carl)olic  acid  is  used  on  account  of  its  known  dcstnictivo 
eli'ects  upon  low  forms  of  organic  life. 

These  low  fonns  of  vegetable  organisms,  which  ilont  in  the  uir  in 
great  abundance  an  constituents  of  the  dust,  are  called  by  niiturulists 
bacteria,  of  which  there  are  many  varieties.  Whenever  they  Hud 
entrance  into  the  body,  there  }>utrefaetion  is  jjroduced. 

Those  vegetable  |)arasites  are  capable  of  a  wonderful  power  of  nuil- 
tijdying  tlieir  Hj)ccics,  —  a  single  germ  producing  in  a  few  hours  many 
tliousands.  Once  admitted  into  the  l)ody,  tiiey  find  their  way«'very- 
where,  —  into  the  muscles,  into  the  blood,  into  the  different  organs  of 
^the  body, — and  they  spread  destructive  fermentation  and  putrefac- 
tion AS  herever  they  go. 

In  accidental  wounds,  it  is  first  necessary  to  kill  any  septic  organ- 
isms which  may  have  been  introduced  from  the  air  or  from  contact 
Avith  foreign  bodies.  We  do  this  by  thoroughly  batliing  the  surfaces 
with  a  solution  of  carbolic  acid,  of  the  strength  of  one  part  of  the  acid 
to  tAventy  of  water. 

When  the  woimds  are  made  by  the  surgeon,  the  germs  are  de- 
stroyed by  means  of  a  spray  imbued  Avith  the  acid.  This  spray  is 
produced  by  an  atomizer,  of  which  there  are  many  kinds,  and  is 
thrown  continually  on  to  the  surface  of  the  Avound,  until  the  comple- 
tion of  the  operation,  including  the  ligaturing  of  the  vessels  and  the 
final  stitching  together  of  its  edges. 

Lister  also  recommends  the  use  of  carbolized  catgut  for  ligatures, 
being  of  an  animal  substance  and  finally  absorbed. 

When  the  opemtion  is  fully  completed,  the  antiseptic  dressings  are 
applied.  Besides  these  antiseptic  precautions,  in  cases  of  large  and 
deep  wounds  a  drainage  tube  is  introduced  to  alloAV  for  the  escape  of 
the  serum. 

The  antiseptic  dressings  consist  of — first,  the  protector;  second, 
the  carbolized  gauze;  third,  the  mackintosh;  and  fourth,  anotl' n* 
layer  of  the  gauze,  and  a  bandage  of  the  same  to  keep  the  Avhole  in 
place.  For  the  purpose  of  protecting  the  cicatrizing  parts  from  the 
irritating  effects  of  the  gauze,  a  layer  of  oil  silk  coated  on  both  sides 
with  copal  varnish,  and  afterwards  brushed  over  with  dextrine,  to 
enable  it  to  become  uniformly  moistened  when  dipped  into  a  Avatery 
solution  of  the  acid,  is  applied  directly  over  the  Avound,  the  ends  of 
the  drainage  tube  protruding  about  an  inch  from  each  extremity  of 
the  incision.  The  Avound  is  then  covered  with  a  layer  of  antiseptic 
gauze  dipped  into  a  solution  of  one  to  forty  of  the  acid.  There  are 
tiien  superimposed  six  other  layers  of  dry  gauze  ;  then  the  mackin- 
tosh or  a  piece  of  rubber  cloth  ;  then  an  eighth  layer  of  gauze  large 
enough  to  cover  in  all  the  remainder,  and  finally  a  bandage  of  the 
i>ame. 

When  the  dressings  are  renewed,  it  is  to  be  done  under  the  spray, 
great  care  being  taken  not  to  admit  any  non-caxbolized  air. 


li.  l.^..'^-Ji-r.^ri.r 


880 


RRVISED   TKEATMENT. 


Tho  dr»Bsin,'rH  aro  not  to  1>e  chanf!;od  until  the  dbchargo  hiut  l)cgun 
to  soak  thruugli  and  appt^ar  l)olow  tho  edge  of  tho  rubber  cloth. 

The  antiseptic  gauze  w  umdi;  by  impregnating  cotton  cloth  of  open 
texture  with  a  mixture  of  carlK)lic  acid  one  part,  roHin  five  partH, 
pn^afiine  ueven  parts.  The  resin  acts  as  a  vehicle  for  the  acid,  while 
the  parafiiue  is  added  to  prevent  inconvenient  adheaivenoss.  (See 
page  440.)  .  . 

Poisoning    Acoidenti. 

Poisons  may  be  classified  under  two  heads;  viz.,  mineral  and 
vegetable. 

In  tljo  treatment,  three  objects  are  to  be  kept  in  v'iew :  first,  to 
get  rid  of  the  poison  ;  second,  to  stop  its  action  ;  and  third,  to  avert 
its  tendency  to  death. 

Tlie  first  indication  is  accomplished  by  the  administration  of 
emetics  to  cause  vomiting,  or  by  the  use  of  a  stomach  pump.  The 
simplest  way  to  provoke  vomiting  is  to  give  large  draughts  of  luke- 
warm water,  and  to  thrust  a  finger  down  the  throat. 

A  teaspoonful  or  two  of  mustard  in  warm  water  is  oftentimes  an 
efiectual  emetic.  Some  of  the  emetics  are  ipecacuanha,  tartar  emetic, 
sul{)hate  of  zinc,  and  sulphate  of  copper. 

Sulphate  of  zinc  in  twenty-grain  doses  is  about  tho  best.  The 
second  indication  is  to  use  an  antidote.  The  third  indication  is  ful- 
filled by  palliating  the  symptoms,  and  neutralizing  the  after  effects  on 
the  constitution. 

After  copious  vomiting,  sootJbing  liquids  should  be  given,  such  as 
oil,  milk,  beaten-up  raw  eggs.  These  are  useful  when  the  poison 
has  been  of  an  irritating  character. 

If  the  patient  be  much  depressed  in  body  or  mind,  the  hands  and 
feet  cold,  the  lips  blue,  the  face  pale,  a  cold  perspiration  on  tho  fore- 
head and  about  the  mouth,  some  stimulant  may  be  administered. 
Strong,  hot  tea  is  the  best,  because  it  is  a  chemical  antidote  to  many 
poisons.  Strong  coffee  is  a  good  stimulant.  Brandy  and  other 
spirits  are  sometimes  necessary.  Sometimes  when  the  powers  of  life 
are  much  depressed,  artificial  heat  also  is  necessary.  (See  page 
496.) 

Acuto    Bhen  natism. 

Since  1875  two  new  remedies  for  rheumatism  have  come  into  use ; 
viz.,  salicylic  acid  and  its  salts,  and  salicin,  the  active  principle  of 
the  willow  bark. 

When  given  at  the  commencement  of  an  attack,  it  oftentimes 
arrests  the  course  of  the  malady  as  effectually  as  quinine  arrests  the 
intermittent  fever,  or  as  opium  and  ipecacuanha  arrest  dysentery. 
It  exerts  such  a  beneficial  influence  that  it  is  recognized  by  the  profos- 


argo  hiiH  iMjgun 
)ber  cloth, 
on  cloth  of  open 
•OHin  five  partH, 
■  tho  acid,  whilo 
siveneus.     (Suo 


Iz.,  mineral  and 

1  view :  first,  to 
i  third,  to  avert 

Iministration  of 
ich  pump.  The 
raughts  of  luke- 

is  oftentimes  an 
la,  tartar  emetic, 

the  best.  The 
indication  is  ful- 
,e  after  effects  on 

)e  given,  snch  as 
when  the  poison 

d,  the  hands  and 
ation  on  the  fore- 
be  administered, 
antidote  to  many 
randy  and  other 
the  powers  of  life 
ary.     (See  page 


ve  come  into  use ; 
ctive  principle  of 

ick,  it  oftentimes 
uinine  arrests  the 
arrest  dysentery, 
ized  by  the  profes- 


nion  as  a  Hpecific,     From  ton  to  liftman  grains  of  Hulicvlic  acid  or  the  | 
Hiilicylato  of  ho<1ii  should  lt<»  given  every  two  hoins  until  relief  i.s  ob- 
tained.    This  nsuiilly  takcsH  pliic**  in  froin  twelve  to  lliiily-six  iiours. 
In  HiOHt  eiises  the  fever  and  HVV(illing  will  al>ato  witiiin  llio  above  time. 
If  not  (Mitirely  arrested,  the  disease  is  very  nnieli  shortened. 

When  tlie  spec  itie  etl'eet  is  produced  on  the  system,  it  causes  ver- 
tigo, headache,  ringing  in  tho  ears.  'I'liese  syniptoniH  indicate  that 
the  medicine  should  bo  given  in  smaller  doses  and  with  longer  inter- 
vals.    (See  page  41G.) 

The    Temperature    of   the    Body. 

TiTE  use  of  the  tliennoiietor  is  un  important  addition  to  tho  means 
of  making  ])hysical  examination,  and  is  one  of  the  improvements  in 
modern  medicine. 

It  is  intended  to  measure  the  boat  of  tho  body. 

Tho  best  kind  now  in  ust  is  the  bolf-registering. 

Tho  bulb  of  the  instrument  is  to  bo  placed  in  tho  warmest  part  of 
tho  body,  and  should  bo  allowed  to  I'emain  there  for  eight  to  ten 
minutes. 

Some  place  it  under  the  tongue  ;  some  in  tho  axilla. 

Sometimes  it  is  necessary  to  inti'oduco  it  into  tho  rectum  or  vagina. 
In  these  parts  the  tempovature  is  a  degree  higher  than  in  other 
parts. 

Tho  normal  tempcraturo  of  the  body  is  from  98°  to  99°  Fahrenheit, 
in  tho  great  majority  of  persons. 

Exceptionally  it  may  be  half  or  a  whole  degree  either  above  or 
below  this  raiig(\ 

Tho  normal  lluctuations  arc  inconsiderable  in  comparison  with  the 
variations  of  disease. 

Tho  natural  variations  in  health  arc  as  follows  :  Tho  temperature  is 
at  its  mininuun  at  five  o'clock  A.  M. ;  tho  maximum  is  reached  in  the 
latter  part  of  the  afternoon,  and  then  continues  till  tivo  o'clock  a.  i\f . 

By  means  of  the  thermometer  we  are  able  to  detormino  all  diil'er- 
ences  with  precision. 

The  increase  of  heat  in  diifereut  febrile  diseases  rarely  exceed* 
110°  Fahrenheit,  and  as  a  rule  tho  amount  of  increase  is  a  criterion 
of  its  severity. 

An  increase  to  100°  Fahrenheit  or  101°  is  evidence  of  niildn:^ss  ot 
the  disease. 

If  the  thermometer  indicates  steadily  105°  Fahrenheit,  it  is  ccrtiir. 
that  tho  disease  is  severe. 

A  persisting  temperature  above  105°  Fahrenheit  denotes  that  there 
is  great  danger,  and  an  increase  to  108°  to  110°  Fahrenheit  is  usually 
a  fiital  sign. 

Tho  abnormal  changes  of  temperature  consist  of  more  or  less  in- 
crease. 


;  i,:..:-^^.i;^-.<'biM  yat-.-jJi; jOladc-t-'—i.. 


882 


KE VISED   TREATMENT. 


Diminution  below  the  normal  standard  is  comparatively  rare  ;  yet 
it  sometimes  occurs  and  is  of  some  importance. 

In  the  course  of  typhoid  fever,  a  sudden  decrease  may  indicate 
intestinal  hemorrhage.  Sometimes  the  temperature  falls,  without  im- 
provement in  the  other  symptoms.     This  is  an  unfavorable  symptom. 

The  value  of  thermometric  changes  depends  in  no  small  measure 
upon  the  symptoms  with  which  they  are  absociated. 


')m 


m 


FysBmia. 

This  frightful  affection  has  been  called  the  baoe  of  surgery.  It  is 
caused  by  a  peculiar  poison,  resulting  from  the  fermentation  and  dis- 
integration of  the  tissues  of  a  wound,  which  is  taken  into  the  system 
either  by  the  veins  or  absorbents,  and  is  usually  accompanied  bj'  the 
formation  of  collections  of  pus  in  the  various  tissues  and  organs  of  the 
body.  It  follows  very  trifling  as  well  as  severe  injuries,  and  it  is  a 
frequent  sequela  of  surgical  operations,  oftentimes  of  a  very  slight 
character.  The  only  tenable  theory  which  can  explain  the  different 
phenomena  of  this  disease  is,  that  the  pyremic  condition  is  caused  by 
the  absorption  of  septic  material,  sometimes  in  a  fluid,  sometimes  in 
a  gaseous  slate,  whitli  unfits  the  blood  for  the  processes  of  healthy 
nutrition,  induces  capillary  stagnation  and  its  consequences,  low 
forms  of  inflammation  in  different  parts  of  the  body,  as  in  the  joints 
and  serous  cavities,  and  may  finally  produce  .nose  secondary  deposits 
of  pus,  in  any  or  all  parts  or  organs  of  the  body,  called  metastatic 
abcessesc 

When  an  internal  organ  is  involved,  the  result  is  generally  fatal. 
When  suppuration  attacks  the  integuments  or  the  extremities,  there 
is  a  fair  chance  of  recovery. 

Thence  the  disease  has  been  divided  into  two  classes  :  the  internal 
or  acute,  the  external  or  chronic  pyiemia.  When  pysvniiu  involves 
the  internal  organs,  the  course  is  usually  rapid  and  fatal.  When  it 
attacks  the  external  parts,  it  is  slow  in  its  course  and  may  be 
recovered  from. 

Duration  of  the  Disease.  —  Sometimes  its  course  is  so  rapid  tliat 
the  patient  may  die  in  two  or  three  uays  after  the  appearance  of  the 
syniptortis.  As  a  rule,  however,  bad  cases  termiiiiite  during  the 
second  week.  Some  go  on  for  six  or  seven  weeks.  In  cases  which 
recover,  the  patient  goes  through  a  long  illness  and  may  be  left  per- 
manently crippled  by  secondary  affections  of  the  joints.  As  a  ride, 
the  longer  a  patient  lives  the  better  the  hopes  of  a  successful  ending. 

Pyosniic  symptoms  generally  make  their  appearance  after  the  fourth 
day.  The  first  symptom  is  a  chill ;  this  is  repeated  at  iiTegular 
intervals,  and  is  followed  by  profuse  and  exhausting  sweats. 

The  hot  stage  which  characterizes  the  malarial  paroxysms  of  inter- 
mittent fever  is  usually  absent  or  but  slightly  marked.    During  the 


m 


ively  rare ;  yet 

o  may  indicate 
Is,  without  im- 

rable  symptom, 
small  measure 


surgery.    It  is 

ntation  and  dis- 

into  the  system 

)mpanied  b}'^  the 

nd  organs  of  the 

iries,  and  it  is  a 

af  a  very  slight 

lin  the  different 

ion  is  caused  by 

id,  sometimes  in 

esses  of  healthy 

pseqnences,    low 

I  as  in  the  joints 

(condary  deposits 

called  metastatic 

9  generally  fatal, 
xtremities,  there 

SOS :  the  internal 

{iywrnia  involves 

fatal.     When  it 

rse  and  may  be 

e  is  so  rapid  that 
ppearanoe  of  the 
iiuite  during  the 
In  cases  which 
may  be  left  per- 
inte.  As  a  rule, 
uccessful  ending. 
)e  after  the  fourth 
ited  at  iiTegular 
r  sweats, 
roxysms  of  inter- 
Led.    During  the 


REVISED   TREATMENT. 


883 


course  of  the  attack,  the  temperature  of  the  body,  which  is  naturally 
98^°  Fahrenheit,  may  rise  six  or  eight  degrees,  and  in  ordinary  cases 
its  fall  is,  as  a  rule,  gradual.  The  greatest  elevation  of  temperature 
corresponds  with  the  period  of  rigor.  During  the  sweating  stage  the 
temperature  falls  again.  Should  the  fall  be  sudden, a  general  break- 
down of  the  powers  of  the  patient  is  indicated.  The  pu Ise  rate  varies , 
according  to  the  violence  of  the  attack,  from  ninety  to  one  hundred  and 
thirty.  The  respiration  is  usually  rapid,  from  forty  to  fifty  a  minute, 
and  in  many  cases  a  hay-like  odor  of  the  breath  is  present,  which 
is  considered  pathognomonic  of  the  disease.  The  countenance  is 
flushed,  the  skin  dusky,  sallow,  sometimes  jaundiced  and  marked 
with  sudamtna. 

The  tongue  is  coated,  und  there  is  a  complete  loss  of  appetite,  and 
often  nausea  and  vomiting.  The  urine  is  frequently  albuminous. 
When  the  brain  is  involved  there  will  be  sleeplessness,  or  delirium 
of  a  low,  muttering  kind ;  some  unconsciousness,  from  which  the 
patient  can  be  aroused  only  to  relapse. 

Intense  pain  usually  attends  the  secondary  complications,  though 
it  is  sometimes  remarkable  how  slight  the  symptoms  often  are  when 
severe  local  disease  exists. 

The  wound  becomes  sanious,  serous,  and  fetid ;  sometimes  the 
secretions  are  arrested  and  the  surface  becomes  dry  and  glazed ; 
sometimes  absolute  sloughing  occurs.  Union,  if  progressing,  will 
become  disunion,  and  all  reparative  action  ceases.  As  the  disease 
progresses,  the  symptoms  become  profoundly  typhoidal,  and  the 
patient  may  die  comatose  or  irom  exhaustion. 

The  exciting  causes  of  pyoemia  are  very  obscure.  It  attacks  the 
healthy  as  well  as  the  feeble,  those  surrounded  by  perfect  hygienic 
influences  as  well  as  those  who  are  exposed  to  deleterious  influences. 
It  is  found  not  only  in  hospitals  but  in  private  practice ;  but  it  is 
more  prevalent  in  unhealthy  places,  in  the  overcrowded  wards,  and 
in  those  spots  where  ventilation  and  drainage  is  bad.  It  lurks  among 
the  poorly  housed  and  poorly  fed  and  clad,  and  wherever  those  influ- 
ences exist  which  are  depressing  to  the  vital  powers. 

The  general  treatment  in  these  cases  is  of  paramount  importance. 
It  is  the  duty  of  the  surgeon  to  see  that  the  patient's  room  is  well 
ventilated,  and  that  it  is  frequently  purified  by  cleansing  and  disin- 
fectants. 
■^^      The  wound  is  to  be  kept  clean  and  well  drained. 

The  dressmgs  should  be  changed  as  often  as  four  times  a  day,  and 
saturated  with  disinfectant  lotions. 

When  sloughing  exists  the  charcoal  poultice  should  be  applied,  and 
every  measui'e  pursued  which  will  insure  the  utmost  cleanliness  of 
the  patient  and  his  suiToundings. 

Tlie  curative  treatment  is  t6  be  conducted  on  the  same  principles 
which  guide  the  surgeon  in  the  management  of  all  cases  of  a  typhoidal 
character. 


The  bowels  if  constipated  are  to  be  opened  by  a  gentle  laxative, 
and  the  dillerent  secretory  organs  restored  to  a  healthy  action  as  far 
as  possible. 

The  vital  energies  of  the  patient  are  to  be  maintained  or  stimu- 
lated, and  everything  that  tends  to  lower  them  must  be  warded  ofl'. 

Quinine  is  the  most  valuable  remedy  we  have  for  the  treatment  of 
pyaMuia  Some  surgeons  give  it  in  large  doses  and  speak  highly  of 
its  ettbcts.  It  is  valuable  in  doses  of  four  or  five  grains  every  thi'oc 
or  four  hours.  It  may  be  combined  with  iron  advantageously  in 
some  cases.  The  best  combination  is  with  the  citnite  of  iron.  Four 
grains  of  each  are  to  be  given  four  or  five  times  a  day. 

Stimulants  are  also  of  great  importance  to  maintain  the  powers  of 
life.  In  some  cases  it  is  necessary  to  employ  them  freely  to  kaep  up 
the  waning  strength. 

The  diet  should  be  as  nutritious  as  the  patient's  assimilative  powers 
Will  bear.     Milk  and  the  animal  broths  are  the  best. 

When  the  stomach  rejects  nourishment  it  must  be  given  by  the 
rectum,  enema  of  beef  tea  and  milk  with  brandy  being  administered 
every  four  hours. 

When  the  nervous  system  is  distui'bed  by  pain  and  want  of  rest 
and  sleep,  some  of  the  forms  of  opiates  or  anodynes  are  to  be  given, 
small  doses  frequently  repeated  being  better  than  large. 

Should  diarrhoea  exist  it  is  to  be  kept  under  control.  It  should 
not  be  checked  suddenly,  as  it  appears  to  have  an  eliminative  ten- 
dency in  cases  of  blood  poison. 

Carbonate  of  ammonia  in  ten-grain  doses  five  or  six  times  a  day 
is  a  valuable  remedy  when  other  tonics  cannot  be  tolerated. 

When  secondary  abscesses  fom  oy  should  be  opened  and  kept 
cleansed  by  some  disinfectant  fluid,  such  as  carbolic  acid  or  the  solu- 
tion of  the  chloiioate  of  soda,  ia  their  proper  strength. 


■"  I 


ntle  laxative, 
action  as  far 

ed  or  stimu- 
le  warded  off. 

treatment  of 
leak  highly  of 
na  every  three 
ntageously  in 
of  iron.    Four 

the  powers  of 
lely  to  kaep  up 

Illative  powers 

given  by  the 
g  administered 

d  want  of  rest 

are  to  be  given, 

e. 

rol.     It  should 

limuiative  ten- 

ix  times  a  day 

sratod. 

poned  and  kept 

cid  or  th©  solu- 

h. 


MARRIED  LADIES'  PERPETUAL  CALENDAR. 


Tmb  utility  of  these  tables,  as  gerving  for  a  faithful  and  confidential  friend  in  matters  of  uiv«Dt 
Interest,  cannot  fail  of  being  perceived.  The  youne  and  newly-married  miglit  be  spareu  an 
ttiiploftsant  amount  of  eujbamissment  by  consulting  the  (Jalendar  as  to  the  tiino  of  contineraent, 
which,  in  reckoning  tlio  full  period  of  gestation  280  days  from  conception,  iniiy  be  very  nearly 
approximated;  or,  in  tlie  event  of  the  lime  of  conception  being  uncertiiiii,  from  the  period  of 
quicltening,  which  she  can  usually  note,  »ho  may  reckon  140  days.  It  will  be  perceived  that  the 
Calendar  has  three  columns  of  tigures,  denoting  the  days  of  the  months  noted  at  the  hearl  of  each. 
The  first  column  gives  the  date  of  conception;  the  second,  that  of  the  period  of  quicUciiiiiK;  and 
the  third,  that  of  delivery.  Thus,  if  a  lady  dates  the  period  of  conception  .Ian.  1, 1870,  quickening 
will  occur  May  20,  and  confinement  about  the  8th  ot  October  following;  or,  if  she  is  ijjnorant  oi 
the  time  of  conception,  by  comulting  the  middle  column  as  to  the  time  uf  quickening,  II  it  occurs 
May  20,  she  may  expect  her  confinement  to  occur  about  the  8tli  of  October  Ibllowing,  or  140  day? 
after  the  period  of  quickening.  The  date  in  the  first  column  is  that  of  conception ;  the  correspond- 
Isg  date  in  the  second  column  is  that  of  quickeuuig;  and  the  corresponding  iliito  of  the  third  col- 
omu,  that  of  confinement. 


January. 


□m«p'ii. 

Tan. 

I 

2 

8 

4 

6 

6 

7 

8 

S 
10 

11 

12 

13 
U 
16 
16 
17 
IS 
19 
20 
21 
82 
23 
24 


duickm'g.  Dttiv'f. 


May 
20 
21 
22 
23 
24 
26 
28 
27 
28 
29 
80 
81 

June 
1 

a 

3 
4 

6 
6 
7 
8 
8 

10 
11 

la 


26 

18 

26 

14 

87 

16 

38 

16 

i9 

17 

10 

18 

81 

18 

Oct. 

8 

9 
10 
11 
12 
13 
14 
15 
16 
17 
18 
19 

20 
-21 
22 
23 
24 
25 
26 
27 
28 
29 
80 
81 
Not. 
1 
3 

a 

4 

6 
6 
T 


Febroary. 


Qmctp'n,  Quietxn't.  Deliv'i/. 


Feb. 

1 
2 

8 

4 
6 
6 
7 
8 
9 
10 
11 


June 

20 

21 

22 

23 

24 

25 

26 

27 

28 

20 

80 
July 


Nov. 

8 

9 
10 
11 
12 
13 
14 
15 
16 
17 
18 


12 

1 

19 

13 

2 

20 

14 

8 

21 

15 

4 

22 

16 

6 

23 

17 

6 

24 

18 

7 

25 

19 

8 

20 

20 

9 

27 

21 

10 

28 

28 

11 

29 

23 

12 

80 
Deo 

24 

18 

1 

26 

14 

a 

26 

16 

8 

27 

16 

4 

38 

17 

6 

Maroh. 


April. 


Cbncep'a.  Qukken'g.  Deliv'y, 


March 

1 

2 

8 

4 

6 

6 

7 

8 

9 
10 
11 
12 
13 
14 

IS 
16 
17 
18 
19 
20 
21 
23 
23 
24 
25 
26 

27 
28 
29 
80 
81 


July 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

29 

80 

31 

Aug 

1 

2 

3 

4 

6 

6 

7 

8 

9 

10 

11 

12 

13 
14 
15 
16 
17 


Doc. 

6 

7 

8 

9 
10 
11 
12 
13 
14 
15 
16 
17 
18 
10 

20 

21 

23 

23 

24 

25 

26 

27 

2f 

2» 

80 

31 

Jan. 

1 

2 

8 

4 

6 


CoHcep'n,  Quiekem*g,  Veliv^p, 


Anril 
1 
2 
3 
4 
6 
6 
7 
8 
9 
10 

a 

12 
13 
14 

15 
16 
17 
18 
19 
20 
21 
22 
23 
24 
26 
26 

27 
28 
29 
SO 


Aug. 

18 

19 

20 

21 

22 

23 

21 

25 

26 

27 

23 

20 

80 

31 
Sept. 
1 
2 
3 
4 
5 
6 
7 
8 
9 

10 

11 

12 

13 
14 
16 
16 


Jan. 

6 

7 

8 

9 
10 
11 
12 
IS 
1« 
lo 
16 
17 
18 
19 

20 
21 
2i 
23 
24 
25 
26 
27 
38 
29 
80 
81 
Feb. 
1 

a 

8 
4 


! 


886 

'    MARRIED  LADIES'   PERPETUAL  CALENDAR. 

May. 

Jmne. 

July. 

Aiiffutt. 

CbHMp'll. 

(XeiOTV 

DtUv-y. 

Ometp'H.  Qmekm'e.  DtHyfy 

Oonev'n.  (iuielcmt'g.  DtlWy. 

Omeep'n 

QuicUn'g.  Dtlie't 

Mny 

Sept. 

Feb. 

June      Oct.    March 

July     Nov.    April 

Aug. 

Dec.      Mn> 

1 

17 

6 

1          18           8 

1         17           7 

1 

18            8 

2 

18 

6 

2          19           8 

2          18           8 

2 

19           8 

8 

19 

7 

8         20          10 

8          19           9 

8 

20          10 

4 

20 

8 

4         21          11 

4          20          10 

4 

21           11 

6 

21 

9 

6         22          12 

6         21          11 

6 

22          12 

6 

22 

10 

6         23          18 

6         22          12 

6 

28          13 

7 

28 

U 

7          24          14 

7         23          13 

7 

24          14 

8 

24 

12 

8          26          16 

8          24          14 

8 

26          15 

9 

26 

13 

8          26          16 

9          2j          16 

9 

26          16 

10 

26 

14 

10          27          1' 

10          26          16 

10 

27          17 

11 

27 

16 

11          28          ^8 

11          27          17 

11 

28          It, 

12 

28 

16 

12          29          19 

12          28          18 

12 

29          19 

13 

29 

17 

13          80          20 

18          29          19 

13 

80          20 

14 

80 
Oct, 

18 

14         81          21 

Noy. 

14          30          20 
Dec. 

14 

31          21 
Jan. 

16 

1 

19 

16           1         2" 

16            1          21 

16 

1         22 

16 

2 

20 

16           2         "w 

IS           2         22 

16 

2          23 

17 

8 

21 

17            8          24 

17           8         23 

17 

8          24 

18 

4 

22 

18            4          26 

18           4          24 

18 

4          26 

18 

6 

23 

19            6          26 

19            6          25 

19 

6          26 

: 

20 

6 

24 

20            6          27 

80            6          26 

20 

6          27 

1 

21 

7 

26 

21            7          28 

21            7          27 

21 

7         28 

22 

8 

26 

22            8          29 

22            8          28 

22 

8          29 

23 

9 

27 

28            9          80 

28            9          29 

23 

9          80 

24 

10 

28 

24          10          81 

24          10          30 

24 

10          81 

March 

April 

May 

June 

26 

11 

1 

25          11            1 

26          11            1 

25 

11            1 

20 

12 

2 

26         12          a 

26          12            2 

28 

12            2 

27 

13 

8 

27          18           8 

27          13            8 

27 

18            8 

28 

14 

4 

28          14            4 

28          14            4 

28 

14            4 

29 

16 

6 

29          16            S 

29          15            6 

28 

16            6 

80 

16 

6 

30          16            6 

80          16           6 

SO 

16            6 

• 

81 

17 

7 

81          17           7 

81 

17           7 

Septembe 

r. 

October. 

November. 

December. 

Vuteep'n, 

Quicken'g 

DtUv'y. 

Qactp'n.  Quui.tn't.  Detiv'w. 

CmcapV  QiacUn'g.  DtUtfy. 

C4MC0p'a. 

Quiclcai'i/.  Drtw't 

Sept. 

Jan. 

June 

OcU      Feb.     Jnly 

Nov.    March   Aug. 

Dec. 

April    Sept. 

. 

18 

8 

1         17           b 

1          20           8 

1 

19           7 

2 

19 

9 

2          18           9 

2          21           9 

2 

20           8 

8 

20 

10 

8          19         10 

«:         22          10 

8 

21           9 

4 

21 

11 

4         20          11 

4          23          11 

4    . 

22          10 

6 

22 

12 

6         21          12 

6          24          12 

6 

23          11 

a 

23 

13 

6         22         18 

i      ib      13 

6 

24          12 

7 

24 

14 

7          ^3          14 

7          26          14 

7 

20          13 

8 

26 

16 

8         24         16 

8          27          15 

8 

26          14 

0 

26 

16 

9         26         i6 

9          28         16 

9 

27          16 

10 

27 

17 

10          26          17 

10         29          17 

10 

28          16 

11 

28 

18 

11          27          18 

11          80         18 

11 

29          17 

12 

29 

19 

12          28          19 

18         81          19 

12 

80           IH 

13 

80 

20 

Mnruh 

April 

Jlay 

U 

81 

21 

1!J           1          20 

18            1          20 

13 

1          19 

fob 

14           2         21 

14            2          21 

14 

2          20 

16 

1 

22 

16           8         22 

16           8         %i 

IS 

3          21 

IC 

2 

23 

16            4          28 

16            4          23 

16 

4          23 

17 

8 

24 

17            6          24 

17            6          24 

17 

5          23 

18 

4 

26 

18            6          26 

18            6          35 

18 

6          24 

19 

6 

26 

19            7          26 

19            7          26 

19 

7          25 

20 

6 

27 

20           8         27 

20           8         37 

20 

S          26 

21 

7 

28 

21           9         28 

21            9          28 

21 

9          87 

22 

8 

29 

22          10         29 

22          10          29 

22 

10          28 

88 

8 

80 

23          11          80 

28          11          30 

23 

11          29 

July 

24          12          81 

24          12          81 

24 

12          80 

24 

10 

1 

Aug. 
26          18            1 

Sept. 

Oct 

26 

11 

a 

25         18           1 

26 

18           1 

26 

12 

8 

26         14           a 

86       ~ 14          a 

26 

14         a 

27 

18 

4 

27          16           8 

27          16           8 

27 

16           8 

28 

14 

6 

26          16           4 

88          16           4 

28 

16           4 

29 

16 

6 

29          17           6 

89         17           6 

it 

17           1 

SO 

14 

7 

80  18           6 

81  la        r 

M         li           6 

80 
«1 

18           • 

la        r 

' 

r^ 


Aiiguct. 


Oomxp'H.  Quickem'i/,  DtUti't 


Aug. 
1 

a 

3 
4 

6 

6 

7 

8 

9 
10 
11 


Dec. 
18 
19 
20 
21 
22 

::8 

24 
26 
26 

27 
28 


12 

29 

19 

13 

80 

20 

U 

31 
Jan. 

21 

16 

1 

22 

18 

a 

23 

17 

8 

24 

18 

4 

26 

19 

6 

26 

20 

6 

27 

21 

7 

28 

2i 

8 

29 

23 

9 

30 

24 

10 

81 

June 

26 

11 

1 

26 

12 

2 

27 

13 

8 

28 

14 

4 

29 

16 

6 

30 

16 

6 

31 

17 

7 

December. 

.    Cuitcep'n. 

QmcktH'ti 

.  DeHv't 

Dec. 

April 

Sept. 

1 

19 

7 

2 

20 

8 

8 

21 

9 

4    . 

22 

10 

6 

23 

11 

6 

24 

12 

7 

2S 

13 

8 

26 

14 

9 

27 

15 

10 

28 

18 

11 

29 

17 

12 

30 
May 

IH 

13 

1 

19 

14 

2 

20 

16 

3 

21 

18 

4 

22 

17 

6 

23 

18 

6 

24 

19 

7 

25 

20 

S 

26 

21 

U 

87 

22 

10 

28 

23 

11 

29 

24 

12 

80 
Oct 

26 

18 

1 

26 

14 

a 

27 

16 

a 

26 

16 

4 

'4» 

ir 

• 

80 

18 

• 

81 

u 

T 

.*'      * 


PRONOUNCING  DICTIONARY. . . .  GLOSSARY. 


An-Do'MEN.    The  belly. 

A-OK-TAnu-LUM  The  socket  for'the  hentl 
of  the  thi);h  bono;  an  uncient  vessel  for  holcl- 
hiff  vinotrar. 

Am-do.m'i-nal  cav'i-t¥.  The  cavity  of 
the  nolly. 

Ad-i>uc'tor.  a  muscle  which  draws  one 
part  of  the  body  towHi-ds  another. 

Ad-80b'bent8.  Glands  and  vessels  which 
absorb  or  suck  up  suliKtances  from  within, 
or  without;  also,  medicines  which.  tboup;h 
nearly  or  quite  inactive  themHclves,  absorb, 
or  combine  with  acid  matter  in  the  stomach 
or  bowels. 

A-CRO'jfi-ON.  That  part  of  the  scapnia,  or 
shoulder-bludo,  which  unites  wth  the  collar- 
bone. 

AL-nu-om'E-A.    The  white  of  the  eye. 

Al'tkr-a-tive9.  Medicines  which  gradn- 
ually  ixjiistahlish  health,  without  sensibly  Id- 
creasini;  the  circulation,  or  augmenting  the 
perspiration,  urine,  or  other  excretions. 

AL'VE'O-LAit.  Relating  to  the  sockets  of 
the  teeth. 

Al'vine  lA^vfri).  Relating  to  the  Intes- 
tines, as  alvine  discluiryts.  —  discharges  from 
the  bowels. 

A-m()r'phou8.    Having  no  regular  form. 

Am-ni-ot'io  Liq'uid  The  fluid  surround- 
ing the  fetus  in  the  womb. 

An-.«;8-the'8ia.    Suspended  sensibility. 

An-as'to-mose.  The  uniting  of  arteries 
and  veins  by  Joining  their  months. 

An-ciiy-lo's!8.    a  stiiT  or  useless  joint. 

An-i-mal'ci;-!.*.  Animals  so  small  that 
they  can  only  l)e  seen  with  a  microscope. 

An-o/mi-a.  Privation  of  blood;  a  com- 
pariitivcly  bloodlejis  state. 

An'o-dvneh.  Medicines  which  diminish 
sensibility,  abate  pain,  and  induce  sleep.  It 
should  always  1x3  remembered  that  anodynes 
wlicn  frequently,  and  louji;  taken,  lase  their 
influence  in  diseitse. 

Ant-a'cid8.  Preparations  which  neutrnl- 
l?,e  acidity  of  the  stomach  and  IkjwcIs. 

Ant-al'ka-libs.  Agents  which  neutralize 
alkalies. 

An-ta-phpo-dis'i-acs.  Agents  which  les- 
sen or  blunt  the  sexual  propensities. 

An-thel-min'tics.  Medicines  which  des- 
troy and  expel  worms. 

An'ti-dotes.  Medicines  which  counteract 
and  destroy  the  effects  of  poison. 

An-tj-pb-ri-od'ic8.  Medicines  which  prc- 
t^nt  or  cure  diseases  of  a  periodical  character. 

AN-Ti-piir.o-oi8'Tic8.  Medicines  or  diet 
which  remove  or  appea.se  inflammation, 


An-ti-8pa8-mod'iC9.  Medidnes  which  pre- 
vent  or  allav  spasms,  commonly  called  crampa 

An-ti-8Ypii-i-lit'ic8.  Medicines  which 
cure  syphilis. 

An-ti-8Ep'tic.  ■'Vhatever  checks  or  coun- 
teracts putrefaction. 

An-ti-8Cor-uii'tic8.  Articles  -which  pre- 
vent and  cure  scurvy. 

A-pe'ri-ent8.  Medicines  which  gently 
open  the  bowels. 

A-pho'ni-a.    a  loss  of  the  voice. 

Aph-ho-di9'i-ac9.  Medicines  supposetl  to 
excite  and  promote  the  sexual  appetite. 

A-pon-eu-bo'8is.  The  memoranous  ex- 
ponsion  of  tendons  and  muscles. 

A-re-o'la.  a  colored  circle,  as  the  circle 
around  the  nipple. 

Ar-o-mat'ic8.  Mcdicn.es  which  have  a 
grateful,  spicy  smell,  and  an  agreeable,  pun- 
gent taste. 

As-piiyx'i-a  Suspended  animation  ;  ap- 
parent death. 

As-then'ic.  Relating  to  debility;  or  to 
disease  marked  by  debility. 

A8-trin'gent8.  Medicines  which  have  the 
power  to  constrinpe  or  pucker  up  the  tissues 
of  the  body,  and  thereby  check  discharges. 

At'ho-phy.    a  wasted  condition ;  leanness. 

Ax-il'la.    The  arm-pit. 

Aus-cul-ta'tion.  The  art  rtf  detecting 
disease  by  listening  to  the  sounds  of  the  lungs, 
heart,  etc. 

Au-TOP'sT.  Personal  inspection,  —  used  in 
the  sense  of  a  post-mortem  examination. 

A-zote'.  Nitrogen;  one  of  tlie  constitu- 
ents of  the  atmo.sphere. 

Bkon'chi-a.  The  pipes  which  convey  the 
air  through  the  inngs. 

Bur's*  Mu-co'sa.  Small  sacs,  situated 
under  tendons,  alwut  the  joints,  containing  a 
stickv  fluid. 

Cal'cu-lus.  a  solid,  unorganized  bmly 
formed  in  the  kidneys,  or  I)ladder,  and  culled 
a  stone.    The  plural  is  calculi. 

Cap'ii--i-a-rt.    Small;  resembling  a  hair. 

Cap'sulk.  a  membraneous  bag,  enclos- 
ing a  part. 

Car'ti-iaoe.  Gristle  attached  to  the  ends 
of  the  bones. 

Car-min'a-tives.  Medicines  which  expel 
wind  from  the  stomach  and  iMjwels,  and  allay 
the  pain  caused  hy  it. 

Ca-thar'tic8.  Medicines  which  purge  the 
bowels. 

Cer'vix.  The  neck.  Car'i'uc  V'Ur-i.  Th« 
necU  of  the  womb. 

Car'i>i-ac.    Kcliitinn  to  the  heart. 


i 


.   * 


I 


888 


GLOSSARY. 


Cau'pal.    Rfliitlns  to  the  wrist. 
Cat-a-me'ni-a.    The  imonthly  flow  of  fe- 
males. 

r'urirlnst- 

(V  tulKj  for  drawing  off  the 


1'.  ' 

E.«t: 


Ca-TIIAR'SI8. 

Catii'e-tkr. 
urine. 
Ci;i,-LU'LAn. 
Ckk'k-iiual. 


Kclnting  to  cells. 
Ki'liitin^r  to  tlic  brain. 

CiiA-i.Yii'E-ATK.     (\>i>tiiiniiif<  iron  or  steel. 

C"iiE-.Mo'si8.  A  faweiliiitt  of  tlie  eye,  in 
wliiili  tlie  eye  projcrts,  wltli  a  dcpregsion  in 
tiie  centre. 

Ciio'i.a-oooi:e.  a  medicine  which  causes 
a  (iiseliin'uie  of  bile. 

Ci.o'Nic  Si'AS.Ms.  Spasm?  'Ich  are  rigid 
and  relaxed  alternately. 

Coi.  i.i'iiCA-TivE.  This  ter'-.i  is  applied  to 
excessive  and  cxhaii'.tini;  diseliarircs. 

Co-i.o8'THiiM.    The  llixt  secretion  of  millc. 

C'o'.MA.     I'rolbnnd  stupor,  or  sleep. 

Condyle  (kon'dil).  A  Itnob;  applied  to 
certain  projections  of  bonos  at  joints. 

Con'flu-ent.  Not  distinct;  running  to- 
gether. 

Con-oen'i-tal.  Kxisting  at  the  time  of 
birtli. 

(Jon-oe8'tion.  Distention  of  parts  by  an 
accumulation  of  I)lood  m  them. 

(Jo>i-,(L'Nc'Ti-VA.  Tlie  membrane  which 
covers  tlie  eye  and  lines  the  eye-lid. 

(,'ON'THA-iN'i)i-cA-TED.  Not  iudicatcd;  the 
opposite  implied. 

C<)ui)'iAi,8.  Medicines  which  have  a  grate- 
ful, warming,  and  exiiilarating  effect  upon  the 
Btoniacli. 

Coun'ter-Ir'hi-tants.  Articles  which  by 
iiTiuiting  one  i)art,  withdraw  blood  from,  and 
relieve  another. 

Cri'sis.    Tlio  turning  point  of  u  disease. 

Cu'ti-ci.e.    The  eiiiderniis;  the  scarf-skin, 

I)e-ciu'l-a.  a  thin,  external  membrane, 
within  the  womli,  tlirown  ofl"  after  child-bear- 
ing. 

De-hq'ui-um.    Fainting. 

De-mui,'cent8.  Medicines  of  a  softening 
nature,  wliieli  correct  acrid  conditions,  and,  by 
tlieir  liland  elfccts,  soothe  inflamed  and  irri- 
tated parts. 

Dp-PLE'TiON.  Diminishing  the  Ailness  of 
a  part  or  parts,  as  by  purgatives,  or  bleeding. 

DE-8QDA-MA'Tioy.  Separation  of  tlie  sliin 
in  scales;  scaling  off. 

De-teu'gent8.    Medicines  which  cleanse. 

Di-AG-NO'sis.  The  art  of  determining  the 
nature  of  diseases. 

Di-A-rno-RET'ics.  Medicines  which  pro- 
mote sweating. 

Di-atii'e-8is.  Any  particular  disposition, 
state,  or  habit  of  tiody. 

Di-ii-ue'8is.    Copious  flow  of  urine. 

Dil'i'-ents.  Watery  drlnlvs,  which  Increase 
the  fluidity  of  llie  blood,  and  render  several  of 
the  secretive  and  excretive  fluid.s  less  viscid. 

Di8-cu'TiENT8.  Mcdlclncs  which  scatter, 
resolve,  or  disperse  tumors. 

Di8-iN-FBC'TANTS.  Articles  which  purify 
or  cleanse  infected  places. 

Di-u-rkt'ics.  Medicines  which  increase 
urinary  secretions. 

Dras'tics.    Strong  and  violent  purgatives. 

Dy8P-n(e'a.     Dirticuity  of  breathing, 

IvME'sis.     Voiiiitlng. 

E-MK'f'ics.  Medicines  which  cau.ie  tlie 
Stomach  to  rever.se  its  action,  and  tlirow  its 
contents  up  througli  tlic  moutli 


Em-mbr'a-oooues.  Medicines  supposed  to 
liavo  the  power  of  exciting  or  increasing  tlie 
menses. 

E-mol'lient8.  Those  substancen  which 
have  tlie  power  of  softening  or  relaxing  the 
animal  flbro,  when  applied  externolly. 

En-dem'ic  Di8-EA8'Ea.  Diseases  prevail- 
ing in  certoin  localities  or  districts. 

X>-i-DEM'ic  Dis-ea»'e«.  Diseo-ses  extend- 
ing over  a  largo  extent  of  country. 

Ep-i-olot'tis.  The  cartilage,  which,  in 
the  net  of  swallowing,  shuts  down  upon  the 
top  of  the  wind-pipe,  and  prevents  food  from 
going  into  the  breath-passage. 

Ep-I8-pa»'tics.  Substances  which  inflnino 
the  skin,  and  raise  the  cuticle,  and  cause  what 
is  called  a  blister. 

Es-ciiA-ROT'ics.  Articles  which  bum,  cor- 
rode, disorganize,  and  destroy  tlio  animal  tis- 
sues, cifUsing  what  is  called  an  eschar,  or 
slough,  which  is  dead  matter,  and  falls  off. 

Ex-pec'to-rant8.  Articles  whidi  act  upon 
the  system,  bo  as'to  make  the  discliarge  of 
mucus  and  other  substances  from  the  air-tul)cs 
more  easy. 

Er'riiine8.  Substances  which  cause  sneez- 
ing, and  a  discharge  of  mucus  from  the  nose 
when  snuffed. 

Es'ciiAR.  The  dead  part,  killed  by  caustic, 
or  mortification,  which  falls  olf;  a  slough. 

Ex-FO-n-A'TiON.  A  sealing  off,  as  a  piece 
of  dead  bone. 

Eau'ceb.    The  back  part  of  the  mouth. 

Ee'iiuile.     Belonging  to  fever. 

Fb'ces.  The  matter  discharged  from  the 
bowels. 

Feb'ri-fu-oes.  Medicines  which  assuage 
or  remove  fevers. 

Fla'tus.  Wind,  or  rather,  gas,  In  the  stom- 
ach or  bowels. 

Fol'li-cle,    a  little  l)ag  or  sac. 

Fo-ra'men.    a  hole,  or  opening. 

For-mi-ca'tion.  a  sensation  liije  the  neep 
ing  of  ants. 

Fl'r-fu-ra'ceous.    Bmnny,  or  scaly. 

Gang'li-on.  An  enlargement  in  the  coarse 
of  a  nerre. 

Gan'grene.    Mortification;  partial  death. 

Gas'thio.     Belonging  to  the  stomacl;. 

Ges-ta'tion.    The  iieriorl  of  pregnancy. 

Glot'tis.  The  opening  into  tlie  wind-pipe, 
covered  by  the  epiglottis. 

Gran'u-lar.    Like  small  grains. 

Gran'u-la-ted,  Covered  with  granula- 
tions. 

Gran-o-la'tiox.  The  filling  up  or  cover- 
ing of  a  wound,  or  ulcer,  wiih  small,  red  eleva 
tions,  looking  like  grains. 

ll.K-iMOP'TY-si8.  liaising  blood  from  the 
lungs. 

llE-Mi-cnA'Ni-A.  Pain  on  one  sMo  of  tliO 
liead 

II.KM'OU-RIIAOE 
II.EJI-OH-RIIAOIC 

bleed. 

IIe-pat'ic.     Beloniring  to  the  liver. 

Hv-i'l;u-cv-THAU  SIS.     Excessive  pufr'ng 

lIv-PKR'TRo-pHv.  An  iiiniatunil  enlMr^e- 
meiit  of  an  oriraii,  wltlioui  cli.murc  of  sinvtii'e. 

Hvp-xor  IC8.    MedU'lnes  wiiicli  cause  sleep 

!<'ir<)R  (/,t:'o/'),  A  tliiii,  watery,  itii.l  acrid 
discliarge. 

Ix-tku-co8'tal.     Between  the  rilis. 

Lar'iN.x.  Tlic  top  of  the  wind-iilpe;  the 
cavity  wliieli  contains  tiie  vucui  ligaiiicnts. 


A  flow  of  bloo  I. 
Having  a  tendency  to 


i 


A  flow  of  l)loo  1. 
c      Uiiviii;;  11  tiii.loncy 


Medicines  supposed  to 
citing;  or  iiicroasinj;  tlio 

1080    suiistnncei   which 

ftoninj;  or  rt'liixlns  tlio 

)li(!(l  extcrnnlly. 

i'Ks.     lUseiiscs   prevail- 

!  or  districts. 

vs'KS.    Ui.seosos  extend- 

t  of  country. 

le    oirtiiiisc,  wliich,   in 

C,  shuts  down  upon  tlio 

iind  prevents  food  from 

piissasre. 

iil)stiin<'cs  which  infliuno 

u  cuticle,  and  cnuso  wlnil 

\rtiel09  which  bum,  cor- 

l  destroy  tlio  animal  tis- 

is    called  an  eschar,  or 

matter,  anil  falls  otf. 

Articles  which  act  upon 

make  tho  discharRe  of 

stances  from  the  alr-tubcs 

tancos  which  cause  sncez- 
of  mucus  from  tlio  noso 

ad  part,  killed  by  caustic, 
ch  falls  off;  a  sloujjh. 
A  scaling  off,  as  a  piece 

ck  part  of  tho  mouth. 

Cinjj;  to  fever.  j 

tter  discliar>;cd  from  the 

Medicines  which  assuafro 

or  rather,  gas,  in  the  st«m- 

ittle  bac  or  sac. 
ole,  or  openinjj. 
A  sensation  like  tho  c»eep 

9.    nrniiny,  or  scaly. 

I  enlargement  in  the  coarse 

irtification;  partial  death. 

iitrinR  to  the  stomach. 

'lie  period  of  prcpiancy. 

openin^f  into  the  wind-pipe, 

llottis 

ike  small  jiniins. 

Covered   with    Rranula- 

.  The  filling  up  or  cover- 
idccr,  with  small,  reil  eleva 
p-ains. 

liaising  blood    from  th& 

.     Pain  on  one  side  of  t!i9 


to 


lonirini;  to  the  liver. 
K  818.    hxeitsslve  imfrini-' 
V.     An   UMiuitund   eiilMi-^e- 
withont  clianiTc  of  s'lii'tu'c 
Medicinc-i  wiiich  canse  sleep 
A  tliiii,  watery,  un.l  acrid 

.     Between  the  ribs. 

top  of  the  wind-pipe;  the 
ftins  the  vmai  iijramellts. 


GLOSSART. 


889 


Lax'a-tives.  Medicines  which  render  the 
bowels  a  llttlo  more  relaxed  than  natural,  but 
do  not  purge. 

Liq'ate.    To  secure  with  a  ligature. 

LuiU-TUKB.    A  cord,  or  thread. 

Lo'CHi-A.  Tho  bloody  discharge  ft-om  the 
womb  for  some  time  after  child-birth. 

Lo'ciii-AL.    Relating  to  the  lochia. 

Lymph.  A  whitish  fluid  c-ontalned  by  the 
lymphatic  vessels. 

Lym-phat'icb.  The  ressels  which  carry 
lymph. 

Mac-er-a'tiox.  The  act  of  softening  or 
soaking  a  thing  by  letting  it  stand  In  water. 

Mac'u-l.«.    Colored  spots ;  blemishes. 

Ma-la'ki-a.  Noxious  gases  from  decom- 
posed matter. 

Mam'ma.    Tho  female  breast. 

Man-dib'u-lar.    Keiating  to  the  Jaw. 

Ma8-ti-ca'tion.    The  act  of  chewing. 

Mas-tur-ba'tion.  The  act  of  exciting  the 
genital  organs  with  the  hands. 

Men'8tru-um.    Any  solvent,  or  vehicle. 

Mkt-a-car'pus.  'tho  hand  between  tho 
wrist  and  tho  fingers. 

Me-ta8'ta-8I8.  The  changing  of  a  disease 
ftom  one  place  to  another. 

Met-a-tar'8U8.  That  part  of  tho  foot  be- 
tween the  ankle  and  the  toos. 

Mi-a8-uat'ic.  Partaking  of  the  nature  of 
miasm 


Composed    of    both 
Composed   of   both 


MU'CO-PU'RI-FORM 

mucus  and  pus. 

Mu'CO-8E'RO-I,ENT 

mucus  and  serum. 

Nar-cot'ics.  Medicines  which  relieve  poln 
and  produce  sleep. 

Nau'8E-ant8.  Medicines  which  cause  sick- 
ness at  the  stomach,  or  a  disposition  to  vomit. 
They  are  often  used  as  expectorants. 

No8-OL'o-oi8i  {Nose-oVo-yist).  One  who 
explains  and  classifies  diseases. 

Ku'CLE  us.    A  central  spot. 

Nu-cle-o'l0s.    a  spot  within  a  nucleiis. 

Or-thop-n(b'a.  Great  difflculty  of  breathing. 

Oa  U'ter-i.    The  mouth  of  the  womb. 

Ob-si-fi-ca'tion.    The  formation  of  bone. 

O'vuM.  An  OKg.    O'VA.  Eggs. 

Pa-pil'i-a.  a  red,  elevated  point  upon  tho 
tonguo,  or  elsewhere.  Certain  diseases  make 
these  points  more  prominent. 

Par-a-ckn-'TS'sis.  The  operation  of  punc- 
turing the  chest,  or  the  abdomen,  for  the  pur- 
pose of  drawing  off  water. 

Par-a-phi.e'gi-a.  Paralysis  of  the  lower 
half  of  tho  body, 

Par'ox-ysm.  a  fit  of  disease  taking  place 
periodically. 

Par-tu'ri-ent.  Bringing  forth,  or  giving 
birth. 

Par-tu'ri-ents.  Medicines  which  promote 
child-bed  labor,  by  causing  contractions  of  tho 
womb.    « 

Par-tu-ri'tion.    Child-birth. 

Pec'to-rals.  Medicines  intended  to  cure 
or  relieve  diseases  of  tho  chest. 

Pel'vis.  The  bony  cavity,  or  basin,  at  the 
lower  part  of  the  body,  containing  the  womb, 
abdomen,  rectum,  etc. 

Per-i-ne'um.  Tho  part,  or  space,  between 
the  anus  and  testicles. 

Per-i-08'te-um.  a  thin,  hard  membrane, 
covering  tlio  bones. 

PER-i-os-Ti'Tia.  Infl&inmat.on  of  the  peri- 
osteuin- 


Per-i-to-ne'um.  a  serous  membrane  lln- 
Ing  the  cavity  of  tho  l)olly,  and  folded  over 
most  of  the  organs  contained  in  it. 

Pet-e'ciii-^.  Purple  spots  which  appear 
upon  tliu  skin  in  low  fevers,  looking  like  flea- 
bites;  called  also  ecchyinoses. 

PnA-OE-i»KN'ic.  Corroding,  eating,  —  ap- 
plied to  ulcers. 

Piia-lan'qeb.  Tho  bones  of  tho  Angers  and 
toes. 

Piiar'ynx.    The  tipper  part  of  tho  throat. 

Piileo-M()'nou8  In-kla.m-.ma'tion.  Inllam 
mation  marked   by  redness,  heat,  and  pain, 
and  a  tendency  to  form  matter. 

Pkoo-no'8I8.  Tlio  art  of  foretelling  the 
termination  of  diseases. 

Pty"'a-li8m.    Salivation. 

Pui'A-Pi8M.  A  contimied  erection  of  tho 
penis  from  exciting,  morbid  causes. 

Ke-frio'er-ant8.  Medicines  which  lessen 
tho  heat  of  tho  body. 

Ke-lax'ant8.  Medicines  which  relax  the 
tension  of  the  muscles. 

Re-mi8'8ion.  a  lessening  or  mitigation  of 
tho  severity  of  the  symptoms  of  a  disease. 

RE8-o-Lf'TioN.  "Dispersion  of  an  inflam- 
mation tieforc  pus  is  formed. 

Re-vul'81ve8.  Medicines  or  appliances 
which  remove  a  disease  by  causing  a  deter- 
<nination  to  some  other  part. 

liu-nE-FA'ciENT8.  Applications  which  ex- 
cite the  skin,  causing  tho  blood  to  flow  to  it, 
and  making  it  red. 

Sa'nies,  a  thin  fluid  discharged  from  ul- 
cers, havhiir  some  of  tho  properties  of  pus  and 
blood 

Sed'a-tiveb.  Medicines  which  diminish 
tho  action  of  tho  heart  and  nerves,  and  wiiich 
are  used  when  wo  wish  to  allay  any  excited 
action  in  tho  system. 

Se'rous.    Watery. 

ScRo'TUM.  Tho  bag  which  contains  the 
testicles. 

ScYB'A-LA.    Hard,  round  lumps  In  the  feces. 

Si'A-LA-GoouES.  Medicines  which  increase 
the  flow  of  saliva. 

Slough  (Stuff)  Any  part  of  the  Iwdy 
killed  by  mortification,  or  caustic,  and  cast  off. 

Sper-mat'ic  Cori>8.  Two  cords,  composed 
of  nerves,  veins,  and  arteries,  descending,  one 
on  each  sido,  from  tlte  abdomen  into  the  scro- 
tum, and  suspending  the  testicles. 

Squa'moub.    Scaly;  having  scales. 

Sor'des.  The  davk  matter  deposited  upon 
tho  lips  and  teeth,  in  low  lovers. 

Steb'num.    The  breast-bone. 

Ster'tor.  Noisy  breathing,  as  In  apo 
plexy.    Snoring. 

Ster'tor-ous.  Snoring  and  noisy,  as  ap- 
plied to  breathing. 

Stim'u-lants.  Medicines  which  increase 
the  activity  of  the  system. 

Sto-mach'ic8.  Medicines  which  support 
and  renovate  tho  stomach,  making  its  action 
healthy. 

Stru'ma.    Scrofula. 

Styp'tics.  Substances  which,  when  ap- 
plied externally,  have  the  power  to  constringe 
or  pucker  up  bleeding  vossals,  and  stop  the 
loss  of  blood. 

SuB-cu-TA'NE-ons.    Under  tho  skin. 

SuB-MAX'iL-i-A-RY.    Uiulor  tlic  lower  jaw. 

Sdb-8ul'tus  Ten'di-num.  Slight  twitch- 
Ings  of  the  tendons,  which  occur  in  low  f'oruw 
of  fever. 


■"190 


GLOSSARY. 


Sr.'-DO-RiF'ics.  Medicines  which  cruso  a 
flow  <)('  ni:rnj)imtion,  riithur  moro  free  thiui 
that  proiluccd  hy  diiiphurcilcs. 

Si  r-i-UH'i-TO-KiES.  Solid  medicinal  Ruh- 
Rtmices,  of  a  conical  or  cylindrical  shape, 
which  arc  placed  in  the  rectum  for  the  pur- 
pose of  relicviiit;  constipation  and  the  piles, 
and  for  removing!;  stricture. 

SvN'co-i'K.    Fuintini;;  swooninp;. 

TE-NK8'Mti8.  A  painful  IjcnrinK  down  In 
the  lower  bowel,  and  u  distressing  desire  to  go 
to  stool. 

ToN'ics.  Medicines  which  gradually  (rlvo 
tone  and  strentfth  to  weakened  orjrans,  or  to 
the  whole  system.  Some  act  ui)on  the  ner- 
vous system,  and  some  upon  the  other  tissues, 
hy  coiidensinit,  hordenini;,  aud  invi|;oratiDK 
them. 


Tor'mi-xa.    OrlplnR  pain. 

U-re'tbrb.  The  tuhes  which  convey  the 
urine  from  the  kidneys  to  the  bliulder. 

U-rb'thka.  The  canol  which  convoys  the 
urine  from  the  bladder  out  of  the  body. 

U'TER-u8.    The  womb. 

Vao'i-na  (Vadgii-na).  The  passa^o  from 
the  external  R^enital  organs  to  the  womb. 

Va'ui-cosk  Veins.  Veins  which  are  mor- 
bidly enlar|{ed,  and  present  along  their  course 
soft,  knotty,  purplish  tumors. 

Ver'ti-oo.    Dizziness;  ^riddlnesa. 

Vk-si-ca'tion.    BlisierinK. 

Vi'rus.    Poison;  conta(:ion. 

Vi8'cu8.  A  liver,  stomach,  kidney,  ueart, 
or  any  organ  within  one  of  the  cavities  of  the 
body. 


It  is  believed  that  tho  hard  words  introduced  into  this  book,  and  not  contained  in 
t}ie  above  Glossary,  are  nearly  or  quite  all  expluned  at  the  places  where  they  are 
uso.(L 

111  ' 


""^':A 


ftfiMtin  mmii^ttitt 


B8  which  convoy  the 
3  the  bliulder. 
nl  whirh  conveyi  the 
ut  of  the  hoiXy. 

'  The  paRsaRe  from 
ins  to  the  womb. 
Veins  which  are  mor- 
lent  olong  their  course 
morH. 
18 ;  niddines*' 

lerinK- 

itaijlon. 

omoch,  kidney,  ueart, 

e  of  the  cavities  of  the 


and  not  contained  in 
ilaces  where  they  are 


H'  ^ 


I  N  33  E  X. 


Abdominal  Cavity,  Dlseaws 

of. 
Abies  rnnadeniil, 

•'      Kxctlxa, 

•'      t'icea, 
Abortion, 
A  bfcesiseB, 
Absence  of  Mcnsei!, 
Absorbent  Vciwelii, 
Aoncift  CbIccIiu, 
Accidenia  on  Water, 

•'  bv  I'oinonlnft, 

Acetate  of  Cooper,  poi«onlnp 


rAoa 


262 
617 
602 


429 
864 

as 

fl04 

496 
496 

497 


"  Lcad,'poi8onlnj{by,  498 
<i     '•      Ointment,       07.'^ 

ottn 


Alamen, 

Amauroril, 

AmenorrhcBa, 

American  Hellebore, 
"         Ipecacuanha, 
"         Ivy, 
"  Valerian, 

Ammonia,  Aromatic  Spirit  of,  m 
"  Carbonate  ot,  oaa 

"  Muriate  ol'  693 

•I  I'oisoning  by.  496 

•>         Solution  of  Acetate 


rAoi 
692 

4S6 
8o4 
692 
693 
693 
6t)o 


ACL'tnm,  -„ 

Achillea  Millefolium,  6* 

Acid,  Acetic,  »» 

.,      ('itric  o9i 

"      Diluted  Hydrochloric,    69 

u  "        Hydrocyanic,     59 

"  "       Nitric,  69 

"  "    Sulphnrio,  69 

»     Nitro  Muriatic,  69 

"      Tannic,  of 

"      Tartaric,  g" 

Aconite,  ^  ^ 

"       Foisoning  by,  ^ 

<<       Tinct.  of,  f 

Aconitum  Napellus,  « 

AcoruB  CalamuB,  " 

Adipous  Sarcoma,  *i 

Affections  of  Chest,  Bj 

"         "  Head,  Oi 

"         "  Stomach  and 

Bowels,  K' 

AfniBlon,  The,  6! 

Age,  Influence  01,  ^ 

Ague  Root,  y 

"     Fever  and,  * 

Air  Cells  or  Vesicles, 

"    "    Enlargement  of,  * 

"    in  Chest,  2 

»    Swolllngs,  2 

"    and  Ventilation,  1 

Albumen,  . 

Albuminuria,  j 

Alcohol,  I 

Alder,  Tag,  « 

Alptris  Farinosa,  ] 

Aliment)!,  Fluid,  j 

Allium  Cepa,  ' 

"        Sativum,  ] 

Almonds,  ' 

Svmp  of,  I 

Almond  Mixture,  ' 

Alnus  Rubra,  ' 

Aloes, 

"     Comp  Tinct.  of, 

"     and  Canella.  Compound 

Powder  of,  6S2 

Alpinia  Cardamomum,    -        W4 
Althiea  Offlclnalia,  681 

Alum,  wa 


694 

698 

693 

114 

114 

116 

116 

691 

638 

647 

818 

14 

18 

466 

472 

262 

260 

694 

463 

606 

434 

496 

497 

660 

37 


of, 
II         Water  of, 
/.mpelopsis  Quiuquefolla, 
Amusements, 

0%mes  for, 
I-ighter, 
Want  of, 
AmygdaluB  Communis, 

it  I'erslca, 

Anagallis  Arvensls, 
Anaxarcn, 
Anatomy, 

"         of  Bones, 
Anchylosis, 

Aneurisms,  , ,.    _i 

Aneuri«mal  Tumors  of  Heart, 
Angina  Pectoris, 
Anise, 

Anicle.  Dislocation  of, 
Anthemis  Nobilis, 
Anthrax,       „  , 
Antidotes  of  Poisons, 
Antimony,  Poisoning  by. 
Antipathies, 
Aorto, 

Apooynln,  .,  „        »°i 

ApocynumAndrosjemlfoUum,  uii 

Apoplexy,  .        „    ,         ™ 

Apparent  Death  fi-om  Various 

CauBes,  ^^ 

Apple  Water, 
Aptliaj, 
Aqua  Caicis, 
Arachnitis, 

Arachnoid,  ^,        r 

"  Inflammation  of, 

Aralla  Htaplda, 

"     Kacemosa, 
I      "     Spinoca, 
Arbutus  Trailing, 
Arsenti  Nitras, 
Aristolochia  Serpentana, 
Arnica, 

'•        Montana, 
Aromatic  Powder,  ^^ 

"         Spiritof  Ammonia.  594 

Arrow  Root,  ^4 

"         "       Gruel,  onl 

Arsenic,  *^ 

Arsenical  Solution,  oM 

Artemisia  Absinthium,  664 

Arteries,  ^ 

"       Pulmonary,  of 


Asarum  Canadense, 
Ascicpias  Incarnata, 
"         Hyriaca, 
"        Tuberosa, 

Ascites, 

Ahiatic  Cholera, 

Aspidum  Fllix  Mas, 

Assafcotida, 

"  Comp.  Tinct. 

Asthma, 

Atmosphere,  Pressure  of, 

Atropa  UelladonuB, 

Atrophy,, 

Attendants,  Unhlred, 

Aurantii  Cortex, 

Auricles, 

Ausculetlon, 


rAot 

662 
667 
609 
641 
817 
290 
6.30 
694 
of,  69<1 
243 
lOH 
612 
lifiS 
669 
6.37 
86 
210 


681 
899 
628 
158 
45 
1.18 
6131 
652, 
645 
658! 
6.34, 
680 1 
5941 
594 1 
682 


Balm, 

"      ofGilcad, 
nalmony, 
Balsam  Copaiva, 

"        Toln, 
Baisamodcntlron  Myrrha, 
Bandagis.  Wet. 
Baptisia  TinctorlB, 
Barberry. 
Barbers'  Itch, 
Barley, 

"        Coffee, 
Barosma  Crenata, 
Barrenness, 
Basilicon  Ointment, 
Bath,  Catiiract, 

"      Cold  Foot, 

"      Donctie. 

»     Kve  and  Ear, 

>•      Half. 

"      Head, 

"      Hose, 

"     Mouth  or  Oral, 
"      Nose, 
"      Plunge, 
"      Shower, 
»     Sitz. 

'•     Towel  and  Sponge, 
"      'Vading  Foot, 
"      Warm  Foot, 
"      y.'ash-Tub, 
"     Wave  or  Sluice, 
"     Cold. 

>'       "      Effects  of, 
"      Hot, 

"        "     Effects  of, 
"     Tepid, 

"       '•        Effects  of, 
"     Vnpor, 
"     Warm, 
<<        ••         Effects  of. 
Baths  of  the  Ancients, 
"      Cold, 

Division  Of, 

Names  of. 

Neglect  of, 


694 
695 
695 
696 
695 
P34 
649 
662 
695 
149 
77 
679 
001 
871 
667 
634 
689 
f38 
640 
686 
636 
6.34 
686 
641 
540 
686 
684 
587 
688 
540 
540 
637 
635 
54:^ 
543 
542 
544 
542 
548 
642 
642 
544 
103 
105 
641 
104 
104 


/! 


p>" 


892                                                       INDEX. 

rinii 

MOI 

P4ni 

BbIIh,  Tlffictlon  iOer,               107  Drain,  AbrcrM  of, 

166 

Cannn  CarnI, 

eot 

MiDwur,                             10« 

•'      Dropsy  of, 

168 

Cartilage.  Ar\li'nold, 

41 

.sjioiitfc,                             1()6 
"       Vhim.i,                               1(16 

'*      Knlarguinent  of, 

166 

"           Crycoid, 

41 

"       Kxeicise  of, 

68 

"           Thyroid, 

41 

"       Winm,                               100 

"      Fever. 
"      lleallli  of. 

168 

Caryophillus  Aromatlcui, 

007 

DaililiiK  una  (.ieHiiliiiem,          101 

67 

CaiOHrilla, 

604 

«i'«,                              614 

"      Induration  of. 

165 

(.'aseiiie. 

IH 

llu^l«!rr),                                   61X) 

"      Inttatnmation  of. 

168 

Cases  Trenlod, 

2U3 

fHiitmont,                  B78 

"      anil  Nerves,  disease*  of,  162 

CaMla  Acutifolla, 

mt 

iK-iiii.  8t  IgimtiUH'h,                   UM 

"      Old  I'eople'i, 

69 

"      Buds, 

007 

It.iiii-,                                    70-78 

"      Overworking, 

69 

Castor. 

604 

HcailMTrv,                                    5'5 

•>      Hhrinking  ol. 

187 

"      Oil, 

604 

lIcMlxuii.rUeildlug,             W-Mi 

"       .Solteiiiiig  of, 

154 

<'astoreum, 

604 

llwtTru,                                      Btfi 

"      Tumors  of. 

166 

Catalepsy, 

1*18 

'■    Kwt'iioe  of,                         6M2  Bran,  di-coctloii  of, 

678 

Cataphisnis, 

680 

licctii,                                           71)  UrRiidy  Mixture, 

H74 

Catamct  Bath, 

684 

Kfi-tvH'  (iaIlH,                            6U*l|  Itruuil  aiitl  Watvr  I'oiilllcc, 

0811 

Cutarrli, 

189 

Uulluduuuii  Atropn,                   612  Ureaet  llonu,  Kructurv  ut, 

4f)2 

Catarrhal  Opihalmla, 

484 

"           Ointment,                flil        •'       Uruki'ii, 

88h 

Catecliu, 

604 

"           I'lamt-r,                   079       "      liiflainmntlon  of, 
"           rolsonhiK  by,        4l'«  BrenfliliiK.  Objects  of. 

8S8 

"        Tinct.  of, 

(»9 

11)8 

"         Comp.  Tinct.  of. 

690 

BiMizolc  Add,                            «»■  ,        "           I'liiloKoidiy  of, 

108 

"         Comp.  I'owder  of. 

682 

IK'iizulii,                                     600 !  Bright'*  Dlw-aneol  KIdneyi, 
Cotnp.  Tluct.  of,          0»()i  Broken  Bone*. 

290 

Catnip, 

004 

440 

Caulophylluni  Thallctroides, 

699 

Met  livrli  Vulgaria,                     605  Bronchiul  Tube*, 

m 

Caulophyllin, 

«()0 

llvlhruot,                                    6U7           ••         Conmimptlon, 

21. 

Cayenne  Pepper, 

«06 

Bile  in  .Stomach,                          Ot|  Broncliltis,  Acute, 

281 

'Tinct.  of,. 

689 

Biiiarv  Culvull,                          2081         "           C'hrouio, 

23;) 

Ceanothus  Americauus, 

647 

Bi!ii)UH  Colic,                             284 !  Bronchocele, 

4.8 

Celaiidyne, 

00.1 

Keinittcnt  Fever,          4111  Brulitex, 

404 

Cerates, 

6tj« 

Bimnutli,                                    6U7  Bubo,                                 821- 

-329 

Cerebellum, 

44 

Nltrateof.                    697|Bucliu, 

601 

Cerebrum. 

44 

"        Kubnitratoof,             £97j      "      TInct.  of, 

089 

Cerevisia;  Fcrmentum, 

mi 

I'rinnltrate  ot,             697  Buckhorn  Brake, 

601 

Cessation  ofMeuses, 

3112 

"        White  Oxide  of,         697  Buckthorn, 

601 

Cetaceiim, 

054 

Bitter  Hoot,                                 697  Bi.ckwhuat, 

79 

Cetrariu  Islandica, 

021 

llilti'i'Kweut,                                  697 1  Bugleweed, 

602 

Chaling, 

492 

Black  Alder.                                698  Bunions, 
■•      Cohosh,                              598' Burdock, 

467 

Chalk, 

606 

602 

"      Mixture 

«74 

•'           '•      Comp.  TJnCt.  of,  891   Burgundy  Pitch, 

602 

"     Comp.  Powder  of^ 

(591 

"      Root,                                  609  Burns, 

486 

"      Comp.  Powder  of,  with          II 

"      Willow,                           6911  Butternut, 

602 

Opium, 

082 

BliickhcTry,                                  6l»8 

Chamomile, 

G(W 

BliiilUer,                                         34  Cabbage, 

79 

Charcoal, 

006 

"     Acute  Inflammation  of,  297  i       "        Skunk, 

661 

Cheliiionium  Majiu, 

005 

"     Chronic        ••             "    298,  Calamine  Cerate, 

6«ti 

Chelone  dlabra. 

693 

Bleeding  from  Kidneys,           802i       "          Prepared, 

660 

Chemical  Food, 

68H 

"           '■     None,                  491 1  Calamine  I'ra'parata, 
"           ■'      Wounds,    878,  49.3  Calcined  Deer's  Horn, 

666 

"         Injuries, 

436 

602 

Chenopodium  Antbelmlntl- 

Bicnorrhagla.                              .S.'!l   Calculus, 

815 

cuni. 

664 

Bli^lel  iiiK  I'lHKter,                     fti7  Calf  s  Feet  Jelly, 

.688 

Cherry,  Wild, 

661 

Blood  ill  .Scrotum,                     474,  Calico  Bush, 

683 

Chest,  Aflections  of, 

674 

Blomlniot,                                    599  Calomel, 

602 

"       Air  in, 

236 

Bloody  Flux,                               202  Calx, 

628 

"      Dii^eai-es  of, 

209 

Blue  Cohosh,                             699;     "     Chlorlnatt, 

628 

"      Water  in. 

237 

"        "       Comp.Tluot.  of,  691  Camphor, 

"    Disease,                             408         '^        Liniment, 

608 

Chicken  Water, 
Chick  weed,  Kcd. 

683 

671 

647 

"     Flag,                                    000          "          Water, 

6T8:ChilbluinH, 

468 

"    I'ill,                                 flOO' Camphorated  .Soap  Liniment 
Body,  .structure  of  the,              14 '  Canabis  Indica  Tinct.  of, 

,  672  Child-Bed  Fever, 

387 

6891  Children,  (a  le  and  Diseases  of,  891    1 1 

"     Cliomical  t'ropertlesof,    14;  Canada  Biilsum, 

Oftj 

"        Cursing  Sick, 

394 

'•      riivsical         •'          "      101       "       Fleabane, 

608 

"        Weaning  of. 

392 

"      \iial               "          "      181       "       Snake  Boot, 

6K2 

ChlmBphilu  Umbellata, 

641 

Boiled  Flour,                           582  Cancer, 

469 

Chloroloim. 

606 

Bolls.                                          43.3        "        ofMouth, 

400 

Chlorolornium. 

606 

Bones,  Anatomy  of,                    18,  Canorum  Oris, 

400 

Chlorosis, 

860 

"      Diseoscs  of,                    4  i5  Canella, 

608  Choice  of  Mick-Koom, 

651 

"      Death  of,                          4«iu^       "        Alba, 

603  Choleia,  Asiatic, 

!i90 

"      ofliead,                            20  Canker  Lettuce, 

648        ■'         Intiiiitum, 

404 

"      "Trunk,                          21' Cantharis  Versicatorla, 

654'       "         Morbus, 

290 

"       "  U|iper  Extremities,     2i  Cant iiarides,  Tinct.  of, 

689  Chorea, 

169 

'•       "  Lower        '•                  24  Capillaries, 

37  j       ••        Chronic, 

17U 

"      Time  required  for  unit-         Capsicum  Aniiuum, 

605  Choroid  Coat, 

49 

ing,                                447          "          I'liister,  Comp., 

679  Chyle, 

64 

"      Unnuturnl  Growth  of,    4<i6  Caput  Obstipam, 

480  Ciiyme, 

64 

'•      Ulceration  of,                  46o|CaraW8v, 

603  Ciliarv  Processes, 

49 

"      Uses  of,                            iOJCarbo  ^'.ignl, 

6'I0  Cinilciliigu  Kucumosa, 

f.ys 

Boneset,                                     600  i  Carbuncle, 

484  Cimicif'ugin. 

699 

BiiiHx,                                        U52,CardiBlKia, 

276  Cinjiiona, 

tsw 

Bowel,  Falling  of,                     406 i Cardamom, 

604  Cinch      ' 

ti3:i 

Bowels,  Alfections  of,               677 1          "         Comp. Tinct.  of, 

690  Ciuba^.  jU, 

fiiT 

'■      Acute  Inflammation  of,  281  Carditis, 

265          '•         Tinct  of, 

689 

"      Chronic      ••               "    2S2  Care  of  Children, 

891           '•         Comp.  1  met  of. 

6ao 

"      Looseness  of,           289-403      "     "  Teeth, 

401  Circulation,  Orirans  of. 

3« 

Brachial  I'lexus,                          47  Caries,                                466—491  Cirsocele, 

4TH 

Brain,                                             44  Carrots, 

70  Citric  Acid.  Syrup  tf, 

684 

^'mwium^ 


1 


•ml.         ,.  8* 

,  Ar\li"nold,  ♦] 

(.'ryuold,  41 

TliyroUl,  *! 

lllui  Arunialloui,  uiii 

''  11 

rullfoll*,  w; 

.U-,  «) 

)ll,  6" 

Halh,  » 

ul  Optlmlmla,  *J 

w 

'Tliict.  of.  ,  « 

(•omp.  Tinct.of,  6! 

Conip.  I'owder  of,      6 

lyllum  riisllctroldes,    6 

iiylli".  " 

fl'epiier,  ^ 

'■         Tinct.of,.  « 

liiiH  AmericauuH,  ( 

iutn, 

iim, 

iiu  Fcrmentum,  \ 

on  ofilfiuM, 

im,  ' 

ia  Itilandioi, 

K. 

Mixture. 

C'omp.  Powder  or 

Clomp,  rowder  of,  with 

Dpwm, 
imile, 

DUl, 

loniuiD  Majus, 
riu  (ilubru, 
ical  Food, 

Injuries, 
ipodium  Autbelminti- 

y,  Wild, 
,  AflvctionB  of, 
Air  ill, 

UisCBI-CS  of, 

VValer  in, 
;eii  Water, 
;weed,  Ued, 
laiiiH, 

l-hed  Fever,  -„; 

run.Cnie  and  DiiseMes  of,  ^1 


082 
WW 
UII6 
01  >6 
5a5 
08« 
435 


burning  8lck, 

Weaning  of. 
inpliilH  Uinbellata, 
roloi  m. 
rolurnium, 

VDSil', 

cc  of  Sick-Room, 
eiB,  Afiutic, 

Intiintum, 

Morbus, 

■ea, 

rbronic, 
roid  (.'oat, 
le, 
me, 

iry  Processes, 
icitiigu  Itttcemosa, 
icifiigiii. 
:lHiiia, 
cli      ■ 

Tlnot  of, 
'•         (Jomp.  finct.  of, 
julatlon.  Organs  of, 

ric  Acid.  Syrup  cf, 


3U4 


INDEX. 


893 


Cltrua  Limonnm,  (B7 

Clap,  881 

ClianlnK  tlie  TMth,  R03 

Clennliness,  100, 6M 

t'li'avern,  807 

(^lerxymen's  8ora  Throat,  101 

Cllinnta,                              '  71 

Clot  lies  Catohlug  Flr«,  496 

Clothiug,  96 

"       Color  of,  100 

"       Cotton,  99 

•<       Hair  a%  99 

'•       Linen,  UH 

-        Poroui,  100 

••       8ill(,  99 

"       Tight,  110,  111 

"       Woolten,  99 

Clover,  Red,  647 

Cloves,  607 

Cloviis,  146 

Clysters,  671 

Coceus  ('RCtl,  607 

CocciiUis  i'almatuB,  '308 

Cochineal,  607 

Cochlearia  Armoraola,  620 

Cod  Liver  Oil,  607 

CoiTee,  84 

"      Barley,  679 

"       Crust,  679 

"      Milk,  686 

Colchicum  Autiimnale,  632 

"         Conip.  Tinot.  of,  601 

Cold,  EITects  of,  486 

"     Foot  Uatb,  689 

Colds,  206 

Colio,  406 

■'      Bilious,  884 

"     Painter's,  286 

»     Wind,  282 

Colica  Piotouum,      '  286 

Colitis,  292 

Colocynth,  608 

Coloiflon,  008 

Colombo,  COS 

Colon,  82 

Coltsloot,  608 

Colt's  Foot,  662 

Comfrey,  608 

"        Comp.  WIneof,  678 

Common  8ilk  Weed,  609 

Ooniplonla  Aspleulfolla,  667 

Comp.  Fractures,  446—465 

"      lulusion  of  Catechu,  670 

"           "         "  tientlan,  670 

"  "  "  Ueranlum,  870 

'•          "          "  Parsley,  670 

"           "          "  Senna,  670 

Comp.  Infusion  of  Trailing        i 

Arbutus,  671 

Compresses,  649 

Con  lections,  668 

Aromatio,  668 

"       of  Catechu,  Comp  ,  668 

of  Senna,  668 

Conpestlve  Fever,  412 

Cuiiium  Maculatum.  641 

Poisoning  by,  499 

Conserves,  668 

Count  ipation,  286 

Cuuetitutlon,  120 

"           Idiosyncrasy  of,  121 

roiistitullonal  DlOereuces,  217 

Consumption,  209 

"       A  General  Disease,  220 

"        Bronchial,  217 

"        Causes  of,        216-218 

"        Tubercular,  212 

Contused  Wni.nds,  +41 

I'ontusions,  464 

Convolvulus  Scammonla,  660 

Cookery  for  Sick  Room,  578 

Copinlera  t^fflcinalis,  595 

Copi)er,  609 

"       Siibacetate  of,  609 

"        Sulphate  of,  609 

Corallorhiza  Odontorhiza,  610 


MO  a 

Com,  Indian,  76 

Cornea,  48 

"       IntUmmation  of,  4M 

Corneltii,  486 

Corns,  146 

Cornu  Cervtnn  Ustum,  003 

Cornus  Florida,  613 

"      Servloea,  667 

Corroaive  Sublimate,  609 
"              "    Poisoning  by,  4U7 

Corydalis  Formosa,  660 

Costiveness,  286 

Cotton,  610 

Cou|i  do  Sollel,  163 

Cow  Pox,  18H 

Coxalgla,  406 

Cramp  Bark,  fdO 

Cram|<s,  171 

Cranexbill,  610 

Cranial  Nerret,  45 

Crawley,  610 

Cream  of  Tartar,  043 

Creosote,  Oil 

"       Ointment,  676 

Creosotum,  Oil 

Crooua  Satlvls,  (M8 

Croton,  F'uterla,  0(4 

"       Oil,  Oil] 

••        "    Liniment,  073 

"       Tiglium,  Oil 

Croup,  401 

Crow  Com,  055 

Crural  Phlebitis,  887 

Crust  Coffee,  679 

Crusted  Tetter,  142 

Cubebe,  Oil 
Cubebs,                               •       611 

Cucumber,  Wild,  662 

Cucunil«  Colocynthii^  608 

Culver's  Root,  611 

Cupri  Subaoetas,  609 

Cupri  Sulphas,  609 

Cuprum,  609 

Cyanosis,  408 

Cypripedin,  686 
Cyprlpcdium  Pubesoens,  626,  6(i5 
Cystine  Deposits  in  Urine,       314 

Cystlrrhosa,  29H 

Cystitis,  297 


Dislocations  of  IIlp  Joint, 
"  "   Knee  Pan  or 

Patella, 
"  "   Knee.lolnt, 

"  "   Lower  .law, 

"  "   Shoulder 

.Inliil, 
■   Wrist, 


fAOl 

4<>1 
4i.'J 

4i'a 

45H 

4.'!> 
4611 
1H2 
1»<1 
fHH 
612 
41)9 
6C7 


Dancing, 

Dandelion, 

Datura  Stramonium, 

Deadly  Nightshade, 

Deafness, 

Death  of  Bones, 

I)ecoction  of  Bran, 

Decoctions, 

DetbrmlUes  of  Spine, 

Debsler's  Cerate, 

Delivery, 

Delirium  Tremens^ 

Dementia, 

Dens  I^onis, 

Derbyshire  Meek, 

Diabetes, 

Diarrhoea, 

"         Chronie, 

Dictionary, 

Diet, 

"    in  Disease  and  Convales- 
cence, 

Difficult  Teetb  Cutting, 

Digestion, 

Table, 

Digestive  Organs, 

Digitalis  Purpurea, 

Dioscorea  Vlllosa, 

Diofpyros  Virginiana, 

Diseases,  General, 
"        of  Children, 

Dislocations, 

"  of  Ankle  .Tolnt, 

"  "  Bones  of  Head, 

"  "  Collar  Bone, 

"  "Elbow  Joint, 


92 
612 
656 
612 

490 
466 
678 
668 
478 
607 
881 
165 
176 
612 
473 
301 

289-403 
289 
717 

228,501 


Disturbed  Sleep 
Diniiiiess, 
Dock,  Vellow, 
Dogwood, 

"  PoiHonlng  by, 

"  Swamp, 

Domestic  Management  of  the 

Sick- Room,  661 

Doses,  688 

Douche  Bath,  633 

"       Pail,  684 

Dover's  Powder,  683 

Dragon  Rout,  621 

Drens,  Wet,  680 

Drink,  Pleasant,  679 

Drniwy  of  Belly,  817 

"       "  Cells,  818 

"      General,  318 

Dry  Pimples.  144 

Drunkiii'U's  Delirium,  166 

Dura  Mater,  46 

"        "     Inflammation  of,    152 

Dwarf  Eiden,  613 

Dysentery,  292 

"         Chronic,  293 

Dysmenorrhoea,  857 

Dys|icp«la,  271 

"       Causes  of,  272 

"       Treatment  of,  274 

"        Urinary  Der>oslt8  In,  2T2 

Dyspeptics,  81 

Ear,  Ai!);ctionRof,  488 

"    Drum  olj  51 

"    External,  51 

"    Foreign  Substances  in,     492 

"     Wixin,  490 

Earache,  490 

l->;lectics,  7 

Ecstasy,  167 

Ecthyma,  143 

F^izema,  189 

Eflervepclng  Draught,  644 

Egyptian  Ophthalmia,  483 

Elbow,  Fractures  of,  450 

'■      Joint,  Dislocation  of,  460 

Elder,  613 

"       Dwarf,  613 

Elecampane,  613 

Electro  Magnetism,  613 

Electuaries,  608 

Electuary,  Lenitive,  668 

Elixir  Salutis,  693 

"       Vitriol,  689 

Elm,  Slippery,  652 

Emphysema,  2.34 

Encephalitis,  ]5.'l 

Eiicephaloid  Tumor,  4T0 

Encysted,           "  471 

i  Knd'ocardills,  255 

I  Enlarged  Veins,  476 

I  Enonvmus  Atropurpureus,       Otil 

I  Enteritis,  2K1 

Eneuresis,  305 

Kptgiea  Itepens,  658 

Epiglottis,  41 

"         T<i/lammation  of,     207 

Epilepsy,  167 

Epllentip.  Fits,  1'37 

Eplstaxis,  491 

Ergot.  655 

Erigeron  Canadense,  605) 

Eruptions,  Scaly,  143 

Erysipelas,  130 

Erythema,  138 

Erythtmatio  Stomatitis,  898 

EfSi-nces,  669 

Essence  ofBeef,  (82 


1 

,.:  -i' 

:       1 

894 


Ropatorin,  601 

Euiialorlum  Perfoltatnm,         euo 

"  rurpureun^  046 

K^iphnrhln  lii<><UU],  6B8 

Kupurpurln,  6M 

KiinlBclilan  Tutw,  61 

Kxoorlatluii,  403 

£xerci*e,  88 

•'    Aotirr  and  raulra,  8^08 

"     Kxaeimlve,  8U 

"    Indoor,  B3 

"    MentuI  Coaporatlon  In,  94 

"    Outdoor,  (»-2a9 

"    I'Iniuurable,  8»-94 

"    UeKiilar,  89 

••    for  HtudentK,  00 

•'    When  to  take,  8t>-96 

•     for  Young  Women, 

BxhalaiiUi, 

KxoMloalii, 

l!j(tr«cta, 

"         Fluid, 
ExtrnoU  of  Uliubarb  and  Po- 

taiwa, 
EyebrowD, 

Eyclaidies,  Disorder  of, 
Eyelid*, 

"       Inflammalion  of, 
Eye,  Coat"  oC, 
«    and  Ear  Hath, 
"    Foreign  Uodies  In, 
•'    Gllbe  of, 
"    Uuraom  of, 


INDEX. 


rioa 

Flaxseed,  814 

KIlM,  Hnanlah,  6M 

Flour,  fiolled,  682 

Fluid  Aliment*,  668 

"      Extraota,  WW 

"      Nutritive,  6H6 

Fluor  Albui,  868,  8»0 

Folded  Wet  Sheet,  681 

FolMolca,  40 

Follicular  InflammaUon  of 

Mouth,  899 

Komenlations, 
Food, 

"    Albuminous, 

'    AmoQiit  of, 

"    Animal  and  Vegetable, 

"     Articlea  of, 

"    Acotlzed  and  Non-aao 
tiled, 

"    Choice  of, 

"    Cost  of. 

"    DlKeKtlbllity  of, 

"    F'atty, 

*•    neat-generating^ 

"    Kature  and  Ueatlnatton 
of, 

"    Nutritive. 

•'    in  Old  Age, 

"    Organic, 

"    8tarcli  and  8ugora», 

"    Tables  of  Value  of. 

In  Youlli  uiid  tianhood. 


Fa'^^  i^anctl  Ignatll, 
Fainting, 
F'alling  of  nowel, 
"        "  Womb, 
"      over  of  Womb, 
FalM!  Grape, 

"      Joints, 

■'      Measles, 

•■      Saraaparllla, 

"      Unicom, 
Fat, 

Fafty  Tumor, 
Favus, 

Fel  Bovinnm, 
Felon, 

Female  Diseases, 
Feri>, 
Fer'i  Ammonio  CItru, 

"     CItras, 

x      lodidum, 

"     Oxldinn  Hydratnm, 

"  "        Nigrum, 

••      Phosphas, 

"     et  Putal<l'a^  Tartras, 

"      Protoxidum, 

"      Pulvis, 

••      et  (juina^CitnUt 

"      .Subcarbonas, 

"      Sulphas, 

'      Syrupus  lodidi, 

"     Tinctura  Cblorldl, 
Ferruni, 
Ferunculns, 
Fever, 

■'     and  Ague, 

"      Bilious  Remittent, 

"     Congestive, 

"      Intermittent, 

•'      Lung. 


91 

40 
466 
669 
609 

674 

60 
483 

CO 
481 

48 
640 
480 

48 

40  Foot  Itath.  Toltl 

'    "        "      Warm. 
666       "     Fractures  ot, 
181   Fore  Arm.  Fractures  of, 
405  Foreign  Kodies  in  Eye, 
8<S8  Fowler's  Solution. 
888  Foxglove. 
608  Fraoture*. 
447! 


669 
61 
74 
80 
81 
78 

67 
70 
74 
68 
76 

oe 

66 

68 
78 
66 
76 
76 
78 
^39 
MO 
4.1i> 
450 


tAmt 

6iUI 
ftM 
400 
f)70 

■11)0 

ni6 
m\ 

015 
610 
617 
616 
601 

616 

40 

60 

48 

81 

81 

48 

068 

S38 

7M 

403 

016 

628 

47t 

eie 

616 
Comp.  Powder  af,  683 


Uelaemlnin, 

(ielBPinliJum  Sempenrirens, 

Genglvitis. 

(ieneral  DlseaB*'^, 

Dyaleiu,  DWaiea  at. 
Gentian. 

"        (^onip.  TInot.  of, 
Gcnilana  l.utra. 
Geranium  Maculalum, 
(iill-over-tlie-gruuud| 
Ginger. 

"        Wild. 

"       Hyrupo^ 
Ginseng. 
Glauda. 

■•       Lachrymal, 

"       Oil. 

"        Parotid. 

"        .Submaxillanr, 

"        Sweat, 
Glauber's  Salta. 
Gleet, 
(ilorsary, 
(iiottis,  Spasm  oC 
(ilycerin. 

Gljcerrhiza  Glabra, 
Goitre, 
Gold, 
Golden  Seal, 


6IS 
10 
471 
161 
606 
467 
889 
657 

6:8 

623 
628 
623 
623 
623 
624 
625 
624 
tS4 

623  Freezing  Mixtures 

624  French  Decimal  Weights, 
626        "        Hilk  Porridge, 

625  Froet  Bite, 

626  Frostwecd 


TInct.  of, 
"         "       "      Wiueof. 
Golden  Tincture, 
(ioiiorrhcea, 
Goesypium  Hcrbaccum, 
Gout. 
4801  Griinuiatlun, 
C68l  Grass.  Htar. 
614;  Grovel' 

Roof, 
Uric  Auld. 
455  Gr«'en  iSlcknecs, 
447i  GrItnthV  Myrrh  MIxKil^ 
462  Ground  Ivy, 

I       "        KIceMilk, 
Grubs  or  Worms. 
Gruel.  Arrow  Root, 
"      Rice, 

"      Water, 
Guaiac,  Ammonlattd  Tinet 

of, 
Guaincum. 
466|  Gullet.  Forelf^n  Rodtes  In, 
448  Gum  Arabic. 
4611     "    Hemlock, 
•'  Slioulder  Blade,  449      •'    Sweet, 
**  Skull,  447  Gums,  Inflnmmation  of, 

"  Thigh  Bone,         452  Gunshot  Wounds. 
"  Upper  Arm  Bone.449  Gymnastics, 
"  Wrist,  451 ! 

606  Ilcmastasis, 

689  llicnmtocele. 

682  Ilo-matoxylon    Campecbla* 

488 1     num, 

614  Hiematuria, 


1178,877-442 
...  ,  Compound,  455 

188  I        "         of  Bones  of  Foot, 
66?  I        '•  "      "      "  Nose, 

"  Breast  Bone, 
"  Collar  Bone  or 

Clavicle, 
"  Elbow 
*•  Fore  Arm, 
"  Uaud  and  Fln< 

gers. 
"  Haunch  Bonea 

or  I'i'lvis, 
**  Knee  Pan, 

"  i^ir> 

'*  Ix)wer  Jaw) 
Ribs 


448 
460 
460 

461 

462 
464 


691 
678 
601 
881 
»iIO 
417 
442 
665 
806 
646 
808 
866 
674 
017 
683 
148 
681 
680 
681 
680 

691 
617 
498 
617 
617 
66S 
400 
442 

ei 

617 
474 


eZi  Fumigation  of  infected  plaoes   604  Hair.  Dixordera  ol^ 


433  Fungus  Uematoides, 

4091         "  ' 

413  I  Galbanum  Plaster,  Comp., 

411  'Galium  Aparine, 

412, Gall  Bladder, 

418      "    Stouee,         ' 

240  Galls. 

Pernicious  Intennlttent,412 ;    '>     Comp,  Ointment  of. 

Refreshing  Drinks  in,      679|Gamboge. 


"     Typhoid, 

"  ^         Lung, 

Feverfbw, 
Fibrlne, 
Fiawort, 
Fining  Teeth, 
Fingers,  Fractures  of, 
Fire,  Clothes  Catehinc 
Fits, 
riag,  Sweet, 


410  I  Gangrene  of  Uoutli, 
243  Gariret, 

613  GarHc, 

16 1      "     8ymp  ofi 

614  Gastrlo  Fever  of  Infancy 
603       >'      Juice, 

461  Gastritis, 

496  (iaxtrodvma, 

406  GaHltheriaProonmbena, 

668  Gebtin*. 


803 

160 

470 'Hair  Cup  Moss,     '  618 

Hill <  Bath.  686 

679  Hanimainelis  VIrglnlCB,  668 

607  Hand.  Dislocation  of  Bones 

88                of.  461 

S68       »     Fractures  oA  461 

616  Hardback,  618 

676  Hardlear(ioldenRod,  618 

615  Haunch  Bonea,  I'raotures  of.  463 

400' Hazel,  Witch,  668 

643  Headaches,  188 

615  Head.  Aflbctlons  of.  674 

6S4      ■'      Bath,  M6 

406i     "      Water  In.  16T 

63  Bearing,  Organs  of,  61 

269  L'eart,  8S 

277       "      Diseases  246 

668       »      Altered  Sonnds  of,  248 

U'      "     Anenrismal  Tnniora  of.  86S 


im  SeroperTlreni, 

^■Iciii.  I)lM.ikMin{| 

onip.  Tlnot.  of, 

I.iitcn. 

I  Maculktum, 

tlic-gruuud| 

rtld. 
lyrup  o^ 

^•chrymtl, 

'nrolld, 
iubmnxlllary, 

■  Salta, 


)p«>m  of.  <oa 

I'iza  GUbi*,  «J8 

47* 
Old 

3e»I,  8'8 

"  Comp.  Powder  of,  0H2 
.»  '•  TInct.  of.  891 
•I       ••      WlneoV.     678 

rinctuiD.  gl 

urn  kerbaceum,  ^10 

ill 

Mon,  ♦« 

lt«r.  S5S 

806 

Root.  SJ2 

Uric  Aold.  »M 

ilcknecs,  o™ 

H  Myrrh  MIxhin,  6T4 

i  Ivy.  "J 

Rice  Milk,  >     Bffl 

)r  Worma.  Jw 

Arrow  Koot,  WJ 

Klce,  ^ 

SaKO,  Ml 

Water,  M" 
,  AminonlaUdTlnct. 

691 

ForelRn  Bodies  in,       49J 

.rnblo.  ^li 

cmlock,  oil 

WPtt  ^^ 

Inllnmmatlon  of,  *2! 

ot  Wouud*.  **! 

utlcs,  >* 


Btaais, 
tocele. 
toxylon 


Campecbia* 


80a 
ISO 
618 
686 


turia, 

Dliiorden  ol^ 
'an  Mom, 

iHtll. 

nanielisVlrglnloa, 
.  Dislocation  of  Bone* 

of.  *<'^ 

Fractures  ot,  *61 

Hack  " 

leaf  (J  olden  Kod,  6J8 

cb  Bone*,  rraoture*  of,  45ii 

,  Witch,  6fi^ 

aches,  JS? 

.  Affections  of.  f** 

¥.^,t.  fiMD 

Water  in.     ^  igT 

tog,  Organs  ol,  Bl 

'Dlieares  "JJ 

Altered  Sonnde  of,        ^ 
Anenrismal  Tnniors  ot.  SB 


INDEX. 


895 


Heart,  AtrophT  of, 

"      Homip.ia('aHlla«)ln,26.1 

"      DilaUtlon  of  Venlriole*  Ityniiop, 

of,  Vfi  lIvwiDpuaOfnclnalil, 

••      IMaplseem^nl*  of,  %ll  llyotcrla, 

•>       RnUnrMmtiiitrif  VantrU        >  lIvMnrloa. 

ale*  of,  Mfl 

■      Fatty  I)«Kenaratlonsor,2(i2  lee  I'lant, 

«'      Hypertrophy  and  011a-_  Iceland  Mom, 


rAOBj  Pioil  rims 

2M  Uyi)Opho«pblte*,Coinp.  Syrup         Iron,  Tartrate  of,  ar.d  Potaim*,  rt2t 
—"      or,  <W4      "    Tincture  of  Muriata  of,     '  ' 

«il      ■•    Vahrlunate  of, 
<B1  Uehuria  Itenill*, 


tatlon  of, 
**      Impulse  of, 
"       iniliinitlon  of, 
"      IntlBinmution  of, 
"      Inflammation  of  Lin- 
ing of, 
"      Neurnlgia  of, 
"      l'ercii«i<ion  of, 
"      I'olvpui"  of, 
«      Shrinking  of, 
"       Hollenintf  of, 
»      8iinn(U  of, 
"      Valve*  of, 
Heartbnrn, 

Ueart-ca*e,  Acute  Inflamma- 
tion of, 
"  Chronio  Inflamma 

ttoii  of, 
"  Water  In, 

Hedeoma  PulegiiMlen, 
Ilelianthcmum  Canadeose. 
livlianthuM  Annuu*, 
Hellebore,  White, 
Ueloulai, 

"        DIoloa, 
Hcmicrenia, 
lli'iniphlt'gla, 
Itemluok,  Comp.  TinCt.  of, 

"         Gum, 
Hemorrhoid*. 
Henbane, 
Hcpar, 

l|p|>atica  Amerieanm, 
Hernia, 
Heriiefl, 
Hiccough, 
High  Cranberry, 


2fi1   lohthyooolla, 
247  Ictorim, 
afi2   Idiocy, 
2Aft  Ignntia  Amara, 
llmm, 

2(10  InciMd  Wound*, 
luouhua, 


248 
201 
263 
363 
247 


Indian  Com, 
"      Hemp, 


Tlnot  of. 


8iH 
864 

631 
631 

638 
2H7 
176 
666 

83 
143 
48H 
183 

78 
621 
080 


Turnip, 
2M  Indlgeatlon, 
270  IniliKO,  Wild, 

Infltncy  of  Helng. 
268  Inraut»,^(Jii«trla  Fever  of, 


lalnglaiw, 

"       Jellv. 
Itch, 
"    Itarber*', 
"    Jaokion'i, 
Itohlug, 

"       of  Fxternal  Tart*, 
Ivy,  American, 

"    l>lg, 

"    Ground, 

"    I'oiaoning  by, 

,Tack«on'*  Itoh, 
Jalap, 

"      Comp  Powder  of, 
ilamrHtown  Weed, 


Comp.Tlnct.of,69l  Intermittent  Fever, 

400  Intestines, 

401  Introduction, 


Hip  Joint,  Dlxoase  of, 

•'       "      Dixlocnllon  of, 
nippurle  Acid  In  Urine, 
Homioopathv, 

Ilomcnopnthio  Remedies,  608 

llouping  Cough,  408 

Hoiw,  619 

Hordeolum,  481 

Horehouurt,  619 

"         Water,  6fi0 

Horsemint,  620 

Horiieradlsn,  620 

H<)«e  Hath,  684 

Hot  Drops,  682 

IlouselRek,  620 

Humid  Tetter,  189 

nnrauhm  Lunulas,  619 

Huxham"8  Tincture,  69J 

Hydatids  Uterine,  866 

Hydrangea,  620 

"           Aboresccns,  620 
HydrargyrI  Chloridum  Hite,   602 

"           Plllulie,  600 
Hydrastin,  Clomp.  Powder  of,  682 

Hvdrastis  CanaacnsIs,  616 

Hydriodate  Potassa,  622 

Hydrocele,  478 

Hvdropathv,  6 

Hydropathic  Treatment,  528 

Hydropericardium,  269 

Hydrophobia,  166 

Uyd-ooaphalus,  Acute,  157 

"               Chronic,  158 

Hjrdrothorax,  387 

Hygien?.  63 

Hyosoyamur  Niger,  618 

"  Poisoning  by,      499 

Hypertrop>iv  of  Lungs,  836 

Uypoohondris,  179 


271 
663 

ns 

406 
680 
Kummi>r  (Complaints  of,  404 
426 
138 
205 
r.79 

680,670 
221 
.  228 
227 
223 
682 

646,  871 
48-) 
487 
178 
177 
175 
2112 
282 
67 
413 
82 
6 
613 
623 
622 
622 
622 


621  Janlpha  Manihot, 


lirilk  to 
254 

259  Inflnmmaticm, 
6.38  Inflanimatory  Dlush, 
614  Influenza, 
667  Infusion  of  Halt, 
601  I.tfusions, 
618  Inhalant*, 
618         "         Objects  of, 
172  Inhalation,  Atmospheric, 
102  Inhaler,  Medicated  Vapor, 
691  Inhiiling  Powder, 

617  Injections, 
287         "  Chemical, 

618  "  Hechanloal, 
645  Insanity, 
628         "       Cause*  of, 
470         "       On  one  Subject, 
189  Instrument,  Tonsil, 
180  Interalgia, 

619  Intermarriages, 


Jaundice, 

Jaw,  Fractures  of  Lower, 

"    Dislocation  of   " 
■Tejunum. 
Jelly,  CalTs  Feet, 

■>     Irish  Moss, 

"      IsliiglaKs, 

"      I'apnwa, 
•Terusalem  Oak, 
ilessaminc,  Yellow, 
Joints, 

"      Diseases  of, 
"      False, 
luglnndln, 
.luglaim  Clnerja, 
.lunlper. 

Junli>erls  Communis, 
JuuljicruaHablna, 


313  Inula  Helenium, 
7  Iodide Totaaslum, 
Iodine, 
lodinum, 
Ipecacuanha, 


Comp.  Powder  o^  083 


Svrup  of. 
Wine  of, 
tpomcea  Jalapa, 
Irldin, 
Iris, 
"    Inflammation  of, 

Veraicola, 
Irish  Uoss,  Jelly  of. 
Iritis, 
Iron, 

'    A  mmonlo-Citrate  ot, 
Ulack  Oxide  of. 
Citrate  of, 

"       "  and  Qntnia, 


085 
673 
626 
600 
49 
485 
600 
581 
485 
e:i2 


iVM 
•M\ 
020 
590 
l.'Kt 
14» 
149 
140 
870 
603 
033 
617 
498 

149 
020 
683 
0,'iO 
fi.-,0 
207 
448 
458 

82 
688 
681 
581 
681 
604 
604 

25 
460 
447 
602 
602 
02ft 
626 
649 


Kalmla  Angustlfolla,  633 

"        Latlfolla,  683 

Kidneys,  34 
"        Acute  Inflammation 

of,  294 
"        Chronio    Inflamma- 
tion of,  290 
"        Bleeding  from,  302 
•'        Bright'*  Disease  of,  20'J 
KIng'fe  P.vIL,  419 
Kino,  626 
"     Comp.  Powder  of,  688 
Knee  Joint,  Dislocatian  of,  '>!'8 
"     Pan,          "              "  40. 
"        "        Fractures  of,  464 
KrameriaTriaudra,  647 


Labor,  381 

Labyrinth,  51 

Lacerated  Wounds,  441 

Lachrymal  Canals,  50 

<'           Glands.  58 
"          Sac,  Inflammation 

of,  482 

Laeteals,  32 

623lLaotuoaSativa,  627 

628  Ladles'  Slipper,  620,  005 


6231 
623 


Lappa  Minor, 

Laryngeal  Shower  Syringe, 


Comp.  Mixture  of,  674 

Hydrated  Oxide  of,  623 

Iodide  of.  623 

Lactate  of,  623 

Per  Salt  of,  624 

Phosphate  of,  624 

Powder  of,  624 

Pr«clpitated  Carbonate 

of,  624 

Protoxide  of;  824 

Solutions  of  Protoxide 

of,  824 

Sulphate  of,  628 

Syrup  of  Iodide  of,  636 

Syrup  of  Iodide  ot,  and 

Manganeae,  62S 


Strychnia,  028'  Larygismue  Stridulus, 


I  Laryngitis,  Follicular, 
Larynx, 

■'       Inflammation  of, 
Laudanum, 

"  Poisoning  by, 

Laurel,  Narrow  Leal^ 

"       Sheep, 
Laurus  Sassafras, 
Lavender,  Comp.  Tinct.  of, 
l«ad, 

"     Acetate  of, 

■'     Ointment,  Comp.| 

"  Palsy, 

"  Pipes. 

"  Plaster, 

«    "   Comp, 


602 
19,'i 
402 
192 
40 
192 
689 
499 
633 
633 
619 
692 
627 
827 
678 
164 
'87 
680 
678 


WPilTT'gW  ■■li'LWFH^  *irt  WiW  H'J.'JWtlM^wjiwv.-Trwr.'SP-ltT'.Mi.'gvtK.  -i^AiaeM 


^teiMi^dai 


szaaaiaaBaBa 


mtimiMiiiiM  I  m  iiiiiiriifr 


hape  of, 

'^olatile  Oil  of, 
irifera, 

Moiicliata. 

mm  TolalferuB, 

mp.  Tinct.  of, 


60li 
696 
C35 
695 
634 
692 


le.  681 

arrh,  1H9 

ct,  W 

3wer  Syringe,  J98 

4h5 
atari  a.  604 

rlechoma,  6ii 

294 

'ranial,  <5 

JisiiiseB  -)'  Brain  and,  152 
)|)tlo.  48 

■ain  In.  •• 

iifSltin,  DlGordereU,  14« 
l.ympliatio,  *• 

Disense,  ™ 

Svatem,  44-52 

"       Sympathetic,  60 
aBh,  131 

ia,  ii' 

of  Heart,  2»i 

Mixture,  6|i 

zing  Cordial,  68r 

Extract,  M 

Powder,  688 

146 
•seyTea,  647 

are,  Jg* 

of  Mercury  Ointment,  6i6 
ofPotasea,  635 

"     Foisoning  by,  49» 
of  Sliver,  634 

feet  Spirit  of,         635, 654 

Void,  Poisonina  by,  498 

:tlier,  Spirit  o^  654 

ath,  640 

leed'ing  from,  491 

Drcign  Substances  in,  492 

raotures  of,  447 
6t>/ 

Activity  of,  659 

Vge  of,  o»7 

<',ilucation  of;  o»9 

iBbitsof,  009 

ilcalth  of,  ooo 

itrcHKtli  of,  66i 

I'emper,  etc.,  of,  658 

g  Sore  Mouth,  ^ 

ion  Table,  .W 

Ive  Fluid,  686 

omioa,  688 

rhite,  «M 

inds,  Dlsonlered,  1*8 

Cajeput,  686 

Turpentine,  JSj 

ent8,  «<6 

;uropaE,  52 

('Bjuputl,  WB 

Morrbtue,  807 

Ollva,  M8 

Klcinl,  jM 

TerebintWwe,  68H 

TlgUi,  S'J 

Oil,  686 

turn,  « 

sm,  ■•; 

dea  Men,  ^ 

laltnia  Catorrhal,  i^ 

'  Egyptian,  «S 

X  Purulent,  4ts 


INDEX. 


897 


riOB 

483 
484 
481 


672 
499 
689 
672 
637 
689 
50 
833 
637 
687 
680 
601 
490 
490 
489 
860 
850 
498 
811 
676 

680 
628 
634 

285 

259 

162  j 

164 

163 

164 

680 

616 


Ophthalmia  of  Children, 
"  Scrofulous, 

"  Tarsi, 

Opium,  630 

"       Camphorated  Tinot.  of;  693 

"       Liniment, 

"       Poisoning  by, 

"       Tinct.  of. 
Opodeldoc, 
Orange  Peel, 

"         "    Tinct.  of, 
Orbits, 
Orchitis, 
Origanum, 

■'  Vulgare, 

OniuR  Europea, 
Osmuuda  Begalis,     , 
Otalgia,  .'     : 

Otitis, 
Otorrhcea, 

Ovaries,  Inflammation  of. 
Ovaritis, 
Oxalic  Acid,  Poisoning  by, 

"      Depojlts  ill  Urine, 
Oxide  of  Ziuo  Ointment, 

Pack,  Half, 

"      Wet  Sheet, 
Pail  Douche, 
Painter's  Colic, 
Palpitation, 
Palsy, 

"      Lead, 

"      Local, 

"      SIAking, 
Panada, 

Panax  Quinquefolium, 
Pancreas, 

Papaver  Somnlferum, 
Papulous  Kcall, 
Populus  Candicani, 
Paracentesic  Instrument, 
Paralysis, 
Par.iphlegia. 
Paregoric  Elixir, 
Parrllla,  Yellow, 
Paronychia, 
ParotUis, 
Pa>^ley, 
Parsnips, 
Partriage  Berry, 

"  "     Comp.  Symp 

of. 
Patches,  Colored, 
Patella,  Dislocation  of, 

"        Fracture  of, 
Patients,  How  to  Examine, 
Peach, 

Pear  Leaf  Wintergreen, 
Pearlash,  Purifle<r 
Peas, 

Pediluvium, 
Pelvis,  Fractures  of, 
Pemphigus. 
Pennyroval, 
Pepi)cr,  Water, 
I'epjjermint, 
Pericarditis, 

Peritoneum,  Acute  Inflamma- 
tion of, 
"  Chronic  Inflam- 

mation of, 
i.   .itonitis, 

PeriiioiouB  Intermittent   Fe- 
ver, 
Persimmon, 
Perspiration, 
Perspiratory  Tubea, 
Peruvian  Bark, 

"  "    Tinot.  of, 

Petrolium, 

Potroseliuum  Sativum, 
Pharmacy, 

Pharyngeal  Shower  Syringe, 
Pbaryngitii, 

*'  Follicular, 


Pharynx, 

"       Inflammation  of, 
Phlebitis, 

"       Chronic, 
Phlegmasia  Dolens, 
Phosphates,  Comp.  Syrup  of,    __, 
I'liosphatic  Deposits  in  Urine,  810 
VliOKpliorus,  224, 640 


rAot 
31 
191 
474 

475 
887 
686 


158 


142 
695 
606 
162 
163 
692 
666 
467 
207 
687 
79 
637 


146 
463 
464 
122 
688 
648 
643 
79 
640 
462 
141 
688 
661 
638 
263 

279 

28(1 

412 
689 
103 
102 
689 
692 
640 


636 
240 
242 
236 


196 
191 
191 


I'hrenitis, 

Phtliisis,  209 

Physical  Development,  91 

Physician,  True,  12 

Physiological  Laws,  62 

Physiologists,  8 

Phytolacca  Decandra,  642 

Phytolaccin,  642 

Pia  Mater,  46 
"       "    Inflammation  of,       163 

PicrEcna  Excelsa,  646 
Pigeon-berry,                     ,        642 

Pile  Ointment,  677 

Piles,  287 

Pills,  678 

Pimpinella  Anisum,  694 

Pimples,  Dry,  144 

'i       Mattery,  142 

"        Watery,  138 

Pink  Root,  640 

Pinna,  61 

Piper  Angustifolium,  682 

l'i|»iiH»ewa,  641 

Pistacia  Lentiscua,  631 

Pityriasis,  143 

Fix  Liquida,  668 

Plantago  Mi^or,  641 

Plantain,  641 

Plasters,  678 
Pleurisy,                              876-238 

"        Boot,  641 
Pleuritis, 
Plumbi  Acetai, 
Plumbum, 
Plunge  Bath, 
Pneumonia, 

Typhoid, 

Pneumothorax, 

I'odopbyllum  Pellatum, 

Poison  Oak,  642 

Hemlock,  640 

"        Ointment,     676 

Poisoned  Wounds,  442 

Poisoning  Accidents,  880-496 

Poisons,  Antidotes  of,  496 

"        Vegetable,  498 

Poke,  642 

"     Ointment,  676 

Polygala  Senegn,  660 

Polygonum  Punctatem,  661 

Polypus,  471 

"       of  Heart.  261 

"        of  Womb,  865 

Polytriohum  Junipenun,  618 

Pompholix,  141 

Poplar,  659 

Porridge,  Milk,  681 

"        French  Milk,  682 

Porrigo,  160 

Fotassa,  642 

"       Acetate  of,  6(8 

■■       Bicarbonate  of;  643 

"        Bitartrate  of,  643 

"       Carbonate  of,  643 

"        Chlorate  of,  643 

"       Citrate  of,  644 

"  "        "  Solution  of,  644 

"       Solution  of,  644 

«  "       "  Araenlta  of,663 

"        and  Soda,  Tartrate  of,  653 

"       Sulphate  of, 

"       Tartrate  of, 

PotafWB,  Acetas, 

ArsenitiB,  Liquor, 
Blcarbona«, 

'         Bitartras,  648 

"       Carbonas,  648 

"       Citra*.  644 


FAOK 

644 
644 
635 
644 
644 
644 
646 
622 
645 
6i4 
644 
645 
645 
79 
680 
681 
S20 
660 
666 
688 
6<i6 
605 
646 
645 
641 
698 

eci 

406 
368 
721 
661 
144 
370 
146 
499 
143 
651 
626 
647 
5S3 
482 
387 
640 
441 
423 
423 
403 
482 
of  Children,  483 
613 
648 
648 
277 
882 
646 
646 
ftJC 
661 
61f, 
6R11 
6311 

165 
164 

32 

647 
647 

670 
605 
680 
667 
647 
647 

'  !r»,  647 

ii  j^  657 

Refk        ag  brinks  in  Fevers,  679 

ReproUi-oFlon  of  Lost  Parts,     442 


Potassffi,  Citratis,  Liquor, 
"       Liquor, 
"       Nitras, 
"       Sulphas, 
"       I'anras, 
Potassii  Bromidum, 
"       Cyaneuretum, 
"       lodidum, 
"       Sulphuretum, 
Potassium, 

"        Bromide  of, 
"        Cyauurct  of, 
"        Sulpburet  of 
Potatoes, 
Poultices, 
Powders, 
Pox, 

Prejudices, 
Preparations, 

"  of  Medicine 

Prepared  Calamine, 

"        Chalk, 
Prickly  Ash, 

"       Elder, 
Prince's  Pine, 
Prinos  Verticillatu, 
Prognostics, 
Prolapsus  Ani, 

"  Uteri, 

Pronouncing  Dictionary, 
Prunus  Virginiana, 
Prurigo, 

"Vulva, 
Pruritic, 

Prussio  Acid,  Poisoning  by. 
Psoriasis  or  Salt  Bbeum, 
Ptelia  Trifoliata, 
Ptercorpus  Marsupium, 
"  Santalinus., 

288 !  Ptisan,  Suet, 
627  Ptosis, 
627  Puerperal  Fever, 


Pumpkin  Seed, 
Punctured  Wounds, 
Purple  Disease, 
Purpura  Hemorrhagica, 
630  Purtusais, 

Purulent  Ophthalmia, 


Pyrethium  Partheuium, 
Pyrola  Rotundifolium, 

"     Bonnd  Leaved, 
Pyrosis, 
Pyeemia, 
Quassia, 

Queen  of  the  Meadow, 
Queen's  Boot, 
Quercus  Alba, 

"       Infectoria, 
Quinia,  Sulphate  of, 

"       Valerianate  of. 

Rabies, 

Ramollissement, 

Rectum, 

Red  Chickweed, 

It    Clover 

"    Iodide  of  Mercury  Oint- 
ment, 

"    Pepper, 

"    Oxide  of  Lead  Plaster, 

"    Ozier, 

"    "oot, 


644  Benin  Plaster.  Comp., 
644  i  Keapiratury  Organs, 
6431  Rest  and  Sleep, 
663  Restorative  Wine  Bittera, 
648  Restoratives, 

Ret'xition  uf  Urine, 

Retina, 

Bhamnus  Cathartioui, 


679 

86 

96 

673 

684 

304 

49 

601 


- 


|i3i 


898 

INDEX, 

PAOl 

rAoi                                                   rAoi 

Khatanv. 
RbeumPalmatam, 

660 

Scrofula, 

419 

Small  Spikenard, 
Smart  Weed, 

652 

648 

.Scrofulous  Ophthalmia, 

484 

661 

Rheumatism,  Acute,          880,4113 

.Scrophularia  Nodosa, 

614 

SmilaxUfflclnalis, 

649 

"            Cbrouio, 

417 

Scrotum,  Uloo<l  in, 

474 

Snake  Root, 

600 

Ehubarb, 

648 

Water  in. 

473 

Snakeroot,  Virginia, 

61  iO 

"       Aromatis  Syrtip  of, 
"       C'omp.  Tinct.  or, 

684 

Soallcap, 

6&0 

Soap, 

6f,2 

C  ' 

Scurvy, 

Scutellaria  LoterifoUa, 

421 

Soda,  Bicarbonate  of. 

ef,2 

"           "       Powder  of, 

683 

660 

'•      Borate, 

652 

"       and  Fotassa,  Comp 

Sea  Uathlng, 

644 

"      Sulphate  of, 

era 

Powder  of, 

683 

Seasickness, 

278 

"      Sulphite  of. 

658 

"       and  Potassa,  Comp 

Secale  Cornutum, 

666 

Sodx,  Bicarbonas, 

6C2 

Syrup  of, 
"       Sweet  Tinot.  of, 

687 

Secretion,  Organs  of^ 
Seidlitz  Powders, 

40 

"      Boras, 

652 

698 

663 

"      et  I'otasss  Tartras, 

era 

"       Syrup  of, 
"       Tinct.  of, 

684 

Self  Pollution, 

Semilunar  Valves,  Disease  of 

836 

"      Sulphas, 

653 

690 

256 

"      Sulphis, 

653 

Rhus  Glabrum, 

657 

Su.Tipervirum  Teotorum, 

620 

Sodii  Chloridum, 

653 

"    Toxicodendron, 

642 

.Seneca  Oil, 

640 

Sodium, 

652 

Ribs,  Fracture  of, 

451 

Senecin, 

627 

"        Chloride  of. 

663 

Rice, 

78 

Senecio  Aureus, 

627 

Solanum  Dulcamara, 

697 

"    Gruel, 

680 

Seneka, 

660 

Solidago  Kigida, 

618 

Rioinns  Communii, 

604 

'•       Syrup  of. 

686 

Solomon's  Seal, 

653 

Rickets, 

407 

Senna, 

650 

Soluble  lurtar. 

644 

Ringworm, 
Roohelle  Salts, 

151 

"     and  Jalap,  Ttoct.  of, 

698 

Sore  Nipples, 

388 

653 

Sensations, 

64 

Soup,  Vegetable, 
Spanish  Files, 

"          "    Liniment, 

6^2 

Rusa  Uallica, 

647 

"          Agreeable, 

65 

(M 

Rose  Rash, 

188 

*,          Unpleasant, 

66 

B72 

"    Red, 

647 

Sexual  Diseases, 

820 

"          "    Poisoning  by. 

4«9 

'•    Water  Ointment, 

677 

"      PreyenUottPf,  886 

Spasm  of  Glottis, 

402 

"    Willow, 

657 

Shaking  Palsy, 
Sheep  Laurel, 

164 

Spearmint, 

664 

Rosemary, 

643 

633 

Speculum, 

845 

Roseola, 

138 

Shingles, 

Shoulder  Blade,  Fractures  of 

139 

Spermaceti, 

654 

RosemarinuB  Officinalto, 

648 

449 

Ointment, 

677 

Rotting  of  Teeth, 

500 

Joint,  Dislooation  of,469 

Spice  Plaster,  Comp., 

679 

Round  Leaved  Pyrola, 

648 

Shower  Bath, 

634 

Spider's  Web, 
Spigelia  Muriiandica, 
Spikenard,  Small, 

664 

Rubbing  Wet  Sheet, 

631 

Shrubby  Trctoil, 

661 

640 

Rubeola. 

131 

Sick,  Care  of. 

55 

662 

RubuB  Villosns, 

698 

"    Children,  Nursing, 

894 

Spinal  Cord, 

46 

Rudbeckia  Laclniata, 

658 

"    Room,  Clioic;  >if, 

661 

"         "    Diseases  of. 

159 

Rue, 

648 

"       "       Cleanliness  In, 

655 

"         "    Inflammation  of,  169     || 

Rules  for  Using  Water, 

648 

"       "       <Jookcrv  for. 

578 

Spinal  NerveH, 

46 

Rumex  Crispus, 
Running  and  J^eaping, 

664 

"       "       Darkening  of, 

658 

Spine,  Detormitles  of. 

478 

90 

"       "       Domestic  Manage- 

Spirit of  Nitric  Kthcr, 

6r,4 

Kupia, 

141 

ment  of. 

661 

Spiritus  ^Etheris  Nitrici,    635,  654 

Rapture, 

476 

"       "       No  Cooking  In, 

562 

"    Ammoui»Aromaticus,594 

Ruptures  ofTendous, 

466 

"       "    .  Prejudices  and 

Spircea  Tomentosa, 

618 

Ruta  Uravelus, 

648 

Antipathies  in 

,  660 

Spleen, 

54 

Rye, 

78 

"       "       Sofa  or  iiawy  Chair 

■>      Acute  Inflammation  of,  266     1 1 

"    Sporred, 

«6e 

in. 

652 

"      Chronic       "             " 

266 

8al'  Bheum 

189 

"       "      Temperature  of, 
"       "       Unhlred  Attend 

666 

Splenitis, 

266 

.  Sacral  Plexiu, 

47 

Sponge, 

655 

Salfron, 

646 

ants  in. 

669 

Spongia, 

655 

Sage, 

648 

Sight.  Organs  of, 

48 '  Sprains, 
486|  Spurred  Bye, 

464 

"    Tea, 

678 

"      Long  and  Short, 
"      Weakness  ot 

656 

Sago  Gruel, 

Saint  Igoatinn'g  Bean, 

681 

485' Squill, 

655 

656 

Silex  Alba, 

663 

"      Syrup  of, 
"     Vinegar  of. 

685 

Sal  Ammoniac, 

693  j  Simple  Ointment, 

677 

693 

Salop  Powders,  Comp., 

680        "       Syrup, 

684 

Squinting, 

487 

Saline  Mixture,                  644, 675  Sinapix  Alba, 

688 

Squirting  Cucumber, 

662 

SnllxNigra, 

699 '  Singultus, 

180 

St.  Anthony's  Fire, 

136 

Salt, 

6.53  Sippets, 

678 

St   IgnatiuB's  Bean, 
St.  Vitus'«  Dance, 

666 

"    of  Tartar, 

64S 

Sitz  Bath, 

687 

169 

Saltpetre, 

"         Poisoning  by, 

685 

Skin, 

42 

Staager  Weed, 

659 

498 

'-    Color  of,  Disordered, 

14«i  Star  GraNi. 

666 

Salvia  OfficinaMi!, 

649 

"    Diseases, 

ISO  Statici  Carolluiana, 

631 

SnmbuouB  Vanadensis, 

618 

"    Nerves  of.  Disordered. 

146  ."-.Jrility, 

871 

Sanguinaria  Caoadensii, 

699:     "    Offices  of, 

108         "       Causes  of. 

874 

KanKuiuarin, 

689 'Skull,  Fractures  of 

4^7  StiffJoint, 
6ul'StillinKieSylrsHcHS, 

468 

Sapo, 

652  .Skunk  Cabbage, 

646 

fiarsaparilla, 

649,  Sleep, 

96'         "         Comp  Syrup  ofj 

687 

"          Comp.  Syrup  of,  687 

"     Amount  of. 

9T  Stomach, 

32 

False, 

668 

"     Disturbed, 

182         '•       AfTeotions  of. 

676 

"          Wild, 

662 

"     Natural  Position  for. 

97 1        "       Bile  in. 

64 

Saumtns, 

649 

"     I'ruparation  lor. 

97 :        "       Acute  Inflammation             1 1 

Savin, 

649 

Sleeping  Apartment, 

661 

of, 

269 

Scabies, 

189 

"        Rooms, 

96 

"       Chronic   Inflamma 

Scalds, 

486 

"          •'     Bedding  in. 

96 

tlon  of, 

"270 

Scaly  Ernptioni, 

148 

"           "      i^edB  in, 

96 

"       Uovement  of, 

US 

Scaiiiniony, 
Scarification, 

860 

"           "      Firo  in. 

96 

"        Pipe, 

81 

443 

«          "     Night  Dres.  i 

n,  97 

"       Spasm  or  Cramp  in 
Stone  In  Bladder, 

277 

Sca'latina, 

183 

"           <•      Open  Fiieplaoe 

ft\5 

Scarlet  Fever, 

183 

In, 

96 

Storax, 

P, 

Sciatica, 

ITS 

"           "     Open  Windows 

Strabismus, 

Soilla  Marltims, 

686 

Tn. 

96 

Stramonium, 

668 

Sclerotic  Coat, 

481       "          •'     Small, 

109 

Ointment, 

677 

Scoke, 

6«  Slippery  Elm, 
421  Small  Fox, 

«62 

"          Poisouinir  b/. 

41*9 

aoorbntut, 

119 

ia4lSti'ychuln*,  Poisoning  b>. 

49U 



"n 

.  . V--^-finiif  i[  [i iilr Wiitiir  I 


yiff>" ;«";'■  yJ'-'J  :\\"!'!V^"Vm>i» .mi .  ■u,;m','yi- 


Kcnard, 
ed, 

iclnalts, 
)t, 
,  Virginia, 

trbonate  ot, 

itc, 

jliatc  of, 

jliite  of, 

larbouas, 

ras, 

?ota8ss  Tartrag, 

Iplias, 

IphiB, 

oridum, 


rAoi 

652 

6I!1 

649 

650 

6(» 

6f,2 

6f,2 

6f)2 

6r.3 

668 

6C2 

662 

6fl3 

663 

663 

668 

862 

668 

69T 

618 

663 

644 


hloride  of, 
Dulcamara, 
Uigida, 
's  Seal, 
altar, 
iples, 
■"('table, 
Flies, 
'    Liniment, 
'    roisoning  by, 
fGlottw, 
nt, 
m, 
leti, 

Ointment, 
BBter,  Comp., 
Web, 

Marilandica, 

rd,  Small, 

Jord, 

"    Difieares  of, 

"    Inflammation  of,  169 

NcrvcH,  46 

Delormities  of.  478 

ilKitricKther,  6r4 

s  .Ktheris  Nitrioi.    686,  664 

Ammonia;  Aromaticua,  694 

Tomentoga,  618 

I  64 

\cute  Inflammation  of,  266 


6S2 
(if>4 
672 
499 
402 
664 
846 
654 
677 
679 
664 
640 
662 
46 
169 


.'hronio 
Is, 


a, 

dBye, 

3ynip  of, 
vinegar  of, 

ing  Cucumber, 
thonv'8  Fire, 
iatiuB'8  Uean, 
uh'k  Dance, 
r  Weed, 
ra»8. 
CaroUniaoa, 

Causes  of, 
Dint, 
giaSylraticus, 

Comp  Syrup  of, 
rb, 

Afi^ctions  of, 

Bile  in, 

Acute  Inflammation 

ot, 
Chronio    Inflamma- 
tion of, 
Movement  of, 

I'll*. 

Sueem  or  Cramp  in, 
in  Uladder, 
(, 

timnn, 
ionium, 

"  Ointment, 

■■  Poisoning  b/, 

liulna,  Poisoning  tajr, 


266 
268 
666 
666 
464 
666 
666 
686 
693 
487 
662 
136 
666 
169 
668 
666 
631 
871 
874 
468 
64« 
687 

32 
676 

64 


270 
68 
81 

277 


66« 

671 
4U9 
4UU 


T 

'       ..           INDEX. 

899 

rikOB                                                                                 PAOB                                                                                 FAQ  a 

Stryobnos  Nux  Vomica, 

686 

Throat  Diseases,  Instruments 

i  Varlocele, 

478 

Stye, 

481 

fur  Treatment  of, 

195  Variola, 
172,  Varioloid, 

184 

Sty  rax  Offlolnale, 

666 

Tic  Douloureux, 

136 

Sudorific  Tiuct., 

698 

Tight  Dressing,                   101 

111  Varix, 

476 

Suet  Ptisan, 

688 

Ti  nctu  res,                            690,  688 1  Vegetable  Poisons, 

498 

Sugar  of  Lead,  Poisoning  by 

,  498 1  Tissues, 

16          "          Soup, 

682 

'•       ofMilk, 

226  Tobacco, 

668 

Veins. 
"    Acute  Inflammation  of. 

37 

Sulpliur, 

656 iToe  Nail,  Ingrow'ng, 

491 

474 

Ointment,  Comp., 

678 

Tolu,  Svrup  of, 
"     Tinct.  of. 

686 

"    Enlarged  or  Varicose, 
Venereal  Diseases, 

475 

SuIpliuricAcid,  Poisoning  by,  498 

690 

320 

Suniacli, 

66(1 

Tonsil  Instrument, 

Tonsils,  Acut/3  Inflammation 

202 

Ventilation,                  57, 108 

,653 

Summer  Complaint  of  Infants,  404 

"          in  Sick-Room, 

110 

Sunflower, 

657 

of, 

201 

Ventricles. 

"         Dilatation  of. 

88 

Sunstroke, 

162 

■'       ChDuto    Inflamma- 

260 

Su^cr  Carbonate  of  Soda, 

652 

tion  of, 

202 

"         Enlargement  of. 

248 

"     Tartrate  of  Potassa, 

643 

Toothache, 
"         Tree, 

601 

Veratrin, 

592 

Suppresfiiim  of  Urine, 

803 

645 

Veratrum  Album, 

6Hl 

Suppuration, 

429 

Towel  and  Sponge  Bath, 

638 

Viride,   - 

592 

Supra  Renal  Capsules,  Disease 

Tracheitis, 

198 

Vervain, 

659 

of, 

298 

Trailing  Arbutus, 

668 

Verbascum  Thapsus, 

433 

Surgical  Diseases, 

426 

Trance, 

168 

Verbena  Hastala, 

669 

Swunip  Dogwood, 
"         Milkweed, 

667 

Travelling,                          112, 280 

Verdigris,  Poisoning  by, 

497 

667 

"          Seasons  for. 

113 

Vermes, 

293 

Sweat  Glands,  Disordered, 

46  Trees,  Cultivation  of, 

110 

Verruca, 

~  146 

Sweet  Fern, 

667; Trefoil,  Shrubby, 

a51 

Vertigo, 

Vessels,  Absorbent, 

181 

"     *"lag. 

658  Trifolium,  I'ratense, 

647 

8S 

"     Gum, 

668  Trillium  Pendulum, 

697 

Vibuninm  Opulus, 

610 

"     Oil, 

636  Trumpet  Weed, 
5,65'  Tulip  Tree, 

646 

Vinegar, 

660 

"     Si)irits  of  Nitre,       681 

659 

Vinegars, 
Virginia  Snakeroot, 

"            "        Comp.  Tine 

698 

Swelling  of  Lungs, 

235  Tumeric, 

669 

660 

Sycoais, 

149 

luniors. 

468 

t. 

Svmpntlietio  Nervous  System,    60 

"       Encysted, 

471 

of. 

698 

S'ympliytum  OtDciuale, 

608 

"       Fatty, 

671 

"            "       Tinct.  of. 

690 
486 

Symplocarpus  Foetidus, 

651 

Turkey  Corn, 

459 

Vision,  Imperfect, 
Vocal  Cords, 

Symptoms,  Table  of. 

122 

Turner's  Cerate, 

667 

41 

Svnc()i)e, 

Synovial  Degenerations, 

181;  Turnips, 

79 

'•     Organs, 

40 

466  Turpentine  Liniment, 

672 

Vomiting, 

277 

Sypliilis, 

320,Tu!isi]ago  Farfara, 

608 

Syringe,  X^aryngoal  Sbower, 

195 

lylosis, 

146 

Wafer  Ash,                   i 

6.51 

"       Nasal               " 

196 

Tympanitis, 

283 

Wahoo, 

661 

"       Phryngeal      " 

196 

Tympanum, 

''          Inflammation  of, 

51 

Walking, 

90 

Syrups, 

683 

490 

Waits, 

145 

Typhoid  Fever, 

410 

Wash  Down, 

639 

Tag  Alder, 

668 

"       Lung  Fever, 

242 

"     Tub, 

687 

Tamarac,  Comp.  Tinct.  of, 
Tuiiuxctum  Vulgara, 

693 

"       Pneumonia, 

242 

Water, 

85 

658 

The  Temperature  of  the  Body 

,881 

"     Accidents  on, 

496 

Taiifiv, 

663 

Ulceration  and  Ulcen, 

431 

"      Apple, 

681 

Tapioca, 

659 

"         of  Bones, 

465 

"      Barley, 

678 

"       Jelly, 

681 

Unhired  Attendants, 

659 

"      Brash, 

277 

Tar, 

66S 

Unicorn  Root. 

665 

"     Camphor,    ' 

673 

"    Ointment, 

"    I'l  aster,  Coinp., 

677 ;  Union  by  First  Intention, 

439 

"      Chemical  Nature  of, 

86 

680 1  Unnatural  Growth  of  Bones, 

466 

"      in  Chest, 

237 

Taraxacum, 

612 1  Upland  Cranberry, 

696 

"      Chicken, 

683 

Tea  and  Cofite, 

84 

Upper  Arm  Bone,  Fractures 

"      Cocliituate, 

87 

"    i«cef, 

082 

ot; 

449 

"     Division  of. 

88 

"    Sage, 

678 

Urate  of  Ammonia  in  Urine, 

812 

"     Gruel, 

680 

Teeth, 

29 

Ureters, 

84 

"      in  Heart  Case, 

259 

"     Care  of, 

600 

Urethra, 

Uric  Acid  Gravel, 

86 

"      Horehound, 

660 

■<     Cleaning  of, 
"      Coniiiosition  of, 
"     Cutting,  Difficult, 

608 

808 

"      Impure, 

88 

80 

Urinary  Deposits, 

806 

"      Impurities  In, 

86 

401 

"        System, 
Urine,  Cystine  DenoelU  in. 

84 

"      Lemon, 

679 

"      Diseased, 

608 

814 

"      Milk  and  Soda, 

684 

"     Filling, 

602!      "      Examination  of, 

307 

"      Modus  Operandi  ot; 

546 

"     First, 

603 

"      Uippiiric  Acid  Deposits 

"      I'cpper, 

631 

"     Names  of, 

80 

in. 

813 

"      I'roperties  of. 

87 

"     Number  of, 

29 

"      Inability  to  hold, 
"      Oxalic  Deposits  in. 

P08 

■'      Rain, 

87 

"     Origin  of. 

29 

811 

"      Rice, 

678 

•*     Rotting  of. 

600 

>'      PlioHphatic  Deposits  in,  810 

"      Rules  for  Using, 

548 

"     Use  of. 

80 

"      Retention  of. 

304 

"      Salt, 

88 

Tela  Araneic, 

6.'>4 

"      Sunnression  of. 

803       "      in  Scrotum. 

478 

Temperaments, 

118       "      Urate  of  Ammonia  In 

,312       "      Schuylkill  and  CrotOD    87     | 

"          Abdominal, 

119 

Urticaria, 

137!  Waters,  Medicated, 

873 

Cephalic, 

118 

Uteri  Prolapsus, 
Uterine  Hydatids, 

868  Watery  Pimples, 
866  Wave  or  Sluice  Bath, 

138 

•'          Medication  and.  119 

635 

"          a.iuscular. 

119 

Uva  UrsI, 

Uvula,  Elongation  of, 

696  Wax, 

661 

Thoracic, 

119 

aoo  Weaning, 

392 

Temperature,                      881, 666 

i  Wens. 
136  Weights, 

471 

TennoiiK,  Ruptures  of, 

465 

Vaccina, 

688 

Tetanus, 

166 

Vagina,  Inflammation  of, 
Valerian, 

868         "       French  Decimal, 

689 

Toiler 

139 

659  Wet  Bandages, 

649 

"      Ousted, 

142 

"       Comp  Tinct.  of. 

693     "     Dress, 

630 

"      Humid. 

189 

Valeriana  Offlcinalia, 

660     "    Sheet,  Folded, 

631 

Tl.ixh  Kone,  FraotoNl  of; 

468 

Valves,  Mitral, 

88  i    "       '•      Pack, 
86     ■'       "      Rubbing, 

628 

Tliiiiibleweed, 

668 

"       Semilunar, 

681 

Tlioiiuipple, 
Throat  DiseaiM, 

666 

"       Triouioid. 

86  Wheat, 

77 

188 1  Varicella, 

186,      '■     Floor,  Unbolted, 

71 

900 


INDEX. 


Whey,  Alum, 

"      Hu8tard, 

"      Orange, 

"      Hcnnet, 

"      Sweet, 

"      Tartar, 

"      Vineaar, 

"     with  Tamarindi, 

"      Wine, 
White  Hellebore, 

"  "  Ointment, 

"      Indian  Hemp, 

"      Liquid  Phytic, 

«      Oak, 

"      I'ond  Lily, 

"      ro|)lar, 

"      Swelling, 
Vitriol,!" 


rioB 
688 
688 
684 
688 
684 
688 
683 
684 
684 
661 
677 
667 
676 
661 
661 
6r>9 
466 
•oisoningby,  498 
368,890 
467 


Whites, 

Whitlow, 

Willi  Clierry,  661 

"      Bark,  Syrnp  of,  686 

■'      Cucumber,  662 

"      Ginger,  662 

"      Indigo,  662 

■      Ointment.  677 

"      Saniaparilla,  662 

'•      Snow  Hall,  647 

"       Inrkev  Tea,  669 

Woodbine,  693 

"      Yum,  662 

Willow,  668 

W^iud  Colio,  282 


843 
368 
308 

36' 


TAO* 

Windpipe,  86 

"        Foreign  Bodies  In,   493 
"         Inflammation  of,      193 
Wine  Bitters,  Restorative,        678 
''      of  Comirey,  Comp  ,  673 

"     of  Golden  Seal,  Comp.,  678 
"     of  Ipecacuanha,  673 

Wines,  Medicated,  673 

Wingseed,  651 

Winter  Green,  663 

Witch  Hazel,  668 

Wolfsbane,  668 

Womb  and  Appendages, 
"    Falling  ot, 
"         "       over  of, 
"    Inflammation  of,  uu, 

"    Inflammation  of  Neck  of,  346 
"    Polypus  of,  866 

Worm  Powder,  683 

Worms,  293 

Wormsced,  664 

Wormwood,  684 

Wounds,  Bleeding  from,  493 

"  Contused  and  Lacer- 
ated, 441 
"  Derangements  from,  166 
"  Gunshot,  442 
"  How  to  Unite,  44n 
"  Incised,  488 
"  Poisoned,  442 
"  Punctured,  441 
"        Bules  for  Kxamin- 

iug  and  Dressing,  440 


PAOI 

460 
4f>l 
480 


Wrist,  Dislocation  of, 

"      Fractures  of. 
Wry  Neck, 


Xanthoxylum  Fraxineum,  645 

Yam,  Wild,              .  662 

Yarrow,                     .-    .  6ti-> 

Yeast,  61)4 

Yellow  Dock,  664 

"         "    Comp.  Syrup  of,  688 

"      Fever,  416 

"      Jessamine,  604 

"       Ladies'  Slipper,  666 

"      Parilla,  665 

Zinc,  666 

"    Acetate  of,  605 

"    Chloride  of,  666 

"    Iodide  of,  666 

"    Oxide  of,  665 
"    Precipitated  Carbonate 

of,  666 

"    Sulphate  of,  ,      668 

»    Valerianate  of,  666 

Zinci  Carbonas  Prsoipitas,  666 

"    Chloridum,  665 

"    lodidum,  685 

"    Oxidum,  665 

"     Sulphas,  668 

"    Vaicrianas,  660 

Zingiber  Officinale,  616 


ADDITIONAL   INDEX. 


Antleciptlc  Dressing, 

Acne,  Spotted, 

Ague  Cake, 

Alteratives, 

Anidrosis, 

Anteversion  of  Womb, 

Aniemia, 

Apoplexy  and  Paralysis, 

Asphyxia, 

Astln'na, 

Astriugentf, 


878 

148 1  Cupping  and  Leeching, 

266l 

7721 
147 
868 1 
259: 
710 
494 
709 
489,772 


428 


Belly  AcBe,  282 

Big-tvv,  683  i 

Black  Vomit,  415  i 

Breathing  Murmurs,  212^ 

Bronchial  Flux,  709 
"            "     treatment  of,  709  i 

Bafiy  Coat,  426 


Calvities,  150 

Canker,  695 

Care  of  the  Skin.  706 

CarniinitS.w  Pnyslo,  766! 

Carminatives,  770 

Catarrh  of  Bladder,  298 

Carthartics,  703 1 

Caustic  Potassa,  642 ' 

Chalk-stones,  418 1 

Chancre,  Sloughing,  821  \ 

"        Gangrenous,  821 1 

"        Eating,  821 

"        Indurated.  821 

Changes  occurring  in 

Advanced  Life,  TOO 

Charbon.  484 

Chicken-pox,  186 

Children'^9  Sore  Hontl^  899 

Chromidrosis,  147 

Coaptation,  444 

Convulsions,  672 

Comedones,  148 

Compression,  489 

Coryai,  181 

Cough  Preparations,  769 

Connter-extensfon,  444 

"       irritatioo,  428 

"       irritsnta,  ^  778 


Depositories  of  Family 

History, 
Diaphoretics  and  Sedatives, 
Diet,  Milk, 

■'     Cream, 

:.'  ffsff,' 

'•     Fruits, 

"  Vegetable, 
Diet  for  the  Old, 
Diphtheria,  696, 697, 

Diseases  of  the  Old, 
Diuretics, 
Dropsy  of  Brain, 
Dumb-bell  Exercises, 

Egophony, 

Electricity, 

Endosniosis, 

Eugorgnraents,  State  of. 

Emetics, 

Epsom  Salts, 

Exercise, 

Exercises  with  Wands, 

Expectorant*, 

Ex  osmosis. 

Extension, 

Falling  Sickness, 
Female  Weakness, 
Fistula, 
Fluctuation, 
Freckles, 

Qkngrene, 
Osrgles, 
Gymnastio  Crown, 


700 
771 
664 
666 
666 
667 
667 
867 
704 
698 
708 
771 
168 
714 


707 
819 
241 
696 
630 
706 
747 
706 
819 
144 

167 
353 
430 
429 
147 

430 
776 
767 


Helpless  dependence  of  the 

Aged,  702 

Ilocmidrosis,  147 

Hepatization,  Stage  of,  241 

Hectic  Fever,  427 
History  of  Gymnastiaa  In  the 

United  Statee,  761 


Hives,  18S 

Honey  Diseases  143 

"       Scab,  143 

Horn-pox,  136 

Hypo,  179 

Idrosis,  147 

Leucorrhcea,  890 

Leeching,  428 

Ligature,  438 

Liniments,  774 

Loneliness  of  the  Aged,  702 

Lotions,  776 

Medical  Treatment  of  the  Old,  708 

416 

708 
142 
609 
704 
147 
706 
486 


Metastasis, 

Milk, 

Milk  Crust, 

Milk  Weed, 

Mode  of  Cooking  Metis, 

Moles, 

Mortality  In  Cold  Weather, 

Myopia, 

Narcotics  and  Anodynes,  770 

Night  Nurse,  662 

No  fear  of  Death,  708 

Nympho-mania,  870 

Oll-Nnt,  003 

Ointments,  710 

Papllln,  146 

Paracentesis  Tho-toi*  240 

I'ectoriloquy,  240 

Pin-worm,  288 

Plastic  Lymph,  426 

Plain  Puddings  and  Ple«,  706 

Presbyopia,  488 

Prescriptions,  768 
Presvervatlon  of  Old  People's 

Health,  708 

ProviHiuiial  Callus,  446 

Puerile  Kespiratlon,  213 

Pulmonic  Cherry  Cordial,  710 

Pussy  WUlow,  690 


mmm 


iiiiMfnrr'-- 


wliMHii  iwimi'nr  \i.i«\iimvj^yifmmm:v*"'VMniiiii..iimmmK 


> 

PAOI 

slocBtlon  of, 
ractures  of, 

460 
451 
480 

ylum  Fraxineum, 

645 

ild, 

C62 
6M 

"    Comp.  Syrup 
>vcr, 

esiiainine, 
Ladies'  Slipper, 
L'nrilla, 

664 
of,  688 
416 
664 
6(iS 
666 

666 
etate  of,  6® 

loride  of,  66" 

iideof,  666 

ide  of,  660 

BCipitated  Carbonate 

Iphnte  of,  .      66b 

iferianateof,  66b 

irbonaa  Pr«oipit«»,       666 

lioHdum, 

didtim, 

Lidiim, 

I|i1m», 

ilcrianas, 

r  Officinale, 


686 
666 


616 


Diseases 

Scab, 
>ox. 


18S 
143 

142 
13d 
179 

147 


rrhcoa, 

ng, 

re, 

ent«, 

mesa  of  the  Aged, 

18, 

al  Treatment  of  the  Old, 

tasiB, 

^nist, 
ffeed, 
of  Cooking  Meets, 

kty  in  Cold  Weather, 
ia, 

itica  and  Anodynei, 

Nurse, 

ir  of  Death, 

>ho-mania, 

lit, 
lents, 


416 
705 
142 
609 
704 
147 
706 
486 

770 
662 
708 
870 

eoa 

710 


lentesis  Tbo-'«oi«  2i 

riloquy,  g 

rorm,  ■ 

o  Lymph,  V 

I'uddingR  and  Pie*,  i< 

yopia,  * 

riptions,  7< 
ervatlon  of  Old  People's 

»lth,  7( 

iHlonal  Callui,  * 

ile  Kcdpiratlon,  2 

ionic  Cherry  Cordial,  7 

r  WUlow,  0 


INDEX  TO  THE  HOM(EOPATHIC  DEPARTMENT. 


i  brief  Treatlae  on  HomoBO- 

natbic  Treatment  of  DiBeaaeR,608 
KboccsscB,  796 

\uiiii'    Inflnmmatlon  of   the 

8|>lnnlCord,  806 

Vc'uu    luHnuimatlon    of  the 

Liver,  621 

Aeute    Inflammation    of  the 

Larynx,  624 

Aeiiu'-  Uronc.hlnl  Inflnmmatlon,  525 
Afl'eelioiiH  of  the  Mliid,  864 

VgUKliik,  889 

vrimeiilK  nl  the  age  of  Puberty,  826 
•'  BttiTHliiiK  (JtiiinKe  of  Llfe,827 
828 
849 
819 
825 
786 
861' 
869 
637 
All 
806 
805 
834 
819 
620 


ituiiiiK  I'rrgiiunry, 
Mnlilydplii, 
AimHurcii, 
AneurlHm, 

of  thi-  Aorta, 
\norexlii, 
VnoHinlii, 
\ntlirux, 

Antidoli'S  to  JJcdlclnea, 
\popli'xy, 
Apoplexiu, 
AplliiB, 
.Vscltls, 

Asliiiic  Cholera, 

Asthnin,  *28 

Aversion  to  Food,  869 

Baldncsa,  80S 

Bathing,  611 

Barbers'  Itch,  801 

Bilious  Komlttent  FtT*r,  613 

Black  Tongue,  812 

Black  Vomit,  813 

Bleeding  of  the  Lungi,  627 

Bloody  Urine,  788 

Bolls,  T84 

Brain  Fever,  804 

Bionchills,  625 

Bunions,  844 

Burns  and  Boald*.  823 

ilancci  of  tbe  Skin.  841 

"    "  Liver,  840 

"         "    "   Intcstlnea,  840 

"         "    "   Stomach,  840 

Canker  of  the  Mouth,  616 

Carbuncle,  794 

Cardl.ilgia,  617 

Oatiiriul,  816 

Ccpliiiliilglji,  802 

(;lil(ken  I'l.x,  616 

rholera  Morbus,  620 

liifiintum,  836 
Chronic  hiflummallon  of  the 

Botrels,  619 
Chronic  Inflammation  of  the 

Stomach  i  618 

i:ibronlc  Catarrh,  623 

"        Dysentery,  620 

'•        Laryngitis,  624 

'*        Inflommatlor  of  the 

Bronchia,  626 

Chronic  Inflammation  of  the 

Pericardium,  786 

Chronic  rericarditl*.  786 

"       UbenmaUam,  61* 


Chllblaina, 

Chorea, 

Child-bed  Fever, 

Colic. 

Cold  Fever, 

Cold  In  the  Dead, 

Consumption, 

Concussion  of  the  Chest, 

"  •'        Brain, 

Convulsions, 
Constipation, 

••  of  the  Boweli, 

Coma, 
Coryza, 
Coup  de  Bolell, 
Croup, 
Crying, 
~      ds, 


706 1  Bpistaxls, 

8091  Erysipelas, 

83)   Eruptive  Fevers, 

Kxccnsive  Uenntruatlon. 

Excoriated  Nipples, 

Extreme  Emaciation, 

Excorliitlona, 


833 
863 
623 
627 
821 
821 
836 
621 
830 
796 
623 


i 


T8T 
086 

SIT 
808 


External  Applications, 
f  tfie  Womb, 


Cystli 

Dentition, 

Deafhesi, 

Dellrlom, 

Derancement  of  the  Fnnetloni 

of  Menstmatlon, 
Disease!   involving   Vuioni 

Organs, 
Diseases  of  the  Allmentuy 

Canal, 
Diseases  of  the  Brain  and 

Diseases  of  the  Kre  and  Lids,  814 

"    "    Head,  802 

"  ResptratoryOrgans,623 

"  Urinary  Organs,      787 

Diseases  of  the  Organs  of 

Generation, 
Diseases  of  the  Organs  of 

Women, 
Diseases  of  InCsnts, 

'*     Involving  variotu  Or- 
gans and  Regions, 
Diseases  of  the  Bar, 
"        "    "  Nose, 
<«        "    "  Skin, 
nilttatlon  of  the  Oavltiea  of 

the  Heart, 
Dlarrhcsa, 
Diabetes, 

DlfDcult  Urlitatton, 
Diphtheria, 
Dyspepsia, 
Dyspeptic  Headache, 
Dysentery, 
Dysmeuorrhtstt, 
Dropsies, 

Dropsy  oi  the  Borotom, 
f'  "  BeUy. 
•'  "  Chest, 
"  "  Bmin, 
«'  "  Womtt, 
"  "  Heart, 
Joints, 


Earache, 
Ear,  Inflammation  of, 
Bars,  Diseases  or 
Ears,  Uunning  of. 
Endocarditis, 
Bcsema, 
I  KpUepsy, 


Falling  o 
False  rnins. 
Fever,  Simple, 

Inflummatory 
Typhoid, 
Bilious, 
Remittent. 
»  Intermittent, 

Yellow, 
Scar  lot. 
Eruptive, 
Bbeumatie, 
Spotted, 
Cold, 
Putrid, 
Febria  Petochlalts, 
Felons, 

Fistula  In  Ano, 
FlgworU, 
Fits, 

Fra::ture8, 
Furunoull, 
Forms  of  Medicine  for  Admin 

istratlon, 
Oastralgla, 
Gastritis, 
Gastrodlnea, 
Gangrene, 

Oonorrhcsai  Sore  Eyes, 
Grippe, 
Stone, 

Hardness  of  tlearing, 
Heartbuni, 
Headache, 
Hectic  Fever, 

Hemorrhage  from  Wonnds, 
786  Hernia, 
018  He-pes, 
~  "  Herpes  CAfclnatus, 
Hcmorrholilit, 
Hiccough, 
Hives, 
Hydrocele, 
Hysteria, 
Ilydrophobla, 
llydrolhorax, 
llydrocepbftlus, 
llydrocffc. 
Uydrometra, 
Hypochondria. 
Ilypocbondrliisis, 
Hysteric  Derangement, 
Imbecility.  ,  ^    „  , 

Imperfect  Action  of  the  Valves 

oftho  llenrt. 
Inflammation   of    the   Groin. 

Inguinal  Glands, 
Inflammatory  Ulieumatlsm, 

"  Fever, 

Inflaminatlon  ( f  the  Tonsils, 


828 
618 


618 

804 


790 

826 
833 


817 
818 
794 


829 
811 
617 
617 
620 
827 
819 
890,791 
819 
819 
820 
820 
819 
824 
814 
814 
817 
8)7 
786 
800 

•oe 


Bit 
615 
514 
827 
8.10 
8:i5 
836 
611 
792 
829 
6i:) 
613 
613 
617 
613 
614 
614 
614 
614 
615 
863 
863 
804 
864 
798 
825 
441 
•M,  836 
823 
795 


6TI) 
517 
518 
618 
584 
815 
848 
788 
817 
617 
802 
844 
8-22 
822 
799 
797 
622,8:12 
836 
798 
791 
812 
813 
819 
820 
820 
820 
868 
868 
859 
859 


788 

848 
616 
51< 
61* 


U 

m 


■  /J 


.'.4 

i 


•|Tf"--(r '-'■■'"'   ---»:^- et-fyii.-' 


— --/(  ■>* 


I. 


902 


PASB. 

Dstlon  of  tlie  Btomaoh,  618 

••    Boweli,  tl8 
••             "    Poriloneiiin,61(> 

«•             "    flploon,  622 

"             "    Larynx,  624 

"               •*    Windpipe,  625 

-  "  Ueart,  785 
"              ",    P«rlcardlum,T85 

-  "  Arteries,  788 
'  "  BInJdur,  787 
**  "  KIdneya,  789 
••  "  Urethra,  790 
"  "  Tc-»le«,  7U0 
"  ,  "  Vulva,  791 
"  "  Vugliia,  791 
"  •'  Womb,  7tfl 
"  "  Ovarina,  792 
"  "  Spinal  Cord, -UM 
•<  «<  ByeUda,  iU 
"  "  Wb,  814 
"  '•  Kara,  817 
"  "  ToD(fue,  616 
"              "    Olaods  under 

the  Anns,  843 
Influenia, 

InUirrupted  Menstraatlon,  820 
induration  o(  tbs  Breasts,  830 
Infitiitlle  Diarrhoea,  833 
Inability  to  take  the  Breast,  833 
(nfuiitllo  Dysentery,  833 
"  Jaundice,  834 
tnturmlttcnt  Fever,  614 
Indigestion,  617 
Injury  of  a  Nerve,  821 
Invermlnatlon,  621 
Incontinence  of  Crloe,  788 
Inordinate  Flow  of  Urine,  789 
Incubus,  812 
InHidiouB  Diseases.  802 
Itcliliig  of  the  Anus,  623 
Itch,  '97 
Itching  of  -Jio  dklD.  '97 
Iritis,  114 
Taundlce,  422 
Labor,  827 
Ludius*  I*erpetual  Calendar,  871 
Leucorrbcea,  798, 881 
LiKtof  llemodles.  609 
L.umbngo,  616 
Lung  Fever,  626 
Lock-<)nw,  808 
'^ciBs  of  Memory,  810 
Uver  SpoU,  800 
Loss  of  Tasto,  809 
"  BmM,  869 
Luxations,  822 
Lumbar  Abscesses,  824 
Usculsa,  800 
Uallgtiunt  Pustule,  862 
UaTiin  from  Kxcited  Emotions,  866 
Uaiiia  prortuced  from  Depres- 
sion uf  SplriU,  866 
Marasmus,  835 
Mcdioines  for  Different  Tem- 
peraments, 600 
ktcaalcs,  615 
Menorrhagia,  827 
Mental  Derangameiit  664 
Uilk  Crust,  1ST 
MQlk  Fever,  (30 
MJlkLet,  Ma 


INDEX. 


PASI. 

Morbid  BmottoM,  866 

Monomania,  860 

Moss,  800 

MyellUs,  806 

Muous  VomltliiK,  618 

Nasal  Polypus,  812 

Nettle  Ilasb,  614 

Neuralgia,  809 

Nervous  DeaAieM,  110 

Nightmare,  112 

Night  BwcaU,  ft>5 

Nocturnal  Kneuresto,  788 

Nose-bleed.  818 

Obstruction  of  the  Nose,  818 

Organs  of  CirculMiOQ,  638 

OUorrhaia,  816 

Ovarian  Dropsj,  820 

Ozena,  818 

Painful  Menstmation,  827 

Painless  CoUo,  622 

Paralysis,  807 

Palsy,  807 

Passage  of  Gall  Stones,  839 

Paralysis  of  the  EyeUda,  851 

I'arturltlon,  829 

ierioardltls,  T86 

I'baryngeal  Bore  Throat,  617 
Piles,                                      (22, 832 

Phlegmasia  Bolens,  843 

Pleuritis,  636 

Pleurisy,  626 

Pneumonia,  628 

Polypus  of  the  Nose,  871 
I'olsons,  and  their  AntldotM,    837 
Porrlgo, 
Paofuse   Bleeding  from  the 

Womb,  827 

Prickly  Heat,  837 
I>rotruslon  or  the  Intestine,       621 

Prurigo,  797 

Pulmonary  Oonsnmptlon,  846 

Putrid  Fever,  884 

IHitrid  Sore  Throat,  616 

Quinsy  Bore  Throat,  616 

Kables,  813 

Red  Oom,  884 

Relapsing  Ferer,  811 

Iteliglous  Mania,  867 
Retention  of  the  Urine,      T88,  836 

Remittent  Feren,  613 

RIckeU,  624 

Ringworm,  797 

^'          of  the  Scalp,  802 

Rheuuatie  Fever,  616 

Rbeumatic  Bore  Eyes,  816 
Rules  for  the  Administration 

of  Medicines,  610 
Rules  for  preserving  the  Parity 

of  Medicines,  610 

Running  at  the  Bars,  817 
Rnsh  of  Blood  to  the  Head       803 

St.  Vitus  Dance,  808 

Salt  Rboum,  799 

Scabies,  797 

Scurvy,  800 

Scrofula,  799 

Scald  Oead,  803 

Scrofulous  Sore  Bvea,  814 
Sorofulons    BwelOnf  of  tbe 

Balivary  Olands  M 


Holatloa, 

Hcarlot  Fev«r, 

Scurf  of  the  Head, 

Schlrrus, 

Sen-sickness, 

Shingles, 

S.  BeuleHsness  of  Infants, 

Small  Pox, 

Snake  Bites, 

SnulUes, 

BorenenH  after  Delivery, 

Horo  'rhroiit  ((Quinsy), 

Sore  Muuth, 

Spotted  Ki'vcr, 

SorenvHS  hdiind  the  Ears, 

Specks  of  the  Cornea, 


ra«i. 

616 
614 
837 
84« 
618 
842 
838 
616 
823 
834 
829 
616 
834 
863 
8:te 
816 
Specillu  Indlcalloua  for  Items 

dies  in  Fevers,  Ift 

Sprains,  S21 

Stammering,  glo 

Stirigs  of  Insects,  gJ8 

StlflT.IoInU,  826 

Htonc,  "88;  Stone  Bruise,  8i;i 

Stranixury,  787 

Strabismus,  gie 

Stye,  gl4 

Sum.-ner  Oojiplaint,  835 

Sunstroke,  gC3 

Suppression  of  the  Lochia,       8S1 
"         ICllk,  830 

"  "       Urine,         631 

Squinting,  816 

Surgical  Diseases,  821 

Swimming  of  the  Head,  802 

Syphilis,  790 

Syphilitic  Sore  Eyes,  816 

Teething,  836 

Tenea  C'apttis,  803 

Tetanus,  808 

Salt  Hhcuin  799 

Thrush,  83i 

Toothache,  616 

Trismus,  bu8 

Traobltis,  625 

Tumors,  Removal  of,  823 

Tussis,  Spusmodlo,  626,  8.'i! 

Typhoid  Fever,  613 

Ulcers,  6ae 

Ulcerations  of  the  Womb,         792 

"  "        Bone,  8241 

Ulcers  of  tbe  Scalp,  8U3 1 

Varioloid,  Variola,  6Ul 

Vertigo,  8021 

Varicose  Veins,  7V8,  829l 

Vomiting  of  Blood,  618| 

Wuterbrash, 

Warts  ou  the  Nose,  84: 

Wurts  on  the  Hand, 
Watery  Kycs,  8ie| 

Weakness  of  the  Bight,  84;] 

Weak  Memory, 
W<>ttlnK  the  Bed,  78i 

A\TilUi  aweUlog,  8^1 

Whiles, 
Whitlow, 

Whooping  Ooagh,  M», 

Wounds,  8J 

Wry  Neck.  lij 

Yellow  Fsm, 


LBFd'OB 


wss^aiM^ 


-^-^"-"^"•^  '■I'-'W^j-    


— ^V/>^.>b 


y 


•  of  th«  Um4,  J 

TUi,  ( 

lckne»«,  f 

jlcrtsncM  of  Inf»nU,  < 

II  rox, 

:e  Ulusa,  | 

nui.Ii  afler  Delivery, 

1  'I'hroiil  cyuluny), 

!  Mouth, 

lied  tVver,  _ 

.nt-HK  hitMud  the  Bars, 

cki  of  llic  Cornea, 

clllu  Iiidluallou*  for  ltM»« 

leB  In  Ffvcra, 

utilR, 

tnmering, 
igB  of  liiaecW, 

,ni-,  TS8 ;  Stono  BruUe, 

aimury, 

abUmtui, 

mmcr  Oxnplalnt. 

nstroko,      ....  ^>,i, 
pprogBlonof^thelgehU, 

TJrtat, 


minting, 
irirlculDU 


IrglcuiTJIa'M'^'n      . 
dimming  of  the  Heaa, 

^phlUtJc  Bore  Byea, 

eclhlng, 

'enea  Captoai 

'etanuB, 

Bit  Uheuin 

'brush, 

;'ootbucbe, 

I'rlBtnuB, 

rraobUls, 

L'umorB,  Bcinoval  ol, 

ruaslB,  Spttsmodlo, 

Pyphold  Fever, 

UlStlons  of  the  Womb, 

it  **  UOUOi 

UlcerB  of  the  Boalp, 
Varioloid,  Variola, 
VerUgo, 
Varicose  VetaB, 
VomHlng  of  Blood, 
Wttterbraah, 

Warts  ou  the  Noae, 
I  Warts  on  the  Uand, 

Watery  Kyi'S, 

WoakneBB  of  the  flight, 

Weak  Memory, 

Wotting  the  ucd, 

A\Tiit«  bwelllDtf, 

Whites, 

Whitlow, 

Whooping  Oonga, 
Wounils, 
I  Wry  Neck. 

Vellow  F»T«, 
I  ZsiMi 


&aS,  8!)1 
513 


w, 


iirtifcii   ■!  n 


